Inflammation and stories on vaccines

Poor Countries Fail to Administer VaccinesOver the years, immunizations have prevented large numbers of infectious diseases from spreading worldwide. Between 2 and 3 million deaths are prevented each year in all age groups due to these vaccines. Expanding access to immunization has become a new United Nations’ Sustainable Development Goal. Currently, 85 percent of the globe has vaccination coverage. In total, these efforts have drastically impacted the world over the last few years. However, there is still a major struggle to reach full coverage in certain regions. Here are three reasons why poor countries fail to administer vaccines.

Three Reasons Why Poor Countries Fail to Administer Vaccines

  1. Vaccines are expensive and difficult to spread across certain regions.
    In 2017, roughly 19.9 million infants globally did not receive a DTP vaccination. This vaccination helps prevent children from getting diphtheria, tetanus and pertussis if a child receives roughly five doses over the course of their life. However, poorer nations have difficulty providing clinics and the means of offering repeated vaccinations.

    People living in rural areas must travel for hours to urban cities to receive treatments. In addition, transporting these goods to rural regions is tough because the hot temperatures can kill the immunity components of the vaccines. Shortages in supplies and lack of trained professionals also hinder the process. This heavily contributes to why poor nations fail to administer vaccines to large amounts of people.

    On top of these issues, the costs of vaccinating a single child increased from $10 to roughly $42 since 2000. However, these heavy costs do not heavily burden extremely poor countries because the vaccine alliance, Gavi, funds them. Gavi encompasses many organizations such as the World Health Organization, UNICEF, The World Bank and others. This alliance has allowed the economic burden to lift for roughly 70 countries, and it is actively seeking ways to overcome the geographical obstacles in these regions.

  2. Many are hesitant to vaccinate due to a lack of trust in immunization.
    According to the WHO, vaccine hesitancy is the refusal to vaccinate despite the availability of vaccines. Lack of trust in immunization is a major reason why people in poorer nations face this issue. Many people fear the side effects and potential dangers of immunization, so they choose not to vaccinate their children. Another reason for this hesitancy revolves around cultural differences. Primarily Western nations have introduced these vaccinations and citizens have difficulties accepting them into their society.

    An example of this is the Democratic Republic of the Congo’s recent Ebola outbreak. For the past few months, a large percentage of Congolese citizens refused to take the life-saving vaccination. These people do not trust the medical system and the government that allowed for a different country to intervene in its lifestyle. Their exposure to the disease has meant that other communities isolate and neglect them, which means they are having a hard time letting outsiders into their homes, even if intentions are good. Some citizens even attacked treatment centers in Katwa and Butembo in February 2019 to make a statement.

    Health officials in the DRC, as well as other countries, are making efforts to interact more with the communities during the vaccination process. A major step is finding ways to educate people on these medicines while respecting the cultures that they are entering. Recent campaigns such as the WHO World Immunization Week 2019 have made efforts to demonstrate the value of vaccines and immunization to start this process.

  3. Conflict and natural disasters prevent access to health care.
    War-torn countries are some of the most difficult places to administer vaccinations. Hospitals and clinics can become damaged and make it harder for people to receive the treatment they need. The Syrian War is an example of this. Before the war began, child vaccination coverage against DTP was 89 percent. However, in 2016, the number dropped to 61 percent as children received less than the three recommended doses of the vaccine. Syria and other countries at the bottom of the WHO’s vaccination coverage list were experiencing a civil war or conflict in their country.

    In addition to wars, natural disasters also hinder the vaccination process with widespread destruction. In Mozambique, a deadly hurricane swept through the country in March 2019. Not only did the storm destroy hospitals and clinics, but it also made reaching citizens living in rural areas with life-saving medication difficult. Natural disasters generally exacerbate issues that many countries already face, making it more difficult for health care officials to work until recovery ends.

    In recent years, Gavi has funded initiatives to help administer vaccines in countries facing these issues. Gavi offered to purchase vaccinations and other equipment to assist vaccinating millions of children exposed to preventable diseases in Syria. Also, the organization funded an influx of oral cholera vaccinations in 2017 to Sierra Leone after flooding and landslides.

