Cte dIvoire will become the first country to roll-out the new R21/Matrix-M vaccine with the first child vaccinated in Abidjan, marking a critical step and historic milestone in the global fight against malaria.
Every year 600,000 people die of malaria in Africa, according to the World Health Organization (WHO). Children under five years of age make up at least 80% of those deaths. Although the number of malaria-related deaths has fallen from 3,222 in 2017 to 1,316 in 2020 in Cte d'Ivoire, the mosquito-borne disease kills four people a day, mostly small children, and "remains the leading cause of medical consultations, according to the Ministry of Health.
R21/Matrix-M was co-developed by the University of Oxford and Serum Institute of India, leveraging Novavaxs Matrix-M adjuvant technology. In December 2023, the WHO granted R21/Matrix-M prequalification status, following a rigorous regulatory process and clinical assessment. Trials also demonstrated that the vaccine was well tolerated, with a good safety profile, with injection site pain and fever as the most frequent adverse events.
In anticipation of the roll-out, the Serum Institute of India has manufactured 25 million doses of the vaccine and is committed to scaling up to 100 million doses annually. In keeping with its aim of delivering vaccines at scale and low cost, SII is offering the vaccine at less than $4 per dose. SIIs production capability means this highly effective and affordable, low-dose malaria vaccine can be manufactured at speed and scale, critical to stemming the spread of disease, as well as protecting the vaccinated.
Adar Poonawalla, SII CEO, says: 'Reducing the malaria burden is finally within sight. Todays start of the R21/Matrix-M vaccine roll-out marks a monumental milestone after years of incredible work with our partners at Oxford and Novavax.'
'At Serum, we believe that it is every persons right to have access to affordable and essential disease prevention. Thats why we have committed to producing 100 million doses of R21, which will protect millions of lives and alleviate the burden of this deadly disease for future generations.'
'We are thrilled to collaborate with our global partners and excited to continue playing a leading role in eliminating a disease that has been so challenging to beat.'
Todays vaccination signifies the culmination of years of dedicated research and manufacturing efforts by the University of Oxford and the Serum Institute of India (SII) and is the start of a pivotal phase that could see many lives saved.
Professor Adrian Hill, Director of the Jenner Institute at Oxford University, says: 'The roll-out of the R21/Matrix-M malaria vaccine marks the start of a new era in malaria control interventions with the high efficacy vaccine now accessible at a modest price and very large scale to many countries in greatest need. We hope that very soon this vaccine can be provided to all countries in Africa who wish to use it.'
A total of 656,600 doses have been received, which will initially vaccinate 250,000 children aged between 0 and 23 months across 16 regions of Cte d'Ivoire. The R21/Matrix-M vaccine has also been authorised by Ghana, Nigeria, Burkina Faso and the Central African Republic.
R21 is the second malaria vaccine available in Sub-Saharan Africa following RTS,S.WHO expert reviews of data of the two available malaria vaccines, RTS,S and R21 shows that both vaccines are expected to have high public health impact. Wide implementation of the malaria vaccines, in conjunction with existing prevention methods like the use of bed nets, is expected to save tens of thousands of young lives each year.
Gavi, WHO, UNICEF, the Global Fund and others are working with countries on their plans for vaccine roll out as part of holistic malaria control and prevention plans. In total, 15 African countries are expected to introduce malaria vaccines with Gavi support in 2024, and countries plan to reach around 6.6 million children with the malaria vaccine in 2024 and 2025. Gavi and partners are working with more than 30 African countries that have expressed interest in introducing the malaria vaccine.
Dr. Sania Nishtar, Chief Executive Officer of Gavi, the Vaccine Alliance said: 'Africa has borne the brunt of malaria for far too long, and Cte d'Ivoire has suffered more than most. With two safe and effective vaccines now available alongside other interventions, we have an opportunity to finally turn the tide against this killer disease.'
John Jacobs,President and Chief Executive Officer, Novavax, says: 'The introduction of the R21/Matrix-M malaria vaccine in Cte d'Ivoire marks a breakthrough in the fight to protect vulnerable children against a leading cause of death across the region, while reinforcing our mission to create innovative vaccines that improve public health. Novavax is proud of the contribution of our Matrix-M adjuvant in this vaccine and in making this moment possible, and value our continued collaboration with University of Oxford and Serum Institute of India, as well as the lifesaving work of WHO, Gavi and UNICEF.'
