The Future of Vaccination: Part 2 – Global, Community and Individual Challenges

In this video by VaccinesToday, experts from vaccine research and industry fields at the World Vaccines Congress 2013 in Lille, France are asked about their views on the future of vaccine research.

Global Challenges

Eradication of Polio

Only Pakistan, Nigeria and Afghanistan are currently considered endemic for polio because they have never eliminated native polio viruses. There has been a 99% reduction in the global incidence of polio since eradication efforts began in 1988, when there were 350 000 people affected with the disease. There are still a few hundred cases of wild polio virus-related paralysis each year, which occur both in endemic countries as well as in countries re-infected via importations.

Live attenuated oral polio vaccine (OPV) and inactivated polio vaccine (IPV) are being used to achieve eradication of wild polio virus. OPV is preferred for its low cost, ease of administration and community protection, but can rarely cause paralysis and regenerate wild-type polio strains. Therefore IPV, will have to replace OPV after eradication of wild polio virus is certified, in order to sustain eradication of all polioviruses. However, uncertainties remain related to IPV’s ability to induce intestinal immunity in populations where transmission of polio is mainly via the faecal–oral route.

The World Health Organisation (WHO), the United Nations Children’s Fund (UNICEF), Rotary International, the CDC and other organisations are leading the Global Polio Eradication Initiative (GPEI). This initiative has developed the Polio Eradication and Endgame Strategic Plan that aims to wipe out the last cases of polio from all causes by 2018.

There are 3 types of poliovirus. Because type 2 virus accounts for more than 95% of recent circulating vaccine-derived polio virus outbreaks and approximately 30% of vaccine-associated paralytic poliomyelitis cases, the currently used trivalent OPV which protects against types 1, 2 and 3, needs to be replaced with a bivalent OPV which protects against types 1 and 3. It is also recommended that all OPV using countries introduce at least one dose of IPV into routine immunisation schedules before the end of 2015. The plan is expected to cost US$5.5 billion but promises to yield up to US$25 billion in additional net benefits over the next 20 years.

Eliminating Measles from the Western Pacific

The Measles Regional Verification Commission has recently verified Brunei Darussalam, Cambodia and Japan as having achieved measles elimination. The three countries join Australia, Macao SAR (China), Mongolia and the Republic of Korea as countries and areas in the Western Pacific Region that have successfully eliminated measles. “Measles elimination is achievable in the Western Pacific Region. Increased commitment, funding and advocacy are all urgently required to immunise all children against measles, especially the most vulnerable in the hardest to reach communities,” said Dr Shin Young-soo, World Health Organization (WHO) Regional Director for the Western Pacific. With these great efforts, it is only a matter of time before measles is eliminated from developing countries.

measlescambodia

Here we discussed just two examples of current vaccination challenges and plans. For more information about what needs to be done, you can download WHO’s Global Vaccine Action Plan 2011-2020 here.

Community and Individual Challenges

In countries such as Australia and the US, where we have not seen the effects of vaccine-preventable diseases in a long time, parents often choose not to vaccinate their children out of fear of side effects or remain skeptical about vaccine ingredients and possible links to other diseases. It is vital that this ambivalence is addressed and parents are educated about the importance of vaccinating themselves and their children. There needs to be more funding to promote vaccination through school programs, health education, advertisements, and clinicians need to be educated on how to be better advocates. An example of something that can be done is: schools should introduce rules regarding proof of childhood vaccination at enrolment. Only through such effects can we fully eliminate these vaccine-preventable diseases forever.

Text References

Bandyopadhyay AS, Garon J, Seib K, Orenstein WA. Polio vaccination: past, present and future. Future Microbiol [Internet]. 2015 [cited 2015 Apr 7];31:1-18 [Epub ahead of print]. Available from: PubMed

World Health Organization, Western Pacific Region (PHL). Brunei Darussalam, Cambodia, Japan verified as achieving measles elimination [Internet]. Manila (PHL): World Health Organization, Western Pacific Region; 2015 Mar [cited 2015 Apr 7]. Available from: http://www.wpro.who.int/mediacentre/releases/2015/20150327/en/

Image References

WHO/B. Bayutas. Brunei Darussalam, Cambodia, Japan verified as achieving measles elimination [Internet]. Manila (PHL): World Health Organization, Western Pacific Region; 2015 [cited 2015 Apr 7]. [Figure], Measles Cambodia. Available from: http://www.wpro.who.int/mediacentre/releases/2015/20150327/en/

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One thought on “The Future of Vaccination: Part 2 – Global, Community and Individual Challenges

  1. Very interesting read. Given all of the political and social ethics surrounding anti-vaccination, it will be interesting to see how the medical profession and government responds, should these preventable diseases begin to get out of hand…

    Like

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