Overall, there are many reasons why poor countries fail to administer vaccines to their citizens, but there are even more efforts going on today to overcome these obstacles. With the efforts of many health care organizations, the path to total global immunization might not be far out of reach.

– Sydney Blakeney
Photo: Flickr

Fragile Vaccines

Researchers at McMaster University in Ontario, Canada, have developed a possible breakthrough with regards to the storage of certain fragile vaccines. They have found a way to protect these vaccines from direct heat, negating the need for them to be stored in a cool environment. The implications of this innovation are massive. If organizations like Health Canada approve it, the reach of vaccinations to rural areas will increase, and with that, disease and sickness should decrease.

Coating on Vaccines

The researchers found that placing a gel-like coating over the vaccines was the best way to protect them from the heat. To make this coating, researchers mixed two sugars, trehalose and pullulan, with the vaccine and let it dry. As the sugars dried, the researchers coated the vaccine, making it resistant to heat and rendering the cold chain (the process of storing vaccines at temperatures ranging from 2 C to 8 C) unnecessary. Heat resistance is important because many people living in more rural areas of the world do not have access to refrigeration. Now, individuals living in impoverished areas will have access to a number of vital vaccines, helping protect them from diseases such as Ebola and influenza.

The technology’s development was the result of countless years of testing and hard work. But it is clear that the end product will be more than worth the time spent. When asked about the significance of the technology, Vincent Leung, an Assistant Professor of Chemical Engineering at McMaster and one of the masterminds of the testing, said that it is “very exciting that something we worked on in the lab has the possibility of saving people’s lives one day.” Leung has reason to be proud; the technology is filling a clear need and will undoubtedly have a massive impact upon its implementation.

What Happens Next

Health Canada and the U.S. Food and Drug Administration must still provide approval for the new technology. These organizations will analyze the effectiveness, practicality and safety of the technology. These organizations are likely to approve it because both have already accepted trehalose and pullulan.

The researchers have received funding from many organizations around the world, including the Bill and Melinda Gates Foundation. They are now working with commercial partners in an effort to get the technology to market upon approval. Once accepted, it will likely see heavy usage in more rural parts of the world, such as in many regions of Africa. In many of these areas, individuals do not receive vaccinations for preventable diseases. In fact, more than 7.6 million children in Africa are not vaccinated each year.

This new innovation to transport fragile vaccines has immense potential to shape the future in a positive way. Vaccines will now become cheaper and more efficient to transport around the world. In addition, as more individuals obtain vaccinations, rates of disease and poverty should decrease and life expectancy should increase. While there are still many steps for this new technology to take before implementation, the promise of the technology provides immense hope.

– Kiran Matthias
Photo: Flickr

First Malaria Vaccine
Malaria is a parasitic virus transmitted through mosquito bites, and those infected with the disease often experience grave fevers, chills and flu-like symptoms. Although malaria can potentially end in death, physical precautions such as safety nets in malaria-dense environments and prompt treatment can usually prevent it. Unfortunately, because malaria largely affects poorer nations, it can be a great strain on national economies and impoverished populations. The World Health Organization is enlisting pilot testing for the first malaria vaccine.

The Problem

Malaria reportedly infects tens of millions, killing over 400,000 people worldwide every year and mostly children; Sub-Saharan African countries are the primary nations in which malaria thrives—the World Health Organization estimates that over 250,000 African children die every year from the virus.

The malaria-carrying parasite is able to evade victims’ immune systems by constantly changing its surface, which is why developing a vaccine against the virus has been so difficult. With today’s modern technology and scientific insight, that is beginning to change.

Testing the First Malaria Vaccine

In April of 2019, a large-scale pilot test of what many are dubbing the world’s first malaria vaccine to give partial protection to children began in Malawi. Scientists from the drug company GSK first created the RTS,S vaccine in 1987 and has been refining it ever since. Organizations like Path Malaria Vaccine Initiative have been instrumental in supporting this initiative.

