Look up the word routine, and you’ll find the synonyms “humdrum,” “monotonous,” and “dull.” Routine immunization is anything but monotonous—it saves millions of lives, prevents disability, and is continuously monitored and re-evaluated as new information becomes available. Perhaps it’s time to rethink the way we talk about the routine immunization schedule to better reflect its importance and complexity. Immunizations are not routine, but vital, critical, necessary—they are essential.
Kathy Neuzil vaccinating a child during the launch of the rotavirus vaccine in Mali. Photo: PATH/Kristen Lewis.
Ten years ago, almost to the day, I made the decision to join PATH
Having devoted my career to vaccines and the control of infectious diseases, for me it was the right time to adjust my predominant focus from domestic to international health. I knew that we had the tools and the vaccines, and that they had the potential to protect millions of children from devastating diseases. My new challenge was to work with the global community to ensure that those tools reached children everywhere—regardless of nationality, income, or proximity to health centers.
And what a decade it has been. The progress that I have seen in the last 10 years has been nothing short of miraculous.
- In 2005, the World Health Organization (WHO) recommended an immunization schedule designed to protect against eight diseases. Today, WHO recommends that children around the world receive vaccines that can prevent 12 serious diseases, and even more vaccines are available for children in certain geographies and risk categories.
- In 2005, Mexico became the first country to introduce rotavirus vaccine to its children. Almost halfway through 2015, 79 countries, including 35 Gavi-eligible countries, now include lifesaving rotavirus vaccines in their national immunization programs.
- In 2005, a meningitis vaccine that was available and affordable in Africa was a vision for many. Today, it is a reality as 217 million people, and counting, in sub-Saharan Africa have received meningitis A vaccine.
- An affordable Japanese encephalitis vaccine has also reached over 220 million people throughout Asia in recent years. Both meningitis A and Japanese encephalitis inflict needless suffering and disability on their victims.
- And let’s not forget the tremendous progress with the global introductions of pneumococcal, HPV, and measles and rubella vaccines.
All kinds of vaccines rely upon the “routine” system to be effectively delivered—it’s the system, after all, that helps to save so many lives.
Strong supply chains and logistics systems are also needed to deliver all vaccines and support the basic platform. The Better Immunization Data Initiative, for example, is designed to improve data quality, collection, and use to help health workers more effectively deliver immunization services. In addition, there is a wealth of ongoing research that will allow us to adapt vaccines and vaccination schedules to optimize their performance for particular settings and geographies.
It’s time to reimagine immunization, what it means, and where our efforts should be focused
I’ve been privileged to witness the progress in expanding and delivering essential vaccines for children in the past decade. We’re so much closer to a day when all vaccines all over the world are delivered so efficiently and effectively that they can be considered routine, and I can’t wait to see the new miracles that the next decade will bring.