The extraordinary journey behind the vaccine has been captured in a new documentary, following the development, trials and manufacturing of R21/Matrix-M over several years. Due to be broadcast by the BBC on 22nd July (8pm BBC Two) following its premiere on PBS/NOVA The Battle to Beat Malaria tells the inside story of this historic breakthrough, revealing the decades of scientific research, as well asprovidingan intimate look at the scientists, medics, pharmaceutical engineers, and trial participants battling this deadly disease.Watch the trailer here.
In a shocking development, Republican presidential nominee Donald Trump has been heard endorsing false conspiracy theories about childhood vaccinations. This emerged during a recently leaked call with third-party presidential candidate Robert F. Kennedy Jr., himself a known distributor of vaccine misinformation.
In the video, Trump claims that vaccines given to protect infants against life-threatening diseases can cause sudden, radical changes in babies. "You see the baby all of a sudden starting to change radically," Trump asserts, echoing discredited anti-vaccine rhetoric.
During the conversation, Trump suggests Kennedy take action on the issue, although it's unclear what specific actions he was recommending. "I would love you to do something. And I think itll be so good for you and so big for you," Trump says, followed by an optimistic "Were going to win" the election, to which Kennedy responds affirmatively.
Also Read: RFK Jr apologises after posting video of phone call with Trump
The 98-second video, initially posted and then deleted by Kennedys son, Bobby Kennedy III, captures Trumps voice on a cell phone held by Kennedy. The call further fuels allegations from Biden supporters that Kennedy's campaign could act as a spoiler, ultimately benefiting Trump.
Trump's assertions include discredited ideas about vaccine doses, comparing the quantity of vaccines given to babies to that meant for horses. "When you feed a baby, Bobby, in vaccination, its like 38 different vaccines and it looks like its meant for a horse," Trump claims.
The spread of such misinformation has contributed to declining childhood vaccination rates in the United States, a trend exacerbated by the COVID-19 pandemic.
The Biden campaign quickly reacted to the leak. "Trump and his anti-vax bud Bobby are spreading dangerous conspiracy theories that threaten the lifesaving care that tens of millions of people depend on," Biden campaign spokesman Joe Costello said in a press release.
This incident raises significant concerns about the spread of vaccine misinformation and its impact on public health. The Trump-Kennedy conversation underscores the ongoing battle against vaccine conspiracies amid a global push for immunization and disease prevention.
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Posted: July 15, 2024
More children were left out of critical vaccination drives for diseases such as diphtheria, tetanus and whooping cough last year as a rise in conflicts across the globe hindered the supply of life-saving shots mostly in strife-torn regions, the United Nations said on Monday.
About 14.5 million children worldwidefailed to get vaccinated in 2023, compared with 13.9 million a year earlier, according to UNestimates. The number, however, was lower than during the COVID-19 pandemic, when about 18 million children missed out on vaccination.
The UNalso said that an additional 6.5 million children failed to receive more than a single dose, meaning they were not fully protected.
The estimates are based on how many children received either the first dose or all three doses of the DTP vaccine, a staple shot that protects against diphtheria, tetanus and pertussis, also known as whooping cough.
In total, 84 per centof infants globally received their full course last year, below the necessary level to prevent disease outbreaks.
WATCH |Canada heading towardmajor measles outbreak without vaccine boost, models suggest:
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War-hit countries in particular saw a big jump in the number of children who were not immunized in 2023, the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) said at a press conference last week, ahead of releasing the data.
The biggest fall in vaccination coverage globally was in Sudan, which has been decimated by 15 months of civil war. It saw coverage rates fall to 57 per centin 2023 from 75 per centin 2022.
That meant nearly 701,000 children in Sudan were not vaccinated at all against killer diseases such as measles and diphtheria.
The data also suggested that vaccination rates against the deadlymeaslesdisease stalled, leaving nearly 35 million children with no or only partial protection.