The new RTS,S vaccine is attempting to teach the immune system how to attack the malaria parasite. A patient needs to receive the vaccine four times—once a month for three months, followed by a fourth and final dose 18 months later. In 2009, Kenya held smaller trials of the vaccine and concluded with a 40 percent protection rate of the five to-17 month-olds who received the vaccination. Since then, malaria rates have plateaued rather than decreased, which is another reason the new pilot test is so vital in the modern-day.

Now testing is taking place in Malawi, Kenya and Ghana with aims to immunize 120,000 children aged two-years-old and younger. These three countries are ideal for two reasons: one, these nations already have large anti-malaria programs in place; and two, in spite of this, they still have high numbers of malaria cases. As Dr. Matshidiso Moeti (World Health Organization Regional Director for Africa) stated, “Malaria is a constant threat to the African communities where this vaccine will be given” and explains that the vaccine is needed because “we know the power of vaccines to prevent killer diseases and [hope to] reach children, including those who may not have immediate access to the doctors, nurses and health facilities they need to save them when severe illness comes.”

Looking Towards the Future

The purpose of the pilot tests is to build up evidence that can be reliably considered while WHO policy is debating its recommendations on the broader use of the RTS,S vaccine. The experiment will examine the reductions (if any) in child deaths, vaccine uptake rates (including how many children receive all four vaccinations) and the overall safety of the vaccine in routine use.

If the testing goes well, not only will the World Health Organization aid the vaccine to its core package of recommended measures for malaria prevention and treatment, but hopefully, it will begin a chain reaction that again sparks a decrease in malaria cases around the world.

– Haley Hiday
Photo: Flickr

Benefits of Needle-Free VaccinesThere are many different methods of non-traditional vaccines or needle-free vaccines that are being produced and becoming more available every day. For example, these include dry powder vaccines or patches. Most notable are jet injectors. Jet injectors use a large amount of pressure and fluid to breach the skin in a very fast motion. These vaccines are effective for usage in countries with extreme poverty because traditional vaccines need to be refrigerated. They also require a way to keep needles sterile. These five benefits of needle-free vaccines detail on how to solve these problems and more.

Five Benefits of Needle-Free Vaccines

  1. Jet Injectors Have Been Around for a Long Time: Jet injector technology might sound new, but it’s not as new as one would think. These kinds of shots were administered back in World War II. In fact, they were actually used through the 1980s until it was discovered that they were spreading diseases. This was due to the fact that the technology hadn’t been developed enough. Until it could be, the jet injectors had to stop being used. Now they have made jet injectors to be single-use, so there is no risk of spreading diseases between patients.
  2. They Require Fewer Resources: Jet injectors have been the most popular method of needle-free vaccines as they tend to use far less of the actual vaccine. This is arguably one of the most important benefits of needle-free vaccines. Jet injectors use up to 60 percent less vaccine than traditional needle vaccines. This is particularly helpful when there are shortages. Because jet injectors use a significantly less amount of the vaccine, it is also a cheaper option. For instance, the cost is $3-4 per vaccine or even $900 for 500 vaccines.
  3. They Are Less Painful: Another problem with the traditional vaccine is that it can cause pain in patients. This can become especially difficult when patients need multiple shots. Furthermore, those who fear needles are less likely to get a vaccination. On the pain scale, a pain score of three is when a person indicates that they are in some pain. This is important to know because when 100,000 subjects were given the jet injection, they had a pain score of zero. This painless injection allows for an alternative to the needle as it can easily administer multiple shots without pain. Lower pain scores are one of the key benefits of needle-free vaccines, as they allow the device to reach the broadest swath of patients possible.
  4. Less Risk of Injury After Disposal or Use: Needlestick injuries are another key problem with traditional vaccines. Needlestick injuries are injuries that happen when a needle accidentally penetrates the skin. The people that are exposed to these injuries are people who work with and around needles. Additionally, this can also happen to people like garbage-men when needles are not disposed of properly. When this kind of injury happens, they can transmit: HIV, Hepatitis B, Hepatitis C and AIDS. With the invention of jet injections, the risk of these injuries is reduced to nearly impossible as these injections need intense pressure to be administered.
  5. They Are More Efficient: The reason these jet injectors were being used in wars was that they are a faster and more efficient way of administering vaccines. Now that the technology has advanced over the last 70 years, these injections are less painful, more sanitary and now even faster. The injection lasts 1/10th of a second. It’s actually so fast that patients can barely feel it. This is helpful for those people in countries with extreme poverty as they are able to administer a lot of vaccines in a short amount of time.

