Opinion: What 2017 taught us about vaccines

A health worker marks a child's finger to indicate that she has been vaccinated at a polio vaccination campaign in South Sudan. Photo by: JC McIlwaine / U.N. / CC BY-NC-ND

This year, I was reminded of how far some people will go to make sure children everywhere get immunized. In Pakistan, health workers boarded trains to ensure even families on the move were vaccinated against polio, once a major cause of child death and paralysis. In Afghanistan, a youth circus group spent their weekends spreading vital information on immunization in underserved areas, all while walking tightropes and juggling.

These heroes are literally jumping through hoops because they understand — like we do at the Bill & Melinda Gates Foundation — the power of vaccines, one of the most transformative tools ever created.

Vaccines have helped billions of people around the world lead healthy, productive lives. They’ve been responsible for eradicating smallpox — one of the most destructive diseases in human history — and have led us to the verge of eradicating polio. Measles, mumps, and rubella have also been virtually eliminated in wealthy nations thanks to routine immunization.

In 2017, we saw the power of what vaccines can accomplish, as well as what can happen when they fail to reach every child, every person, everywhere. Here are some of the year’s highlights.

Vaccines saved millions of lives

Polio is my favorite example of how vaccines change lives. There have been just 17 cases of wild poliovirus so far this year, the lowest number ever recorded and a huge contrast to 30 years ago when polio paralyzed about 1,000 children every day. Thanks to the polio vaccine, there are 16 million people walking today who would have otherwise been paralyzed — more than the entire population of metropolitan London.

Also this year, the World Health Organization announced that measles-related deaths last year fell below 100,000 for the first time, thanks to the collaborative work of Gavi, the Vaccine Alliance; WHO; UNICEF; national health ministries; the Centers for Disease Control and Prevention and other committed organizations. Since 2000, measles deaths have declined 84 percent and more than 20 million lives have been saved.

Shockingly, pneumonia continues to be the leading infectious killer of young children — causing 1 in 6 child deaths worldwide — and claimed the lives of 20 children in India every hour. But 2017 marked the beginning of the end of pneumonia in India. In May, the country introduced a vaccine to combat this deadly disease, which will have a significant impact on India’s health and development. India is also a standout for its ambitious plan to reach 90 percent immunization coverage by the end of 2018 — a deadline brought forward two years thanks to the plan’s success to date.

Vaccines also continued to show how they can eliminate diseases from entire countries and regions. Neonatal tetanus was eliminated from the region of the Americas. South Korea and New Zealand eliminated local transmission of measles and rubella, and the United Kingdom, Bhutan, and the Maldives eliminated measles. By prioritizing vaccines, these countries will experience the lifesaving benefits of immunization, as well as its impressive return on investment, since every dollar invested in vaccines generates $44 in economic and social benefits.

Outbreaks reminded us that progress is fragile

We are reaching more people than ever with vaccines, and global vaccine coverage — the proportion of the world’s children who receive recommended vaccines — is at the highest it has ever been, at 86 percent. That sounds impressive, and it is, but it’s not good enough. We still face major challenges, including the fact that coverage rates have stalled in recent years.

When progress stalls, the consequences can be dire, particularly in places with low vaccine coverage, where preventable disease outbreaks remain an unfortunate reality. In Brazil this year, global vaccine shortages contributed to the country’s worst yellow fever outbreak in decades. Vaccine shortages, compounded by low access to basic health services, also led to a meningitis outbreak in Nigeria that infected more than 10,000 people.  

We even saw outbreaks in places where vaccines are readily available, though for very different reasons. Due in part to the spread of misinformation about vaccine safety and more families refusing to vaccinate their children, a measles outbreak took hold across parts of Europe. As of September, 30 people had died on the continent because of needlessly low child and adult immunization rates — double the number of European fatalities in 2016.

Inspiring pushback against vaccine skepticism

You may remember that 2017 began on a disheartening note. Contrary to overwhelming scientific evidence of the safety and efficacy of vaccines, their value was called into question. Reports circulated of an emboldened vaccine hesitancy movement in the United States, while political parties in some European countries campaigned on an antivaccine platform.

But what could have spiraled into a dangerous assault on a keystone of global health became an inspiring rallying cry. In the face of skepticism, people pushed back. Lawmakers, prominent health institutions, scientific experts, and influential editorial boards in the United States passionately supported vaccines, reaffirming that they are safe, effective and save lives. As Dr. Sanjay Gupta put it: “The benefit of vaccines is not a matter of opinion. It is a matter of fact.” In addition, several governments, including France, Italy, Germany, and Australia, took steps to safeguard children’s access to lifesaving immunizations.

New efforts are needed to reach children everywhere with vaccines

As we head into the new year, we need to harness this collective support for vaccines so that no child has to suffer or die from a preventable disease. We must continue to urge governments to prioritize investment in routine immunization, ensure that vaccine misconceptions never stand in the way of healthy children and communities, and build on the successes of disease elimination efforts. Better health, and lives, are in the balance.

Read more Devex coverage on global health.

About the author

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    Chris Elias

    Chris Elias, MD, MPH, is president of the Global Development Program of the Bill & Melinda Gates Foundation. He leads the foundation’s efforts to accelerate the delivery of proven health care products and solutions to those who need them most — especially women and children. Chris recently served as the president and CEO of PATH, an international nonprofit organization dedicated to improving the health of people around the world by developing innovative health technologies, strengthening health care systems, and encouraging healthy behaviors.