IVAC at 10: Assessing Access and Tackling Tough Challenges
Efforts to expand vaccine access for children around the world have been a huge success of the past 10 years. Nearly 1.5 million children’s lives have been saved by Hib and pneumococcal vaccines alone since 2000, with much of that progress happening since 2010. Measles vaccination is estimated to have prevented 21.1 million deaths since 2000. What might imperil or aid in a continuation of this success? Bill Moss, the new executive director of the International Vaccine Access Center (IVAC), talks about future opportunities for global vaccine programs.
2019 marks IVAC’s 10th year as a center in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. IVAC grew out of two large projects that took a unique approach by bringing epidemiologists and vaccine clinical trialists together with experts in financing, strategic vaccine supply, policy, advocacy, and communications into a team with a single focus, nested within an academic institution and working closely with international agencies, in-country researchers, and leaders in 38 countries.
Since 2009, our scope has broadened and we now generate, synthesize, and interpret evidence on about 15 different vaccine preventable diseases, supporting policy makers based to increase vaccine equity and coverage to ensure access. We are working toward a common vision to create a world where people and communities are free of the health, social, and economic consequences of vaccine preventable disease.
5 critical knowledge gaps we are exploring in our work right now
1. How can broad and targeted mobile messaging generate demand for immunization?
A recent survey in Nigeria showed that at least 40% of children had never received any vaccine through the routine immunization program. Demand for vaccines remains poor, largely due to lack of information and knowledge about the vaccination program. We are working to improve vaccine coverage through broadcast mobile messages and targeted texts across one state, with potential for national scale-up.
2. Can blood tests reveal gaps in immunization programs?
Policy makers may be better able to evaluate the progress of vaccination programs—especially for measles and rubella elimination programs—by understanding population immunity through large-scale or targeted serological surveys. In India and Zambia, we are training dozens of health care workers and scientists to design, implement, and interpret serological survey for measles, rubella, and other vaccine preventable diseases, which may identify hidden gaps in immunization programs.
3. What is the economic cost of common, serious, and preventable childhood illness?
What does it cost when a child is hospitalized with measles, pneumonia, or diarrhea—from medical costs to lost productivity? Through projects like the Decade of Vaccine Economics study, we measure the economic value of vaccines. In Bangladesh and Uganda, we recently presented these costs to policy makers, who took away a clear message that these vaccine preventable diseases have a heavy health and economic burden.
4. Where in the world are children fully vaccinated against Hib, pneumococcal disease, and rotavirus? How can advocates implore policy makers to do more?
IVAC provides custom training enabling advocates and policymakers to understand the broad, cross-cutting value of immunization and develop strong, evidence-based cases for immunization. Training is supported by advocacy networks like ROTA Council and resources like VIEW-hub, which provides real-time information on vaccine use, product type, coverage levels, impact assessments, and disease burden estimates in easy-to-digest, interactive maps.
IVAC’s VoICE tool, an online compendium of evidence for vaccine advocates, contains more than 200 key ideas, data summaries, and sources illustrating the broad value of immunization and toll of vaccine preventable disease.
5. How can countries be proactive in protecting adults from vaccine-preventable disease?
Both young children and older adults are at higher risk for potentially devastating and debilitating vaccine preventable diseases. Countries prioritize and routinely immunize infants, yet the same cannot be said for older adults. We are developing technical guidance and aligning global advocates to ensure adults can maintain good quality of life and maximize their productivity by minimizing disability and death from vaccine preventable diseases.
The next 10 years
Throughout this work, IVAC is engaged in capacity building and training in countries to achieve our shared vision, to eliminate the health, social, and economic consequences of vaccine preventable disease.
The future presents challenges for immunization programs. We must improve access and equity, especially for newer and under-utilized vaccines such as the human papillomavirus (HPV) vaccines (we’re starting to work on this in South Asia). We need to do a better job of preventing disease in pregnant women, helping to protect their infants. Major changes in the world, from humanitarian emergencies to displaced populations and an increase in the urban poor, will challenge the incredible success immunization programs have achieved in the past decade.
Our partnerships with supportive global agencies and visionary leaders in countries around the world will be instrumental to continuing and expanding upon this progress. We will continue to partner with countries to bring important vaccines into communities, measure people’s access, and ensure equitable and complete coverage in communities.