In 2023, only 83 per centof children worldwide received their first dose of themeaslesvaccine through routine health services, while the number of children receiving their second dose modestly increased from the previous year, to 74 per cent of children. To prevent outbreaks of measles, 95 per centvaccination coverage is needed.
The number of children who failed to get immunized in the occupied Palestinian territories rose to 17,000 for the first nine months last year, based on data available until September, from 1,000 in 2021, the agencies said.
Sudan, Yemen and Afghanistan were all new entrants on the list of the 20 countries with the most unvaccinated or "zero-dose" children in 2023.
More than half of the world's unvaccinated children live in countries with fragile, conflict-affected or vulnerable settings, although these nations only make up 28 per centof the global birth cohort,UNICEF said.
There were some positives in the UNreport. For example, there were around 600,000 fewer zero-dosechildren across the African region in 2023 than in 2022, and coverage of the HPV vaccine, which protects against cervical cancer, also improved globally.Ukraine also saw an improvement despite its war with Russia.
On July 15, WHO and UNICEF unveiled their latest national immunization coverage estimates (WUENIC), the most comprehensive dataset on vaccination trends against 13 diseases. The results are a mix of progress and urgent calls to action.
In 2023, an impressive 108 million children globally received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP) a key marker for global immunization coverage. However, the data reveals a stark reality: 14.5 million missed all doses of DTP containing vaccine, putting them at grave risk of diphtheria, tetanus, and pertussis. Even more concerning is that over half of these children live in fragile, conflict-ridden areas, where their vulnerability is compounded.
Worse still, 6.5 million children did not complete their follow-up DTP doses, and global immunization coverage of this critical core measure of programme performance has stagnated since 2022. The pandemic's impact lingers, with 600,000 more zero dose children in 2023, than 2022, and 1.7 million more than in 2019. This increase over pre-pandemic levels rises by 2.7 million when under-vaccinated children are also included. This stagnation in recovery and strengthening of coverage highlights the dire need to innovate, find locally impactful approaches, and most critically, enhance the political and social leadership that are the basis for intensified actions needed to meet the Immunization Agenda 2030 (IA2030) targets: 90% coverage and a 50% reduction in the number of zero-dose children (to no more than 6.5 million) by 2030.
The data on measles vaccine coverage is particularly alarming. Despite measles being a highly preventable disease, nearly 35 million children are still missing one or more doses of vaccine through routine immunization. These figures fall woefully short of what's needed to prevent outbreaks and deaths, underscoring the urgency of closing immunization gaps. The WUENIC estimates particularly highlight that the 91 countries without significant measles outbreaks in the past 5 years are at least 10 percentage points higher in their MCV1 coverage than the average coverage among the 103 countries that have suffered measles outbreaks. This hammers home the point that high routine immunization coverage of measles vaccine forms the foundation on which prevention of outbreaks is achieved, though that achievement often includes supplementary, gap-filling outreach efforts. These supplementary efforts are insufficient to fully avoid outbreaks, when the foundation of coverage through the routine delivery channel is lacking.
Yet, amidst this global stagnation, there are some bright areas, particularly in Africa. The region defied the odds increasing routine immunization coverage, with 1.5 million more children vaccinated with DPT vaccine than in 2019 and a fall in the number of zero dose children from 7.3 million in 2022 to 6.7 million in 2023. This progress, despite the challenges of a growing child population, reflects the growing national prioritization and focus on resilient immunization programmes.
WHO and UNICEF, alongside Gavi and other partners, are committed to the IA2030 strategy, aiming for universal vaccine access and disease prevention. Turning these goals into reality, means that countries must lead the charge.
Revitalizing immunization programmes, strengthening community-centered health systems, ensuring vaccine supply, and boosting demand through community engagement are critical components of success. Policy and resources should urgently prioritize routine immunization, particularly for measles, and focus on reducing zero-dose children.
The message is clear: the time is now for action, to secure a healthier future for all. The world cannot afford to wait any longer.
Global forum for vaccine sovereignty and innovation sets bold targets
On June 20 in Paris, the Global Forum for Vaccine Sovereignty and Innovation marked a significant step towards enhancing global immunization efforts. The event was hosted by Gavi, the Vaccine Alliance, the Government of France, and the African Union with Team Europe partners.
