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Advances in medical science have enabled the world to protect children across the globe against more infectious diseases than ever before. Some diseases that once killed or infected children have been completely eliminated today because of safe and effective vaccines. Vaccination provides immunity against deadly diseases like Polio, Tetanus, Diphtheria, etc. and protects children by eliminating the risk of these highly infectious and dangerous diseases. As a result of national vaccine drives conducted across the countries, the childhood mortality rate has reduced considerably since the 1990s. There has been a 60 per cent decrease in deaths under the age of five, from 12.6 million in 1990 to 5 million in 2020. In developing countries, even today infectious diseases are a primary cause of under-five mortality which needs immediate action through increased focus on vaccination.
How are vaccines highly effective in reducing under-five mortality?
Vaccines are one of the most studied products for safety and efficacy before introducing for human use. A vaccine contains a dead or weakened strain or a component of the germ that is the cause of the disease. It helps build antibodies against that disease and protects children from contracting the illness if they ever get exposed to the disease in future. Today, it is the most successful and cost-effective way to protect future generations.
Over the years, more than 20 vaccines for diseases of high importance have significantly reduced mortality and morbidity. Some of the most important vaccines which are part of universal immunization programme in India are Polio vaccines (oral polio vaccine, inactivated polio vaccine); pneumococcal conjugate vaccine (PCV); liquid pentavalent vaccine against Diphtheria, Tetanus, Pertussis, Hepatitis B, Hib (LPV); BCG vaccine; Rotavirus vaccine; Measles and Rubella vaccine (MR); Inactivated Japanese Encephalitis Vaccine (JE); Tetanus and Diphtheria vaccine for adults (Td).
Other important vaccines which are available for vaccination in through private clinics and hospitals are: Typhoid conjugate vaccine (TCV); Measles, Mumps, Rubella (MMR), Flu vaccine; Hepatitis A vaccine, Meningococcal conjugate vaccine, Rabies vaccine, Varicella vaccine against Chickenpox, Human Papillomavirus vaccine (HPV) for preventing cervical cancer etc.
UNICEF has reported that vaccination saves 2 to 3 million kids yearly from deadly diseases. Between 2000 to 2015, immunization reduced under-five deaths due to Measles by 85 per cent, Neonatal Tetanus deaths by 83 per cent, Pneumonia deaths by 47 per cent, and Diarrhea deaths by 57 per cent. Today the world is much closer to eradicating polio.
Impact of Covid-19 on declining vaccination
The outbreak of the Covid-19 pandemic across the globe has impacted several aspects of human life. Despite progress made over the years in making vaccination available and accessible to all, the coverage declined after the pandemic. The new data on global vaccination coverage shows that it fell further in 2021 as 25 million infants missed out on lifesaving vaccines. As per WHO and UNICEF, it is the most significant decline in childhood vaccination in the last 30 years.
Going by the data, children receiving three DTP doses reduced from 86 per cent in 2019 to 81 per cent in 2021, as 18 million children did not receive a single DTP dose in a year. Most of these children live in low- and middle-income countries, of which India, Nigeria, Indonesia, Ethiopia, and the Philippines are recording the highest numbers. Another contributing factor is the accessibility to immunization for children in conflict regions. Other causes are directly related to Covid-19, such as supply chain disruptions, diversion of resources to respond to Covid-19, and measures to contain the spread of the disease.
The impact of inadequate vaccination coverage has started cropping up with Measles and Polio outbreaks. After the Measles outbreak in the US, Mumbai is currently grappling with Measles as the city has reported more than 200 cases in two months. The latest media report about Measles from the city is nine confirmed and five suspected fatalities in the last forty days.
Why do parents refuse to vaccinate their children?
It is not just Covid-19 that has impacted vaccination coverage. Many parents hesitate to ask their doctors about the vaccination of their children due to some doubts caused by myths and misinformation. Doubts could be created due to misinformation campaigns against some vaccine components. For example, a myth was propagated in western countries more than a decade back that some vaccines may contain mercury that causes Autism which was later completely debunked by major global scientific bodies, including WHO. However, some parents might delay vaccines for their kids due to such doubts, and they must be educated by doctors and others that there is no truth to such rumors.
Why vaccinate?
Vaccinations save lives: Measles vaccines have prevented over 21 million deaths between 2000 to 2017.
Vaccines are safe and effective: Vaccines are safe and have proven to be most effective in preventing disease.
Vaccinations protect others: Some vaccines prevent the spread of infection from vaccinated to unvaccinated children and susceptible adults and elderly who may not get the vaccine for some reason.
Vaccinations save time and money: A child who is not vaccinated may be denied school, and parents' time is also affected if they get infected. They are extremely cost-effective if you compare the cost of vaccination vis-à-vis cost of later treatment and hospitalization if disease happens.
Vaccinations protect future generations: Vaccines for Smallpox and Polio protect future generations.
How can we improve vaccination coverage?
There is a need to take strong steps to improve vaccination coverage, such as intensifying catch-up vaccination campaigns. Government bodies also need to undertake trust-building activities within communities through people’s centres, tailor-made strategies, and counter misinformation and myths. Increased resource allocation and political commitment at the national level will also play a significant role.
After seeing the impact of the pandemic, agencies must strengthen their capacities to deal with such unforeseen events and invest heftily in primary healthcare services to deliver vaccines without any hindrance. Another way is to leverage Covid-19’s vaccination atmosphere to extend other vaccinations. It is also essential to prioritize health information and disease surveillance systems.
Conclusion
India’s role as a vaccine supplier across the globe is well known. It produces nearly 60 per cent of the vaccines available in the world. India’s capacity to supply vaccines at the peak of the pandemic to control the spread of the virus cemented its position as the largest producer of vaccines. UN agencies like UNICEF rely heavily on India to supply vaccines as part of its global health programmes.
It is vital to ensure that no child goes unvaccinated against vaccine preventable diseases and the benefits of vaccination must reach every single child. Timely vaccination among children ensures that they enjoy their childhood in good health and get their education without hindrance which also impacts the country's overall economic growth.
(Author is SVP - Domestic Business, Biological-E)
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