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Vaccines Don't Save Lives, Vaccination Does
Published in Norman Begg, The Remarkable Story of Vaccines, 2023
There are a few multinational players worth mentioning. The World Health Organization is a branch of the United Nations, with its HQ based in Geneva. My father, also a public health doctor (and also called Norman!) worked there (he was the head for Europe), so I suppose I have inherited some of his genes. The WHO’s strength lies in its collective membership of 194 member states. A WHO recommendation is a global mandate for action and has been particularly successful for vaccines. Smallpox would not have been eradicated without the WHO. Polio eradication is close. The WHO cannot force countries to act, but its recommendations are hard to ignore.
Polio
Published in Rae-Ellen W. Kavey, Allison B. Kavey, Viral Pandemics, 2020
Rae-Ellen W. Kavey, Allison B. Kavey
Before the GPEI began, poliomyelitis was endemic in 125 countries around the globe and more than 350,000 children per year were paralyzed for life. There has been dramatic progress towards polio eradication but the final steps are proving just how formidable an opponent the poliovirus can be.
Enteroviruses
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Karen Straube-West, Burk Jubelt
The World Health Assembly has endorsed the Polio Eradication and Endgame Strategic Plan 2013–2018 with the goal of eradicating polio from the globe [65]. In the Western hemisphere, the last known case of poliomyelitis due to an indigenous wild-type strain occurred in Peru in 1991 [66]. More recent cases in the Dominican Republic and Haiti appear to have been caused by mutants of the oral polio vaccine. Globally, wild polio cases have gone from 350,000 in 125 endemic countries in 1988 to 51 cases in two endemic countries in 2015 [67]. Paralytic diseases caused by coxsackievirus and ECHO are isolated and rare. In the period 1976–1979, 52 cases of paralytic disease caused by enteroviruses were recorded in the United States; 25 were caused by poliovirus, 18 by echoviruses, seven by coxsackieviruses, and two by EV71 [68]. Paralysis from EV70 occurs during epidemics of AHC. Approximately 1 in 10,000–15,000 cases of AHC are complicated by neurological involvement, which primarily affects adults. EV71 has quite variable manifestations. It has resulted in both epidemic and isolated cases throughout the world.
Health economic analysis of vaccine options for the polio eradication endgame: 2022-2036
Published in Expert Review of Vaccines, 2022
Kimberly M. Thompson, Dominika A. Kalkowska, Kamran Badizadegan
In 2007, a study on eradication versus control assumed ‘that eradication is achievable provided that we are willing to commit the necessary resources’ and it relied on a simplifying assumption that in the event that global leaders abruptly ended polio eradication efforts then endemic transmission of polioviruses would return to the level of approximately 200,000 expected cases per year in low-income countries [31]. At that time, India met the World Bank criteria as a low-income country and the feasibility of it ending poliovirus transmission came into question [32]. In the early 2000s most countries relied exclusively on Sabin trivalent OPV (tOPV) for routine immunization (RI), and over 40 countries still reported poliovirus cases. Substantial changes in polio epidemiology and the use of polio vaccines occurred since 2006, including the introduction of at least one dose of inactivated poliovirus vaccine (IPV) into the RI schedules of all countries by 2018, albeit with low coverage in some countries [33].
Understanding mother and child health-seeking behavior in urban Pakistan
Published in Health Care for Women International, 2022
Marina Haque, Allysha Choudhury, Alina Haque, Roland Alexander Blackwood
With regard to the sixth scenario involving vaccines, immunization coverage has become increasingly controversial throughout the greater Middle East over the past decade. For instance, in Pakistan vaccine administrators have been targeted by militants (Khan et al., 2015; Obregón et al., 2009). As a result, Pakistan is one of only two nations worldwide with the rapidly disabling wild-type poliovirus (Global Polio Eradication Initiative, 2019). While immunization coverage in Islamabad is estimated to be much higher than the rest of the nation, only 50% of children were fully vaccinated in the city as of 2013 (NIPS, 2013; World Health Organization, 2016). On the other hand, 94.3% of our survey participants said they would take their child to a provider to receive immunizations. This suggests there may be a mismatch between mothers’ vaccination preferences and children’s immunization coverage. The reasons behind this difference were not explored in our study, but would make a critical research focus for international stakeholders as lowering the global burden of infectious disease benefits everyone.
Eradicating polio in Pakistan: a systematic review of programs and policies
Published in Expert Review of Vaccines, 2021
Anushka Ataullahjan, Hanaa Ahsan, Sajid Soofi, Muhammad Atif Habib, Zulfiqar A. Bhutta
The goal of global polio eradication is ambitious and requires the buy-in from multiple stakeholders at different levels of the health system. Pakistan has continuously fallen behind on its milestones and optimism has begun to wane [138]. If Pakistan is to make progress toward this goal in the next five years, it will require concerted and targeted efforts. As we have described, the Pakistan Polio Programme has experienced large amounts of variability due to variable governance, and weak management. Poor governance has thwarted Pakistan’s polio eradication efforts [128]. Creating systems of accountability to address corruption, and variable governance will be fundamental to its success. Ensuring continuity after election cycles will ensure that any progress made will not be undone. Moreover, as one epidemiologic zone, eradication in Pakistan is contingent upon eradication in Afghanistan and vice versa [15]. Improved collaboration toward the common goal of polio eradication and cross-country learnings can help improve vaccination uptake.