Immunization is a global health and development success story, saving millions of lives every year. Between 2010 and 2018, 23 million deaths were averted with the measles vaccine alone (1). The number of infants immunized each year – more than 116 million, or 86% of all infants born – has reached the highest level ever recorded. More than 20 life-threatening diseases can now be prevented by vaccination (2). Since 2010, 116 countries have introduced vaccines they did not use before (3), including those against major killers like pneumococcal pneumonia, diarrhea, cervical cancer, typhoid, cholera and meningitis.
Additionally, there have been many innovations in vaccine development. There are now vaccines for malaria, dengue and Ebola virus disease, and promising vaccines for respiratory syncytial virus, tuberculosis and all strains of influenza virus are in the pipeline. New research on broadly neutralizing antibodies and therapeutic vaccines is opening new horizons. Increasingly, vaccines protect health beyond infancy – into adolescence and adulthood, during pregnancy, and for the elderly.
Innovative ways are found to distribute and administer vaccines and to improve immunization services. Digital tools, new needle-free techniques for administering vaccines, and more robust vaccine storage and supply chains promise to transform immunization programs over the next decade. Rapid access to reliable data will provide new opportunities for national programs to continuously monitor and improve their performance, reach and effectiveness.
Vaccines are essential for the prevention and control of many communicable diseases and are therefore the basis of global health security. Moreover, they are widely considered essential for combating emerging infectious diseases, for example by containing or limiting outbreaks of infectious diseases or combating the spread of antimicrobial resistance. Regional epidemics (e.g. Ebola virus disease), the COVID-19 pandemic and the threat of future pandemics (such as with a new strain of influenza) have and will continue to strain even the most difficult health systems. resilient. A clear risk is a reduction in essential services and in particular vaccination and the prevention of other communicable diseases. Countries should identify essential services that need to be prioritized and maintained during emerging infectious disease threats and act as soon as possible to provide missed vaccinations. In the longer term, intensive and collaborative investments in research and development and an equitable supply of new vaccines will likely be part of the solution to preventing relapses.
Nevertheless, significant challenges remain. The benefits of vaccination are unevenly distributed: coverage varies widely between and within countries. Some populations – often the poorest, most marginalized and vulnerable, in fragile and conflict-torn contexts – have limited access to immunization services. Each year, 20 million infants do not even receive a full course of basic vaccines, and many more do not receive the latest vaccines. Among them, more than 13 million do not receive any vaccine under immunization programs – the “zero dose” children.
In some countries, progress has stalled or even reversed, and the risk that complacency will undermine past achievements is real. The outbreaks of measles and vaccine-derived poliovirus are stark reminders that strong immunization programs and effective disease surveillance are needed to maintain high levels of coverage and to eliminate and eradicate disease. Because measles is highly contagious, its presence serves as a tracer (the “canary in the coal mine”) of inadequate coverage and gaps in the health system. Detection of measles cases through surveillance reveals communities and age groups that are unimmunized or underimmunized and immunization programs and overall primary health care systems that are inadequate, indicating where a special attention and interventions are required. High measles vaccine coverage is an indicator of a strong immunization program, which can signal a strong foundation for primary health care services. The second dose of measles vaccine is an opportunity to place greater emphasis on strengthening immunization programs to reach children beyond the first year of life and to expand immunization services throughout life.
While all people should access immunization services, vaccines should be administered in geographically, culturally, socially or otherwise isolated areas and to marginalized populations such as displaced people and migrants and those affected by conflict, political instability and natural disasters. The causes of low vaccine uptake must be understood and addressed in order to increase people’s demand for immunization services. Sufficient and predictable supplies of appropriate, affordable and quality-assured vaccines should be available at service delivery points, and stock-outs should be avoided. Tailored strategies are needed to understand and overcome barriers to immunization, especially gender-related barriers of caregivers and health workers to accessing immunization services. New approaches are needed to reach older age groups and provide people-centred immunization services integrated with primary health care.
The Immunization program 2030 (IA2030) sets an ambitious and comprehensive global vision and strategy for vaccines and immunization for the decade 2021-2030. It builds on lessons learned, recognizes the ongoing and new challenges posed by infectious diseases, and capitalizes on new opportunities to address these challenges. IA2030 positions immunization as a key contributor to people’s fundamental right to enjoy the highest possible physical and mental health and also as an investment in the future, creating a healthier, safer and more prosperous world for all. IA2030 aims to ensure that we maintain hard-earned gains and also achieve more – leaving no one behind, in any situation or at any stage of life.
IA2030 aims to inspire and align the activities of community, national, regional and global stakeholders – national governments, regional bodies, global agencies, development partners, healthcare professionals, academic and research institutions, vaccine developers and manufacturers, private sector and civil society. Its impact will be maximized through more effective and efficient use of resources, innovation to improve performance, and measures to achieve financial and programmatic sustainability. Success will depend on building and strengthening partnerships within and outside the health sector in a coordinated effort to improve access to affordable, high-quality primary health care, achieve universal health coverage and accelerate progress towards the 2030 Sustainable Development Goals (SDGs).
IA2030 provides a long-term strategic framework to guide a dynamic operational phase, responding to changing country needs and the global context over the next decade. This document is therefore only a beginning. The IA2030 global vision and strategy will be complemented by annexes providing detailed technical information on the strategic framework, as well as new and existing immunization strategies and plans, including those for disease-specific programs to control, eliminate or eradicate the disease. IA2030 will become operational through regional and national strategies, a mechanism to ensure ownership and accountability, and a monitoring and evaluation framework to guide implementation in countries.
Through the collective effort of all stakeholders, we will achieve the vision of the decade: a world where everyone, everywhere, at all ages, fully benefits from vaccines for good health and well-being.