With these benefits of needle-free vaccines, it’s clear this is the direction that the world should be headed in. They are cost-effective, sanitary, fast and nearly painless. As a result, access to vaccines could be provided to third-world countries at a more effective and reliable rate as they don’t need refrigeration and clean water.

– Ian Scott
Photo: Flickr

Ebola VaccineThe Democratic Republic of the Congo (DRC) is currently facing its worst outbreak of Ebola in the country’s northeastern regions, with over 2,000 declared cases, but in cooperation with the DRC’s government, the World Health Organization (WHO) has worked to provide Ebola vaccine for those who are at risk of contracting the virus.

First declared by the DRC’s government in June 2018, the Ebola outbreak has resulted in the death of over 1,000 people, and cases have also spread into neighboring Uganda. This outbreak is the second largest ever Ebola epidemic, after the outbreak that took place in West Africa from 2014-2016. There is worry that the virus could spread across the nation’s eastern borders or into major cities.

How the WHO is Combatting Ebola with Vaccines

The Ebola vaccine that the WHO uses is known as Merck’s V920, and was first employed in the early stages of an outbreak in the DRC’s Equateur province. The WHO was able to contain the virus and put an end to the epidemic in that province in under three months, although 33 people unfortunately still fell victim to the Ebola virus. When the DRC officially declared an outbreak, the Ebola vaccine, although still unlicensed, was employed on the grounds of compassionate use. The Ebola vaccine was highly effective, achieving a nearly 100 percent protection rate for more than 119,000 people living in the eastern provinces of Ituri and North Kivu.

The WHO is following a “ring vaccination” strategy, which proved successful in fighting the epidemic in Equateur. In this strategy, all those who are known contacts of people who contracted Ebola are offered the Ebola vaccine. Then, the WHO offers the vaccine to any contacts of those, as well as to anyone classified as at particularly high risk of contracting the virus, such as healthcare workers. By forming a ring of immunity around someone that is confirmed to have Ebola, they are able to reduce the chance that the virus will spread.

However, the ring vaccination strategy is quite time consuming, as it requires what is known as “contact tracing” in which every single person diagnosed with Ebola must disclose every single person that they might have been in contact with. By following this ring vaccination strategy, the WHO was able to vaccinate more than 119,000 people from August 2018 to May 2019. However, despite the vaccine’s high success rate, the number of cases continued to grow. Due to increased occurrences of violence in the country, it is more difficult for aid workers to build these vaccination rings around those who are at risk.

Modifying the Vaccination Strategy

On May 7, 2019, the WHO’s Strategic Board of Experts (SAGE) announced new recommendations that would significantly modify the vaccination strategy in order to strengthen their fight against the virus. These new recommendations focus on adjusting the dosage of the vaccine, offering an alternative vaccine for those that are at a lower risk of contracting Ebola, expanding the scope of people that are eligible for one and working to accelerate the vaccination process. In addition, SAGE recommends that the WHO provide a different vaccine to those in affected areas that are at a low risk. Johnson & Johnson have developed a MVA-BN vaccine that is currently being investigated and is at an advanced stage in moving towards deployment.

In order to expand the scope of people that can receive the vaccine, the WHO will begin to establish “pop up” vaccination sites in villages so that everyone in an area who consents to the vaccine can receive it (the WHO says that 90 percent of people consent to the Ebola vaccine). SAGE recommends that the WHO also work to vaccinate members of neighborhoods and villages where a case has been reported within the last three weeks. Vaccinating entire villages will ensure that the virus’s movement is limited, and will definitely make it much easier to contain.

