Global experts highlight strategies to immunize more children

In advance of World Immunization Week, global experts are highlighting strategies to further advance progress on the Global Vaccine Action Plan that was endorsed by the World Health Assembly, 2012. Better supply and logistics systems are essential to reach the estimated 22 million children in developing countries who are still not protected from dangerous diseases with basic vaccines, according to a special immunization issue published today by Vaccine.

Articles in the special supplement also underline the need to improve understanding about the health benefits of immunization. World Immunization Week starts 20 April with its call to "Protect your world, get vaccinated" with a range of activities in some 180 countries to help immunize more children against preventable diseases.

"We have seen some major advances in the development and delivery of vaccines in the past few years," said Dr Flavia Bustreo, Assistant Director-General at WHO. "But many countries still face obstacles in getting life-saving vaccines to every child who needs them."

Many countries encounter serious challenges in vaccine supply and logistics, from inability to keep vaccines at the correct temperature, to record keeping which enables community health workers to ensure the right vaccines reach the children who need them.

Inefficient health and delivery systems threaten access, availability, quality - and health outcomes. WHO, UNICEF, the GAVI Alliance, the Bill & Melinda Gates Foundation and the many other partners active in the Decade of Vaccines have drawn up new plans to strengthen immunization systems to:

• ensure that more vaccines are discovered and developed and that packaging is designed to meet the needs of developing countries - such as the MenAfriVac vaccine for Meningitis A in Africa which can be transported and stored for as long as four days without refrigeration;
• establish supply and logistics systems that support and sustain efficient and effective vaccine delivery - this can include, using 'moving warehouses' to distribute vaccines to remote health centres, and integrating the distribution of vaccines with other health commodities;
• improve immunization information systems to show more accurately where the needs are - for example by using immunization registries, such as those used in Albania, Sri Lanka, and Uruguay. The registries track and follow individual children which makes it possible to trace and better understand who is not being vaccinated, and why;
• maintain a competent and motivated health workforce, through professionalizing supply chain positions improved training for staff and better management and supervision
• explore the use of mobile technology to strengthen communication and data capture across the supply chain, including stock management;
• allocate more resources to remote and marginalized groups, including specific programs to target nomadic and indigenous communities, such as the programs under way in Sudan.

There is also an urgent need to better communicate the health benefits provided by vaccines, and the dangers of not immunizing children. Immunization averts an estimated 2-3 million deaths every year, protecting children from diphtheria, measles, pertussis (better known as whooping cough), pneumonia, polio, rotavirus diarrhoea, rubella (or German measles) and tetanus.

"In some parts of the world, complacency about immunization has led to gaps in vaccination coverage," said Geeta Rao Gupta, Deputy Executive Director, UNICEF. "When gaps occur, outbreaks follow."

In other places, myths are circulating that vaccines do not work, or on the nature and frequency of side effects, which lead parents and caregivers to refuse to vaccinate their children.

"We need to help parents to better understand the benefits of immunization to ensure they reach all children, no matter where they live," said Dr Seth Berkley, Chief Executive Officer of the GAVI Alliance. "Today vaccines protect the lives of hundreds of millions of children; but with our partners, we need to ensure that an additional quarter of a billion children are immunized by 2015," he added.

Chris Elias, president of Global Development at the Bill & Melinda Gates Foundation, agrees. "We know that vaccines work to save lives and protect children for a lifetime. Strong immunization systems protect our gains against polio and provide a platform for new vaccines and primary health care."

Nevertheless, in recent years, there have been resurgences of diphtheria, measles and rubella in developed and developing countries alike. For example, outbreaks of measles have occurred in France, Italy, Spain, the United Kingdom, and Pakistan.

World Immunization Week, with its call to "Protect your world, get vaccinated" is an opportunity to raise global awareness of the health benefits of vaccination. Governments, development partners, international organizations, manufacturers, health professionals, academia, civil society, communities and individuals come together in 180 countries to promote the goal of universal immunization coverage - and to overcome challenges to achieving it.

Different geographical regions emphasize different themes to adapt to their specific needs. In World Immunization Week 2013 the regional focus is as follows:

• Africa: Save lives, Prevent disabilities, Vaccinate!
• The Americas: Vaccination, a shared responsibility.
• Eastern Mediterranean: Stop measles now!
• Europe: Protect. Prevent. Immunize.
• South-East Asia: Intensification of routine immunization.
• Western Pacific: Finish the job - No more measles for anyone.

WHO, UNICEF, the GAVI Alliance, and the Bill & Melinda Gates Foundation are all committed to giving all children a healthy start to life by achieving the Decade of Vaccines vision via the Global Vaccines Action Plan launched in 2012. The Plan aims to deliver universal access to immunization by 2020.

Source: The World Health Organization