Gavi's 20262030 Investment Opportunity was launched at the event, aiming to start off the replenishment period through the coming months, in support Gavi 6.0 strategy for 2026-2030. The alliance ambitiously aims to vaccinate one billion children by 2030, a goal driven by the urgent challenges of climate change, economic instability, and global health crises. In this period, Gavi plans to support the use of malaria vaccine to vaccinate 50 million children and HPV vaccine to protect 120 million girls from cervical cancer, potentially saving 1.5 million lives.
To achieve this, Gavi seeks US$9 billion in new pledges out of the US$11.9 billion needed for the strategic period. Encouragingly, US$2.4 billion in new pledges wereannouncedat the launch event, including US$1.58 billion from the United States.
The forum also launched the African Vaccine Manufacturing Accelerator (AVMA), a pioneering initiative to boost vaccine production in Africa. Developed by Gavi in collaboration with the African Union and Africa Centres for Disease Control and Prevention, AVMA aims to create a robust vaccine ecosystem with strong regulatory frameworks and efficient procurement strategies. It is set to receive approximately US$1.2 billion in donor funding over the next decade to procure vaccines manufactured in facilities on the continent.
As the world rallies behind these initiatives, our collective efforts will be pivotal in achieving these historic milestones, ensuring that millions more children, adolescents and adults receive life-saving vaccinations, and strengthening global health resilience.
Next steps for the TB Vaccine Accelerator: a global push for novel TB vaccines
Following the impactful Second High-Level Meeting of the TB Vaccine Accelerator Council in late May, WHO is spearheading a collaborative effort to fast-track the development, approval, and use of innovative tuberculosis (TB) vaccines. WHOs Immunization, Vaccines and Biologicals (IVB) and the Global TB departments alongside the Science division, are joining forces to bring countries and partners together to advance this critical mission.
In an exciting move, WHO has issued a call for proposals to support the TB Vaccine Accelerator secretariat. The Accelerator aims to unite key stakeholders across four pivotal areas: Vaccine Science and Research, Product Development and Manufacturing Policy, Financing and Access Strategy, and Country Readiness and Community Partnership. The goal is to establish robust, inclusive working groups, fostering both existing collaborations and new partnerships, particularly involving those from high TB burden countries.
Additionally, IVB has launched a call for experts to join a newly formed Technical Advisory Group focused on clinical and policy considerations for novel TB vaccines. Interested experts have until July 22 to apply, contributing their expertise, ideas and insights to this vital technical area. Preparations are also underway for country workshops anda2025 TB Vaccine Financing Conference. These efforts represent a significant step toward creating a cohesive and comprehensive strategy to assure that should TB vaccines for adolescents and adults be successfully developed, there is a pathway for these vaccines to be accessible, and equitably deployed with scale and speed.
Together with our partners we are eagerly looking forward to enabling the necessary steps, knowledge, and commitments across the entire value chain, working to accelerate the journey from vaccine development to widespread use, ultimately aiming to turn the tide on TB and save millions of lives.
As we conclude the first half of 2024, I would like to take this opportunity to wish you all a moment of reflection, as many of you may be taking some well-earned holiday time. Much has already been accomplished this year, and I look forward to reconnecting with our next update in September.
Overview
Ensuring quality of the health product ensures its safety and efficacy. Manufacturers in lowand middle-income countries (LMICs) face challenges to achieve quality in local production, such as the lack of an available manufacturing workforce trained in quality and understanding regulatory quality standards and difficulties in implementing a quality culture in the manufacturing facility.
The Local Production and Assistance (LPA) Unit in the Regulation and Prequalification Department (RPQ), Access to Medicines and Health Products Division (MHP), WHO, supports Member States (MS), particularly low- and middle-income countries (LMICs), to strengthen sustainable local production and technology transfer to improve timely, equitable access to quality, safe and effective essential medical products. The LPA Unit provides assistance and support to MS with an ecosystem-wide and holistic approach, such as conducting ecosystem assessments for sustainable, quality local production, developing & implementing strategies/roadmaps and tools, providing comprehensive capacity building and technical assistance, including for WHO Prequalification (PQ)/Emergency Use Listing (EUL), and facilitating technology transfer (TT).
