Vaccines remain out of reach for poorer countries

Written by By Jeanne Hruska, CNN; Shannon Preston, CNN

Vaccines are a crucial tool for safeguarding public health in developing countries, where outbreaks of viral and bacterial diseases like measles, pneumococcal diseases and Haemophilus influenzae B (Hib) are common.

However, the comparatively low cost of the vaccines available in these countries and the low uptake rates among people in these countries are largely responsible for more than 70% of diseases by the age of 15 being eliminated, according to a study in The Lancet, published April 15.

They are also one of the leading causes of death in the world.

The paper — which analyzed data from 19 African countries — found that more than two-thirds of vaccines are unavailable, out of the worldwide stock of 7.7 million. The cost of a dose of pneumococcal conjugate vaccine — one of the most affordable vaccines — is 14 times greater than that of a “business-as-usual” vaccination program and more than double that of the lowest cost vaccine, the seroquine for malaria.

Researchers found that the lack of vaccines led to a large number of deaths, including deaths from pneumonia, tuberculosis, and acute diarrheal diseases like cholera and typhoid. It also led to an increase in morbidity, noting that people in India, Pakistan and Nigeria — which account for 50% of children deaths caused by vaccine-preventable diseases — die more from vaccine-preventable diseases than from malaria, cholera and pneumonia, which together account for 60% of global mortality from vaccine-preventable diseases.

The findings showed that about 17% of deaths were prevented due to improved vaccination coverage, but a “vast proportion” of these prevented deaths were not due to immunization at all. However, they also showed that the most significant reduction in mortality was achieved by vaccination rates in countries with low immunization rates — with access to immunization providing much greater benefit, given that vaccines can also improve survival and morbidity in these countries.

“Bolstering immunization coverage will be instrumental to creating a critical mass of children, adolescents and adults capable of bearing a special collective responsibility for the global health agenda,” the study authors wrote.

“One of the most important changes to the world’s vaccine landscape will be the scaling up of children in those countries that are not yet fully immunized,” said John Bolton, director of the International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health, in a press release.

For instance, immunization rates in countries like Mali and Niger are currently very low, Bolton said, and mass vaccination programs in Mali and Niger have proven to be very effective. “Nearly every child in the two countries was vaccinated,” he said.

Bolton said that further innovative research into access and cost effectiveness of vaccines will need to be implemented for vaccine administrations to reach people in poorer countries.

“Some vaccines in certain regions of the world are still not found on the market. Vaccines in some regions are expensive. This means we need to find more innovative ways to extend access to vaccines,” he said.

One example of an example of innovative research was the pilot study for a new formula of hepatitis B vaccine in Ghana, which has already provided a significant reduction in mortality, the study authors said.

“The use of two new formulations of Hepatitis B vaccine in Ghana demonstrated superior safety, reduced cost, and increased coverage rates,” they wrote.

The introduction of the vaccine also showed a boost in the prevention of the disease among children, the study found.

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