Together with the DRC’s government, WHO has made great strides in fighting against the Ebola outbreak and working to contain the virus. In establishing the ring strategy that focuses on vaccinating individuals that may have been in contact with the virus, the WHO has been successfully able to build rings of immunity. The WHO has used the highly efficacious Merck’s V920 vaccine to vaccinate over 119,000 people and continues to research additional vaccines and strategies. The WHO continues to refine their approach so they can contain the Ebola epidemic as soon as possible and save as many lives as they can.

– Nicholas Bykov
Photo: Boston University

Vaccines in Egypt On March 14, 2019, the vaccination company Pfizer, in partnership with Gavi, The Vaccine Alliance reduced the price of the pneumococcal vaccine (PCV) to $2.90 per dose for eligible countries. Gavi’s mission since 2000 has been to “improve access to new and underused vaccines for children living in the world’s poorest countries”. Public and private sectors fund the creation and distribution of important vaccines in 73 developing countries partnered with Gavi.

The Benefit of Price Drops

In 2017, the price of a single dose PCV was $3.30. However, as a result of negotiations between Pfizer and Gavi there have been three pneumococcal vaccine price drops since January 2017. It is expected to save developing countries $4.1 million this year. Dr. Seth Berkley, the CEO of Gavi says “pneumonia remains the single largest cause of death for children worldwide and [the] pneumococcal vaccine is one of our largest weapons against it”. The price drop comes at a pivotal time.

PCV is a Priority

PCV takes as long as 15 years to reach developing countries that need it the most. Whereas the vaccine is already easily accessible and widespread in industrialized nations. Vaccines have not been easily accessible in developing nations. They are expensive and difficult to distribute effectively in nations lacking funds and resources. The focus is on different areas. For example, the proportion of developing countries’ exports that is needed to service their overseas debt rose from 11 percent in 1970 to 18 percent in 1996, while overseas aid from the U.S. plummeted $14 billion. With the drop in PCV pricing, developing countries can invest in their public health.

The value of vaccines as a long-term investment for developing countries is leading to pneumococcal vaccine price drops. Vaccinating the youth population of developing countries, according to Gavi, creates a “virtuous cycle”.

The Cycle Follows This Order of Cause and Effect

  • Children have vaccines before the age of two
  • These children are likely to be healthier and live longer
  • Children have fewer and less serious illnesses
  • This leads to lower care costs for health systems and family
  • Which means more family money available to spend or save
  • Children will attend school more, fueling better outcomes
  • A family’s economic outlook will strengthen based on these outcomes
  • Birth rates drop and mother’s health improves
  • A community becomes more economically stable and productive
  • Contributing to politically and economically stable countries

By looking at the cost-benefit analyses for vaccinations, scientists are able to see this “virtuous cycle” in action. A study, conducted by the Cebu Longitudinal Health and Nutrition Survey in 1975, took data from a sample of Filipino children. Researchers compared test scores of children who received six vaccines in their first two years versus those that did not. The study reveals the association of immunization with improved IQ scores, language and mathematics tests. Untreated childhood illness can impair cognitive development.

Developing countries often have large obstacles to face such as food scarcity, a lack of widespread education and low GDPs. Investing in vaccines is a long-term solution that will benefit the economic, health, societal and governmental sectors of these nations. With the pneumococcal vaccine price drops, this seems to be an attainable reality for developing countries.

– Meredith Breda
Photo: Flickr

Drones Bringing Vaccinations

Over the past few decades, Ghana has been able to drastically improve its vaccination rates through education and communication with communities. Right now, vaccination rates for diphtheria, tetanus and whooping cough are at 98 percent in Ghana, compared to 94 percent in the U.S. The child mortality rate in Ghana has dropped by 30 percent and is now at 5 percent.

Additionally, measles, which used to be one of the predominant causes of child mortality in Ghana, has now been nearly eradicated. This is due in part to the double-roll out in 2012, which was the first time any African country introduced two vaccines at the same time, the pneumococcal and rotavirus vaccines. It proved to be wildly successful, reinforcing Ghana as a model for neighboring countries.

Despite these improvements, one of the main roadblocks to increasing the coverage and effectiveness of vaccines in Ghana is accessibility. One promising solution to this roadblock is drones bringing vaccinations to Ghana.