To support MS to overcome challenges to locally produce quality-assured vaccines, medicines and in vitro diagnostics (IVDs), the LPA Unit organized a new global training event Week of Quality to complement the annual Virtual cGMP Training Marathons organized by the LPA Unit. The first Week of Quality was organized from 16 to 20 June 2023 and focused on establishing quality specifications of vaccines, medicines and IVDs based on WHO and other international guidelines, one of the stepping stones to achieve quality. More than 1700 vaccine and biopharmaceutical manufacturers and regulators attended the sessions on vaccine quality specifications. More than 1400 pharmaceutical manufacturers and regulators strengthened their foundations in establishing quality specifications for medicines. And for the first time, over 1000 IVD manufacturers and regulators, built capacity in narrowing the gap between quality specifications of IVDs and design validation.
Questions raised by manufacturers and regulators in the Week of Quality have been assembled in this training material with questions-and-answers (Q&A) with answers prepared and peer-reviewed by experts with long and rich experience in the vaccine, medicine or IVD industry, national regulatory authority (NRA), and other organizations. This document has been developed to provide manufacturers and other relevant stakeholders with a continuous learning resource and reference document to acquire new and fortify existing, knowledge and capacities to strengthen the local production of quality vaccines, medicines and IVDs.
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The world has yet to catch up from a major drop in childhood immunisations during the COVID pandemic, according to new data.
Fewer children are getting vaccinated today than they were before the COVID-19 pandemic, according to new data that shows the world is not on track to meet global vaccination goals by 2030.
The pandemic disrupted immunisation campaigns around the world, and while vaccination rates rebounded in some countries in 2022, progress stalled in 2023.
Lower-income and conflict-ridden countries in particular are being left behind, according to the new data from the World Health Organization (WHO) and UNICEF, which covers immunisation across 195 countries.
In 2023, 21 million children were unvaccinated or undervaccinated for DTP, which covers diphtheria, tetanus, and pertussis and serves as a benchmark of overall immunisation coverage. Thats up from 18.3 million in 2019, the report found.
"We've never seen backsliding of that magnitude or of that scale, meaning the number of countries, in probably 20 or 30 years," Dr Katherine O'Brien, director of the WHOs department of immunisation, vaccines, and biologicals, said of the pandemic period during a press briefing.
The WHO is now trying to identify kids who missed shots during the pandemic and get them up-to-speed on routine vaccinations, in what the group calls "the big catch-up".
"It is important that the next pandemic wouldnt really affect delivery of regular services, not only immunisation, but also other primary health care services," Dr Ephrem T Lemango, associate director for health and global chief of immunisation at UNICEF, told reporters.
In Europe, half a million children missed one or more of their DTP innoculations in their first year, according to WHO data.
Globally, there were 14.5 million "zero dose children" who missed all routine vaccinations in 2023.
Ten countries account for 59 per cent of these children: Nigeria, India, Ethiopia, the Democratic Republic of the Congo, Sudan, Indonesia, Yemen, Afghanistan, Angola, and Pakistan.
These countries are characterised by having weak health systems, many babies born each year, or a combination of both factors, the report said.
The lower immunisation rates relative to previous years have led to outbreaks of preventable diseases that divert healthcare workers from regular vaccinations and other health services as they tried to tamp down infections, O'Brien said.
For example, among the 103 countries with measles outbreaks in recent years, the vaccination rate is about 10 percentage points lower than the countries without recent outbreaks, the report found.
"It's kind of a negative cycle that we really need to break out of," O'Brien said, highlighting "the importance of rapidly responding to outbreaks so that they can be shut down as quickly as possible to prevent serious disease and death".
Regional conflicts have also made it harder for healthcare workers to vaccinate children.
In 2023, 55 per cent of unvaccinated children lived in countries experiencing conflict or other vulnerabilities, a disproportionate share given just 28 per cent of babies were born there, the report found.
Sudan has seen a particularly steep drop in DTP immunisation between 2019 and 2023, for example, while levels have also dropped in the occupied Palestinian territories, Yemen, Lebanon, and elsewhere.
Ukraine bucked that trend, with a much higher DTP immunisation level in 2023 than in 2019.
