By Teodoro B. Padilla
IMMUNIZATION is the greatest success story of the twentieth century.
Vaccines eliminated most of the childhood diseases that used to cause millions of deaths, making possible a life without disabilities caused by certain communicable diseases like polio for the first time in human history.
In the twenty-first century, though, the fruits of modern medicine are not reaching some of the most vulnerable, making global health insecure against vaccine preventable diseases (VPDs) once more.
Vaccines are critical to the prevention and control of many communicable diseases across all ages and therefore underpin global health security.
Yet, only a few countries have implemented a life-course approach to immunization (LCI) in line with recommendations in the Global Vaccine Action Plan 2011–2020 (GVAP) and the Immunization Agenda 2030 (IA2030). While there has been some progress, GVAP goals remain unachieved, and the pandemic has further exposed weaknesses in global immunization policies and most notably, on reaching out to the adult population.
Some progress has been made over the last years, though: the IA2030 explicitly adopts an LCI frame: “A world where everyone, everywhere, at every age, fully benefits from vaccines for good health and wellbeing,” which is an important reorientation of immunization goals.
Additionally, the United Nations has designated 2021-2030 the “Decade of Healthy Ageing,” to improve the lives of older people and their families and communities.
Together, these initiatives offer an opportunity to highlight the importance and value of LCI, especially for adults and older adults.
But there is much to be done in seven years if we are to reach these goals.
There are significant operational gaps, as clearly documented in the GVAP 2020 evaluation. Few countries have inclusive national immunization programs (NIPs). Expanding coverage of adult vaccination will require major shifts in immunization programs to remove barriers to access and uptake.
With an aging population, the societal need to prolong healthy living in the face of waning immunity means that new methods will be necessary to deliver integrated, people-centered vaccination services, expand protection with existing vaccines, and incorporate new vaccines as they become available for older age groups.
Programs will also have to respond to significant global demographic shifts, which will have a major impact on the design and delivery of immunization services.
The COVID-19 pandemic made it amply clear that the sick, the old and the vulnerable need a life-course approach to protection from infectious diseases.
Viral disasters like the one we are witnessing also provide opportunities to strengthen infrastructures and recalibrate our approach to health insecurities. The transition to ‘vaccination programs for all ages and all groups’ is critical for future pandemic preparedness and health security, by providing additional protection against waning immunity and stemming the rise in mortality from VPDs during adulthood.
Strengthening immunization programs is not simply about protecting individuals but about developing the capacity to protect health systems during future pandemics, which are sure to come.
Meticulous education in illness among the vulnerable, including the aging population, is a sure way to protect health systems as they face steadily increasing routine demands. These systems require awareness, advocacy, funding, infrastructure, measurement and continued support from healthcare professionals.
The IA2030 foresaw it well before the pandemic and called for vaccination of people of all ages.
This emphasis on immunization of older people is also reflected in the focus on prevention of United Nations Decade of Healthy Ageing, which will help achieve Sustainable Development Goals. The Decade’s plan says, “Older people require nondiscriminatory access to good-quality essential health services that include prevention…”
The World Health Organization (WHO) has recently declared an end to COVID-19 as a public health emergency, while stressing that this does not mean the disease is no longer a global threat.
It is important to remember that as the coronavirus swept the world, vaccines arrived at record speed and transformed both policy and lives. Over the next decade, as we deal with climate change, changes in population demography and disease epidemiology, the importance of vaccines cannot be overstated.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP). PHAP represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.