Drones Bringing Vaccinations to Ghana

Planning to reach the remaining unvaccinated Ghanaians, the Ghanaian government recently launched the start of its partnership with Zipline, a company utilizing drones to deliver medical supplies to underserved regions. The technology increases the accessibility of essential medical supplies without having to wait for the costly infrastructure development of better roads and train access. Zipline is currently able to provide 13 million people vital medicine incredibly quickly. At the four distribution centers located throughout Ghana, doctors can place an order via text for any necessary medications and reliably expect a delivery within 30 minutes.

In addition, one of the primary challenges in increasing vaccination coverage is access to electricity for refrigeration. Zipline’s quick and reliable delivery system solves this issue as supplies are received still cold. This innovative battery powered medical delivery system is able to deliver goods pilotless, thus reducing emissions costs and medicine transport costs. This makes it an incredibly cost-effective mode of transport, aiding initiatives to offer free vaccinations to children in Ghana.

With dozens of hospitals relying on Zipline for emergency medicinal deliveries, access to life-saving medical supplies has already increased dramatically in hard to reach areas. In Rwanda, where Zipline has served for the past 3 years, maternal mortality rates are dropping drastically due to emergency drone deliveries of rare blood types.

Just a few decades ago, Ghanaians were in a statistically alarming situation. The introduction of Zipline is bringing medical supplies to Ghanaians who still lack access. With plans to eventually provide access to vital medical supplies all around the world, Zipline appears to be revolutionizing the world of medicinal accessibility for the world’s underdeveloped regions. As Zipline is a relatively new company, it’s too soon to have data determining long term impacts. However, given the rapid changes Zipline has brought to Ghana and Rwanda’s medical access already, it’s feasible to imagine a future where drones bringing vaccinations is commonplace.

– Amy Dickens
Photo: Flickr

How the Cayman Islands Defeated the Zika Virus
In 2016, the Grand Cayman faced a Zika outbreak. Curious to find out how the Cayman Islands defeated the Zika virus? Here is some background information that will explain how the Grand Cayman eliminated this threatening outbreak in 2016.

What is the Zika Virus?

The Zika virus a disease that may cause a variety of symptoms. For example, some symptoms include a fever, rash, conjunctivitis, muscle or joint paint and a headache.

This virus is particularly dangerous during pregnancy. If a pregnant mother becomes infected, it can lead to complications, such as the increased risk for pre-term birth and miscarriage.

Certainly, the Cayman Islands government believes that a plan used by a company called Oxitec and the Mosquito Research and Control Unit was a huge factor in how the Cayman Islands defeated the Zika virus.

The Cayman Islands

The Cayman Islands is a territory made up of three different islands. The three islands are:

  1. Grand Cayman
  2. Cayman Brac
  3. Little Cayman

These islands are considered a British Overseas Territory. They are also a part of the overseas territory of the European Union. Grand Cayman is the largest island of the three. The islands are located approximately 150 miles south of Cuba, 460 miles south of Miami, and 167 miles northwest of Jamaica. The capital of these islands is George Town, which is located on the Grand Cayman.

How the Cayman Islands Defeated the Zika Virus

To combat the Zika outbreak, Oxitec deployed Aedes aegypti (male mosquitoes) in an attempt to eradicate the disease. To achieve this, they used genetically-modified males in hope that they would mate with the female disease-carrying Aedes aegypti mosquitoes. This tactic was a beneficial step in how the Cayman Islands defeated the Zika virus.

The female Aedes aegypti mosquitoes are a species that are non-native to the Cayman Islands. The females are the culprit who spread the Zika virus. The females also spread other diseases such as dengue, chikungunya, and yellow fever. Male mosquitoes do not bite. Rather, they eat nectar or honeydew of plants. When the genetically-modified males mate with the females, they produce offspring that will not survive into adulthood. Thus, this reduces the disease-carrying mosquitoes. This strategy helped to reduce the number of females in the region. Furthermore, it was a huge component in how the Cayman Islands defeated the Zika virus.

The project was tested in East End, Grand Cayman in 2009. Furthermore, this technique proved to be very effective. Subsequently, the disease-carrying females were reduced by 90 percent where the genetically modified males were released. In fact, Brazil and Panama employed the same technique, with equal success.