"The reason thats important is those children who are living in those settings also lack security, they lack nutrition, they lack healthcare, and are most likely, as a result of those things, to die from a vaccine-preventable disease if they get it," OBrien said.
There were also some bright spots in the report. The Americas and Africa saw improvements in some vaccinations in 2023, particularly in Brazil, South Sudan, Ethiopia, and Cameroon.
Meanwhile, 27 per cent of girls around the world received the first dose of the HPV vaccine, up from 20 per cent from the year before. Thats due in part to countries switching from a two-dose to a single-dose schedule.
The HPV vaccine has been shown to significantly curb the risk of cervical cancer, though it still isnt widely accessible in large countries like China and India, which have a high burden of the disease, according to the report.
Going forward, health officials are trying to address vaccine misinformation and hesitancy, which increased during the pandemic.
They also want to increase the number of children who get all of their vaccines, as many kids in lower-income countries drop out of immunisation programs after receiving their first or second shots.
In 2023, for example, 13 per cent of children in low-income countries who got their first DTP shot didnt go on to get the measles vaccine, the report found.
"Countries must strengthen immunisation programs at this time," Lemango said.
Key facts
While immunization is one of the most successful public health interventions, coverage plateaued in the decade prior to COVID-19. The COVID-19 pandemic, associated disruptions, and vaccination efforts strained health systems in 2020 and 2021, resulting in dramatic setbacks. Data from 2023 show that performance has not yet returned to 2019 levels.
During 2023, about 84% of infants worldwide (108million) received 3 doses of diphtheria-tetanus-pertussis (DTP3) vaccine, protecting them against infectious diseases that can cause serious illness and disability or be fatal. However, these global figures hide significant disparity among countries of different income strata, with low-income countries lagging behind.
Measles, because of its high transmissibility, acts as an early warning system, quickly exposing immunity gaps in the population. Still, 22.2million children missed their routine first dose of measles, far from the 2019 level of 19.3million.
A summary of global vaccination coverage in 2023 follows.
Haemophilus influenzae type b (Hib) causes meningitis and pneumonia. The Hib vaccine had been introduced in 193 Member States by the end of 2023. Global coverage with 3 doses of Hib vaccine is estimated at 77%. There is great variation between regions. The WHO European Region is estimated to have 94% coverage, while it is only 33% in the WHO Western Pacific Region.
Hepatitis B is a viral infection that attacks the liver. Hepatitis B vaccine for infants had been introduced nationwide in 190 Member States by the end of 2023. Global coverage with 3 doses of hepatitis B vaccine is estimated at 83%. In addition, 117 Member States introduced 1 dose of hepatitis B vaccine nationwide to newborns within the first 24 hours of life. Global coverage is 45% and is as high as 79% in the WHO Western Pacific Region, while it is estimated at only 17% in the WHO African Region.
Human papillomavirus (HPV) is the most common viral infection of the reproductive tract and can cause cervical cancer in women, other types of cancer, and genital warts in both men and women. One hundred forty-three Member States provided the HPV vaccine in their national immunization schedule and services by the end of 2023, including 13 new introductions.In 2023, 37 countries representing more than 45% of girls aged 914 years old vaccinated in that year used a 1-dose schedule. Global coverage with the first dose of HPV among girls is now estimated at 27%. While far from the 90% target by 2030, it represents a large increase from 20% in 2022 and was driven by new introductions in several large countries and further improvements in existing programmes, including in countries using the 1-dose schedule.
Bacterial meningitis is an infection that is often deadly and leaves 1 in 5 individuals with long-term devastating sequelae after the acute infection. Before the introduction of MenAfriVac in 2010 a revolutionary vaccine Neisseria meningitidis serogroup A (NmA) accounted for 8085% of meningitis epidemics in the African meningitis belt. By the end of 2023, more than 350million people in 24 out of the 26 countries in the meningitis belt had been vaccinated with MenAfriVac through campaigns and 15 countries had included MenAfriVac in their routine immunization schedule. In the 26 countries of the meningitis belt, coverage is estimated at 29% in 2023. No case of NmA meningitis has been confirmed since 2017 in the meningitis belt.
