COVID-19 disrupts immunization programs

By Desmond Davies, London

As the search for an effective vaccine against COVID-19 continues, there is concern that other critical areas of disease control are being neglected.

According to the UN Children’s Fund (UNICEF) over 13 million children did not receive any vaccines in 2019.

The fear now is that amid the COVID-19 pandemic even more of the world’s marginalized children would be without access to life-saving vaccines.

UNICEF therefore has used World Immunization Week, which began on Monday, to warn that millions of children would be missing out on vaccines against measles, diphtheria and polio.

Even before the coronavirus pandemic, measles, polio and other vaccines were out of reach for 20 million children below the age of one every year.

Given the current disruptions, UNICEF warned that this could lead to disastrous outbreaks in 2020 and well beyond.

“The stakes have never been higher.

“As COVID-19 continues to spread globally, our life-saving work to provide children with vaccines is critical,” said Robin Nandy, UNICEF Principal Adviser and Chief of Immunization.

With disruptions in immunization services due to the COVID-19 pandemic, he stressed that the fates of millions of young lives “hang in the balance”.

UNICEF estimates that 182 million children missed out on the first dose of the measles vaccine between 2010 and 2018, or 20.3 million children a year on average.

This is because the global coverage of the first dose of measles stands only at 86 per cent, well below the 95 per cent needed to prevent measles outbreaks.

So, while global leaders met at a virtual event last week to ensure everyone everywhere could access new vaccines, tests and treatments for COVID-19, organizations such as the Vaccine Alliance (GAVI) are doing what they do best – focusing on providing vaccines for close to half of the world’s children every year.

GAVI has estimated that at least 21 low- and middle-income countries are already reporting vaccine shortages as a result of border closures and disruptions to travel.

So far, 14 vaccination campaigns supported by GAVI against polio, measles, cholera, human papillomavirus, yellow fever and meningitis have been postponed, which would have immunized more than 13 million people.

The Director-General of the World Health Organization (WHO), Dr Tedros Adhanom Ghebreyesus, said this week: “The tragic reality is that children will die as a result.”

Since 2000, GAVI and partners have helped vaccinate more than 760 million children in the world’s poorest countries, preventing more than 13 million deaths.

GAVI has set an ambitious goal to immunize 300 million more children with 18 vaccines by 2025, and to attain this the organization is looking to raise US$7.4 billion in its upcoming third replenishment that has been scheduled for June.

Dr Tedros noted: “We call on the global community to ensure GAVI is fully funded for this life saving work.

“This is not a cost, it’s an investment that pays a rich dividend in lives saved.

“Just as immunization has been disrupted in some countries, so have services for many other diseases that afflict the poorest and most vulnerable people – including malaria.

“Immunization is one of the greatest success stories in the history of global health,” he said, adding: “More than 20 diseases can be prevented with vaccines.”

Dr Richard Sezibera, a former Minister of Health in Rwanda and a long-serving member of GAVI Board, explained in an Op-Ed for the Africa Briefing website earlier this month: “Now more than ever, the need to bring together public and private sectors in strengthening our healthcare systems is being shown.

“With GAVI, this kind of collaboration has been going on for 20 years and is still going strong with the shared goal of creating equal access to new and underused vaccines for children and persons all around the world.”

Dr Sezibera, who is also Chair of the GAVI Program and Policy Committee, said this year’s replenishment was “seeking to build on the historic gains it has made with governments and other partners”.  

He added: “We will need to step up with even more.

“Commitments are needed towards increased domestic financing and for recognition of the critical role of vaccines to primary healthcare in Africa, at least for the for the next period of 2021-2025.”