In 2016, Oxitec released hundreds of thousands of genetically-modified males per week on Grand Cayman. This release occurred in June and July and lasted for a total of nine months, according to Glen Glade, Oxitec’s head of business development. Little Cayman and Cayman Brac do not use this technique as they do not have a problem with the female Aedes aegypti.

Zika Virus in Cayman Islands Today

Overall, the Cayman Islands are no longer considered a major risk in regard to contracting the Zika virus, according to the Center for Disease Control and Prevention. On the other hand, some environmentalists may believe that using genetically-modified mosquitoes is controversial. According to the Mosquito Research and Control Unit, the World Health Organization recommends evaluation of this technique.

-Nicholas Bartlett
Photo: Flickr

Vaccines in Egypt
For the past 20 years, the Centers for Disease Control and Prevention (CDC) of the United States has assisted the Egyptian government by providing aid to fight vaccine-preventable diseases. Efforts such as strengthening immunization services, responding to public health emergencies and conducting surveillance studies and surveys have contributed to the reduction of these fatal diseases. The CDC has provided financial support for diseases that can be prevented by vaccines in Egypt through the World Health Organization (WHO), which focuses on polio, measles and rubella elimination.

Impeding Access to Vaccines

In 2006, vaccinations in Egypt eradicated wild poliovirus transmissions. The government continues to monitor the environment for wild polioviruses in a program involving the CDC and other organizations. However, despite the efforts of these organizations, many of those living in poverty in Egypt still do not have access to the vaccination. This presents a problem in the eradication of vaccine-preventable diseases since disease such as the wild poliovirus could return.

According to WHO, full immunization coverage for the poorest to the wealthiest populations showed national levels in Egypt to be under 20 percent. Studies show that the high rates of unemployment and low literacy rates contribute to the increase in the population living in poverty. This results in many individuals being unaware of the healthcare and medical aid they are entitled to and leads to the low proportions of immunization within the population.

Many children are also part of the child labor industry. Working interferes with their school attendance and education, resulting in low literacy rates, which perpetuate the ongoing poverty cycle. Without awareness of health and safety maintenance, those who live under the poverty line may not have the necessary knowledge to access vaccinations in Egypt.

Improvements Made in Vaccinations

The Expanded Program of Immunization (EPI) in Egypt focuses on saving lives by controlling vaccine-preventable diseases such as measles, diphtheria, tetanus, polio and whooping cough through constant surveillance and an increase in vaccine coverage. Despite the extreme decline of cases of vaccine-preventable diseases in the past decades, outbreaks of measles in 2013 and 2014 suggests that full immunization coverage is not yet supported for all populations of Egypt.

However, despite 60 percent of the population living under the poverty line and a large number of people not receiving immunizations, resources and efforts towards improving access to vaccinations in Egypt have increased. WHO claims that only 24 cases of measles, 5.9 cases of mumps and 34 cases of rubella were reported in 2017. A drastic decrease compared to decades of consistent outbreaks in the thousands. Part of the progress could be a result of the fact that 94 percent of children aged 12-23 had received measles vaccinations in 2017. Furthermore, in 2008-2009, there was a significant increase in vaccines in Egypt for measles, mumps and rubella, with 95 percent of children having been vaccinated, an increase of 53 percent from 2007.

The Future of Disease Control

The Ministry of Health and Population (MoHP) works to promote the funding of the Haemophilus influenza vaccine as a part of the PENTA vaccine, a type of vaccine designed to protect the receiver from multiple diseases. The PENTA vaccine will help fight bacterial pneumonia, a communicable disease that contributes to high mortality rates. With WHO supporting the MoHP, the push for programs that fight viral hepatitis is stronger as more resources are being devoted to procuring equipment, allocating funding and the constant surveillance of vaccine-preventable disease outbreaks.

Efforts to control vaccine-preventable diseases are allocating funding to provide coverage for those who may not be able to afford it. Now, increased focus on spreading awareness to the population about the importance and availability of vaccines in Egypt is needed in order to increase coverage and finally eradicate some of the vaccine-preventable diseases in the country.