Measles is a highly contagious disease caused by a virus, which usually results in a high fever and rash, and can lead to blindness, encephalitis or death. By the end of 2023, 83% of children had received 1 dose of measles-containing vaccine by their second birthday, and 74% of children received 2 doses of measles vaccine. By the end of 2023, 190 Member States had included a second dose of measles vaccine in their national immunization schedules.
Mumps is a highly contagious virus that causes painful swelling at the side of the face under the ears (the parotid glands), fever, headache and muscle aches. It can lead to viral meningitis. Mumps vaccine had been introduced nationwide in 124 Member States by the end of 2023.
Pneumococcal diseases include pneumonia, meningitis and febrile bacteraemia, as well as otitis media, sinusitis and bronchitis. Pneumococcal vaccine had been introduced in 159 Member States by the end of 2023 and global third dose coverage was estimated at 65%. There is great variation between regions. The WHO European Region is estimated to have 86% coverage, while it is only 26% in the WHO Western Pacific Region.
Polio is a highly infectious viral disease that can cause irreversible paralysis. In 2023, 83% of infants around the world received 3 doses of polio vaccine. In 2023, the coverage of infants receiving their first dose of inactivated polio vaccine (IPV) in countries that are still using oral polio vaccine (OPV) is estimated at 83% as well. In these same countries, the coverage of infants receiving their second dose of IPV is estimated at 42%. There is great variation between regions. The WHO European Region is estimated to have 89% coverage, while it is only 6% in the WHO South-East Asia Region. Targeted for global eradication, polio has been stopped in all countries except for Afghanistan and Pakistan. Until poliovirus transmission is interrupted in these countries, all countries remain at risk of importation of polio, especially vulnerable countries with weak public health and immunization services and travel or trade links to endemic countries.
Rotaviruses are the most common cause of severe diarrhoeal disease in young children throughout the world. Rotavirus vaccine was introduced in 123 countries by the end of 2023. Global coverage was estimated at 55%.
Rubella is a viral disease which is usually mild in children, but infection during early pregnancy may cause fetal death or congenital rubella syndrome, which can lead to defects of the brain, heart, eyes and ears. Rubella vaccine was introduced nationwide in 175 Member States by the end of 2023, and global coverage was estimated at 71%.
Tetanus is caused by a bacterium which grows in the absence of oxygen, for example in dirty wounds or the umbilical cord if it is not kept clean. The spores ofC. tetaniare present in the environment irrespective of geographical location. It produces a toxin which can cause serious complications or death. Maternal and neonatal tetanus persist as public health problems in 10 countries, mainly in Africa and Asia.
Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. As of 2023, yellow fever vaccine had been introduced in routine infant immunization programmes in 37 of the 42 countries and territories at risk for yellow fever in Africa and the Americas. In these 42 countries and territories, coverage is estimated at 50%.
In 2023, 14.5million infants did not receive an initial dose of DTP vaccine, pointing to a lack of access to immunization and other health services, and an additional 6.5million are partially vaccinated. Of the 21million, just under 60% of these children live in 10 countries: Afghanistan, Angola, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan, Sudan and Yemen.
Monitoring data at subnational levels is critical to helping countries prioritize and tailor vaccination strategies and operational plans to address immunization gaps and reach every person with life-saving vaccines.
WHO is working with countries and partners to improve global vaccination coverage, including through these initiatives adopted by the World Health Assembly in August 2020.
IA2030 sets an ambitious, overarching global vision and strategy for vaccines and immunization for the decade 20212030. It was co-created with thousands of contributions from countries and organizations around the world. It draws on lessons from the past decade and acknowledges continuing and new challenges posed by infectious diseases (e.g. Ebola, COVID-19).
The strategy has been designed to respond to the interests of every country and intends to inspire and align the activities of community, national, regional and global stakeholders towards achieving a world where everyone, everywhere fully benefits from vaccines for good health and well-being. IA2030 is operationalized through regional and national strategies and mechanisms to ensure ownership and accountability and a monitoring and evaluation framework to guide country implementation.
In 2020, the World Health Assembly adopted the global strategy towards eliminating cervical cancer. In this strategy, the first of the 3 pillars require the introduction of the HPV vaccine in all countries and has set a target of reaching 90% coverage. With introduction currently in 74% of Member States, large investments towards introduction in low- and middle-income countries will be required in the next 10 years as well as programme improvements to reach the 90% coverage targets in low- and high-income settings alike will be required to reach the 2030 targets.
