Vaccines Work: Leaving No Child Behind – How Pediatricians Can Contribute to Global Vaccine Coverage

This guest post was written by Louis Z. Cooper, MD, American Academy of Pediatrics. It originally appeared on the Centers for Disease Control and Prevention blog.

Today, more children are saved by vaccines than ever before, but over 19 million children are still missing out on these critical life-saving vaccines each year across the world (WHO, 2017). To put that in perspective, that’s almost the entire population of the state of Florida. Globally, coverage for the first dose of the measles vaccine has reached 85%, a remarkable accomplishment. Yet, in Somalia, progress in measles coverage has stagnated in the past five years, with coverage holding below 50%. While I celebrate our achievements, it is these missed children in vulnerable communities who keep me up at night.

Louis Z Cooper
Louis Z Cooper

Whether we practice in Long Island or Lagos, pediatricians’ number-one job is to keep children healthy. We often come together to share our experiences, learn from one another, and improve the practice of pediatrics globally. Our discussions over the last several decades helped me become a better clinician for the children I served.The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) have sought to solidify these informal knowledge exchanges by partnering in a multiyear project focused on reaching the goals of the Global Vaccine Action Plan. The plan, also known as the GVAP, is a roadmap to ending inequity and extending the benefits of vaccination to everyone, regardless of where they are born.

Because they are uniquely trusted, pediatricians and their national societies can play a special role in strengthening the vaccine delivery system; helping to ensure children and families understand the importance of vaccines and supporting public health vaccine programs. I have been fortunate to serve as a senior advisor on this project, which aims to harness the power of pediatricians by building a cadre of pediatric advocates dedicated to improving vaccine access. The lessons we learned through training our members here in the U.S. to become strong advocates for children has provided a curriculum of competencies that AAP can share with other national pediatric societies. The curriculum is then tailored to meet the specific needs of their country. Partnering has begun with societies in six priority countries in our first two years. We have worked closely with pediatric societies in Kenya, Nigeria, Ethiopia, Nepal, Indonesia, and the Philippines.

The GVAP calls for a coordinated response across partners to meet its global targets; the AAP, the CDC, and our six country partners, believe pediatricians and pediatric societies are especially well-positioned to support this effort. Pediatric societies play an important role cutting across all aspects of vaccine delivery—getting routine vaccines to kids, championing new and under-used vaccines, educating future child healthcare providers. Our country partners work to build country-owned strategies for improving healthcare services for all children, while urging their patients and their governments to consider how best to protect their children from vaccine-preventable diseases.

In just two years of implementation, we have developed new partnerships, strengthened existing institutions, and improved linkages between the public and private sectors. In Indonesia and Philippines, our colleagues are working to improve surveillance by linking vaccine service delivery data between public and private sectors. In both Nigeria and Ethiopia, they are committed to working closely with policy-makers by providing evidence-based, community driven information so children’s needs receive deserved high priority. Pediatricians in Kenya and Nepal have focused on educating the workforce to ensure that healthcare providers at all levels know why vaccines are important and how they are playing a significant role in children’s health. In many countries, pediatricians are not the ones giving vaccines, so we’ve found it is important to expand communications with the individuals who are administering them, the frontline vaccinators. We can provide the why’s of vaccines, but without vaccinators, we will not know enough about the how’s and the challenges they and we face to immunize all children.

When polio vaccine was licensed in 1955, I could not imagine how immunization would save millions of lives in my lifetime and how vaccines would change child health and the practice of pediatrics. While we deservedly rejoice at the momentum facilitated by GVAP, globally one in five children remain unprotected from vaccine-preventable diseases, and immunization rates have plateaued. This reality warrants deep concern and increased, creative effort from all of us.

The public/private partnership of AAP and CDC builds on the collaborative foundation of GVAP.  Its mission aligns with the core value of pediatrics, the inherent worth of every child. Working and learning with our global colleagues is reinforcing our collective commitment and can give the extra push to eradicate polio, measles, and rubella and to expand access to the still underutilized newer vaccines. Until no child left is behind, our work continues.