– Aria Ma
Photo: Flickr

immunizations africa
Globally, more than 2 million children are saved every year by immunizations. In Africa, the success of programs for immunization plays a significant role in world health. Immunization programs bring benefits to Africa and other countries around the world by reducing, containing and eliminating life-threatening diseases.

Successful Immunization Program

The Expanded Programme on Immunization (EPI) is responsible for most of the vaccinations in Africa. EPI focuses its attention on immunizing children against six life-threatening diseases: diphtheria, pertussis, tetanus, tuberculosis, polio and measles.

EPI has been acknowledged for maintaining control over many infectious diseases, showing significant progress since its initiation in 1974. For instance, EPI is credited for being on the forefront of eradicating smallpox. The eradication of the polio-virus is currently underway. This disease was responsible for infecting and killing millions of children previous to EPI. After the launch of EPI, enormous reductions of paralysis caused by polio was observed due to polio immunization.

Eradication and Vaccination

In 2017, the required three doses of the polio vaccine were successfully distributed to 85 percent of newborns around the world. With the exception of Afghanistan, Nigeria and Pakistan, polio has been eradicated in almost every country, according to The World Health Organization.

Measles vaccinations have been a huge success as well. In 2015, about 85 percent of children around the world, including Africa, have been immunized with the measles vaccine. In 2017, 167 countries had received two doses of the measles vaccine. Since 2000, more than 20 million lives worldwide have been saved through measles immunization.

MenAfriVac, the first vaccine created specifically for Africa, is a vaccine for adults and children (9 months to 29 years old) that protects them from group A Meningitis. More than 270 million people have been immunized, and cases due to the type A bacterium have declined 99 percent in areas that obtained full vaccinations. It is predicted that more than 400 million people will be vaccinated with MenAfriVac in fewer than two years. This can prevent over 150,000 deaths.

Immunization programs are making huge changes for better healthcare. Immunization coverage in Africa has advanced since the start of EPI, which has helped increase the needed dosages of DPT3 (a vaccine that shields diphtheria, pertussis and tetanus) for children. In 2017, DPT3 had reached as high as 90 percent in 123 countries.

The Economic Impact of Vaccinations

Vaccines also have a strong economic impact on people. “A healthy child is more likely to go to school and become a more productive member of society in later life while their families can avoid the often crippling healthcare costs that diseases can bring” explained Dr. Seth Berkley, CEO of a vaccine alliance (GAVI). “[…] this is enough to save millions of people from the misery of extreme poverty. [..] we now need to redouble our efforts to ensure every child, no matter where they’re born has access to lifesaving vaccines.”

Not only are families saved undo economic hardship thanks to vaccines but also governments save money through ensuring a healthier population. On average, $16 is saved for every $1 that is spent on vaccinations. This can be due to the money that would be lost from missing work, healthcare costs and lower productivity due to illness.

Other Immunization Programs

There are many other programs like EPI that are aiming to make a difference such as The Global Immunization Vision and Strategy (GIVS), The Sustainable Development Goals (SDGs), and The Global Vaccine Action Plan (GVAP). Programs such as these are continuing to help Africa in powerful ways.

Although these developments have been successful, 1 in 5 children still will not get the vaccines needed to prevent life-threatening diseases. Immunization coverage in Africa is still below the goal of 90 percent, leaving many people without vaccines.

The need for extending immunization to everyone is extremely high, and a plan is currently in place through The Global Vaccine Action Plan (GVAP) to continue to achieve the goal. GVAP has set six principles to elaborate on the plan in order for it to be achieved by 2020, saving millions of lives. These principles include partnership, country ownership, equity, integration, sustainability and innovation.

Hope

To help GVAP achieve their goals, each region has developed their own plan in order to ensure that every child will be immunized and protected from deadly viruses. If this plan works out, all communities will have access to life-saving vaccines.

Vaccinations meet the needs to care for weaker societies by enabling good public health, which helps in reducing poverty. Immunization programs bring benefits to Africa as well as saving millions of people in need of vaccines. Challenges are still faced but hope continues.

– Kathleen Smith

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