Immunization is known to be one of the most important factors that can significantly impact the overall health status of a particular country. However, due to the current healthcare landscape and certain unfounded dilemma that can possibly affect the health care system, several countries are still facing the challenge of achieving an improved vaccination rate, most especially among children. As a result, many of its residents are still at high risk of acquiring diseases that can be prevented by immunization.
A report published by the World Health Organization (WHO) last July 15, 2016 can give us an overview of the current immunization status of all regions, including the African, American, Eastern Mediterranean, European, Southeast Asian and Western Pacific regions.
The Eastern Mediterranean region (EMR) has the lowest overall vaccination rate around the globe with 0% coverage for YFV. However, among all its member states, Sudan is the only country in EMR that belongs to the yellow fever zone wherein epidemics are reported in the years 1940, 1959, 2003, 2005, 2012 and 2013. Unfortunately, there is no known cure for YFV. Thus, preventive vaccination and routine child immunization are currently being reinforced by the region for both its residents and travelers.
Using the data published by WHO, the overall vaccination coverage in the African region is considered to be relatively low compared to the other regions across the globe. In fact, among all the vaccines, MCV 2 has the lowest coverage, which equates to only 18% of the target population. Aside from this, three of its member states, Equatorial Guinea, Central African Republic (CAR) and Kenya, ranked lowest in WHO’s global statistics for vaccination coverage by antigen.
Equatorial Guinea is considered as one of the most deprived countries in terms of health resources. In fact, it has the lowest DTP 1, DTP 3, HepB3, HiB3 and Pol3 Vaccination rate, as reported by WHO. Other than inadequate resources and facilities, training programs for health workers and ineffective information dissemination are also some of the relevant issues that must be promptly addressed.
On the other hand, through WHO’s Health Resources Availability Mapping System (HeRAMS), several aspects of the CAR’s health system were adequately assessed. These include the country’s health facilities as well as availability of health workers. Such assessment gave a full picture of the current health care situation in CAR. In 2013, CAR was categorized as Grade 3, which is equivalent to humanitarian emergency, alongside with South Sudan, Iraq and Syrian Arab Republic. Moreover, the conflict encountered by CAR in March 2014 hindered immunization and other health programs geared towards preventing diseases, increased prevalence of malnutrition and destroyed hospitals and other health facilities. Until now, the country is still facing serious health problems such as malaria, respiratory infections, watery diarrhea and physical trauma.
Furthermore, the National IHR focal point in Kenya notified WHO about two cases of yellow fever that were reported last March 16 – 18, 2016. Both patients were Kenyan nationals who travelled to Luanda, Angola for work. None of them were vaccinated against yellow fever prior to their departure to Angola. Despite this situation, WHO reported that the risk of transmission is minimal since the density of Aedes aegypti in Nairobi is very low and none of the two cases arrived in viraemic state. Hence, WHO advised to reinforce immunization of travelers going to potentially endemic areas.
Covering nearly one-fourth of the global population, the Southeast Asian region has been focusing on the improvement of maternal and child health. In May 19, 2016, the whole region was able achieve maternal and neonatal tetanus elimination (MNTE), thereby, reducing the cases to less than one per 1000 live births. According to WHO Southeast-Asia regional director, Dr Poonam Khetrapal Singh, “Persistent efforts and innovative approaches to enhance tetanus vaccination coverage of pregnant women and children, increase skilled birth attendance and promote clean cord practices made MNTE a reality.”
Viral hepatitis is considered a public health threat and its elimination has been envisioned by WHO by the year 2030. As one of the steps to help achieve this goal, the Western Pacific Region has been reinforcing hepatitis B vaccination, which averted 7 million deaths that could have affected children born between 1990 and 2014. Aside from this, with the theme ‘Vaccination is everyone’s job, protect your community. Immunize all throughout life’, the celebration of immunization week last April 18 – May 1, 2016 was able to empower its citizens to protect their communities through vaccination.
Through the European Vaccine Action Plan 2015–2020 (EVAP) implemented since September 18, 2014, the whole region was able to achieve high vaccination rates to achieve its goals such as maintaining a polio-free status, eliminating measles and rubella, controlling hepatitis B infection, making evidence-based decisions related to the introduction of new vaccines and supporting national immunization programs to reach a greater population.
However, it may be contradicting that Sweden, one of its member states, has the lowest BCG vaccination rate compared to all countries across the globe, with only 24% coverage of its target population. In 1975, Sweden switched to selective BCG vaccination from routine vaccination of newborn infants due to the relatively low incidence of tuberculosis in the country. Aside from immunization, Sweden also focused on intensified active case finding identify the source of infection and eliminate it to prevent transmission of the disease to the vulnerable population.
In order to achieve and a sustainable and equitable reduction in morbidity and mortality related to diseases preventable by vaccines, the Comprehensive Family Immunization continuously coordinates and establishes partnerships with both public and private sectors and the international community. In this regard, despite having the lowest vaccination rates for Rota1 and Rotac, Bahamas has been exerting its greatest effort in preventing spread of preventable diseases through immunization. In fact, measles and diphtheria vaccination in the Bahamas have significantly lowered the incidence of infection and death rate among children. However, prevalence of HIV infection is still high, causing 500 deaths in the year 2013. Aside from this, the country also draws its attention in providing immunization to its adult residents in order to prevent diseases such as hepatitis B, yellow fever, diphtheria/ tetanus (DT), and influenza, as well measles, mumps, and rubella.