For scientists and medical professionals well versed in the safety and effectiveness of vaccines, it is often too easy to write off the concerns of people who fear them, or feel they have been injured by them. But vaccine expert Kizzmekia S. Corbett-Helaire argues that professionals should be more empathetic when it comes to listening to these concerns, and that understanding them may help developers make better vaccines.
Corbett-Helaire, an assistant professor of immunology and infectious diseases at the Harvard T.H. Chan School of Public Health in Boston and a Freeman Hrabowski Scholar at the Howard Hughes Medical Institute, joins The First Opinion Podcast this week to discuss her experience helping roll out the first Covid-19 vaccines in the midst of the pandemic. She also addresses her desire to close the gap between public health experts trying to end disease and people who genuinely fear harm from vaccines.
Experts must listen carefully and respond with empathy. Vaccine development goes beyond the clinic and it goes toward trust and actually getting people taking these very lifesaving vaccines,she said.
You can read more of Corbett-Helaires thoughts in her first opinion essay Empathy should guide responses to reported vaccine injuries.
Be sure to sign up for the weekly First Opinion Podcast onApple Podcasts,Spotify, or wherever you get your podcasts. And dont forget to sign up for the First Opinion newsletterto learn about each weeks First Opinion essays.
Though federal health officials are moving ahead with a plan to produce 4.8 million doses of H5N1 avian influenza vaccine that targets the clade (strain) circulating globally and infecting US dairy herds and some farm workers, older H5N1 vaccines in the Strategic National Stockpile (SNS) might be useful in a pinch.
A team led by researchers from the US Food and Drug Administration looked at the ability of three H5N1 vaccines targeting three earlier H5N1 clades from Indonesia and Vietnam that circulated in the early 2000s to neutralize antibodies against the current 2.3.4.4b clade. All three are already licensed and are in the SNS. Two are adjuvanted, meaning they contain an immune-boosting substance.
The group published its unedited findings yesterday in Nature Communications to provide early access to the new information.
At a media briefing this week, federal health officials said H5N1 vaccination isn't yet recommended for farm workers exposed to animals that carry the virus, but discussions remain ongoing. Their rationale is that infections are mild, and they have seen no changes to suggest the virus is more transmissible or is poised to cause more severe disease.
An official from the Department of Health and Human Services' Administration for Strategic Preparedness and Response said the fill-and-finish of a vaccine specific to the current clade from bulk candidate vaccine is still on track, with the first doses to be delivered in July. However, once produced, the vaccine would still need to go through regulatory approval before doses are used in people.
In conducting the study, the team used blood samples from 68 adults who had participated in earlier H5N1 vaccine trials. The hemagglutinin (HA) sequence of the 2.3.4.4b H5N1 clade has several mutations compared to the HA of the three H5N1 viruses targeted by the earlier vaccines.
The researchers found that the two adjuvanted licensed H5N1 vaccines generated cross-reactive binding antibodies and cross-neutralization titers against the 2.3.4.4b clade.
"These findings suggest that the stockpiled U.S. licensed adjuvanted H5N1 vaccines generate cross-neutralizing antibodies against circulating HPAI H5N1 clade 2.3.4.4b in humans and may be useful as bridging vaccines until updated H5N1 vaccines become available," they wrote.
In other H5N1 developments, the US Department of Agriculture Animal and Plant Health Inspection Service (APHIS) added three more confirmations, all from Colorado, to its list of H5N1 outbreaks in dairy farms. The nation's total is now 161 outbreaks across 13 states.
APHIS also reported one more H5N1 detection in poultry, which involves a backyard flock of 30 birds in Idaho's Twin Falls County. It also reported 21 more detections in wild birds, several of which were agency-harvested birds in Sioux County, Iowa, where the virus has been detected in dairy herds. Other detections involved waterfowl and raptors found dead in other states, including California, Florida, and New York.
Meanwhile, APHIS reported H5N1 in samples from 11 more mammals, mostly house mice in New Mexico's Roosevelt County. They also included a red fox in New York's Tomkins County and a raccoon in Iowa's Sioux County.
