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| DUMBEST & DUMBEST! |
The Staggering Success of Vaccines
Vaccines are the first step toward health equity in many parts of the world
This article is part of “Innovations In: Solutions for Health Equity,” an editorially independent special report
Once a week, early in the morning, community health worker Kiden Josephine Francis Laja mounts her bicycle and pedals as far as 10 miles away from her small village in South Sudan. Some weeks Laja is doing outreach, spending her day educating a community about which vaccines she can provide and what diseases they prevent. “It’s my responsibility to tell the mothers to bring the children for vaccination,” she says. She answers their questions and lets them know she’ll be back, usually the following week, to vaccinate their children. Late in the evening she mounts her bike and heads home.
When Laja returns with the vaccines, kept in a cooler with ice packs, she will spend the day immunizing anywhere from a few to 200 children against a range of diseases: polio, tetanus, diphtheria, pertussis, hepatitis B, influenza, bacterial meningitis, tuberculosis and, more recently, COVID. Most people in high-income countries haven’t seen these diseases in decades, but the people of South Sudan know them well. Many have seen family and friends die from them.
During the rest of the week Laja works at the community health center in her village of Pure, monitoring the solar-powered refrigerator and the vials inside. She vaccinates anyone who comes to the facility and metes out drugs for a few maladies such as ulcers, malaria and typhoid. But the village doesn’t have antibiotics—or electricity. Villagers grow their own food, raise goats and chickens, and get their water from wells in the ground.
It’s not easy work for just $102 a month, especially when it sometimes takes three months for the 25-year-old mother of two to get her pay. When it rains on travel days, she and her outreach pamphlets get soaked. She must regularly check the temperature of the vials in the cooler and replace the ice packs at just the right time to ensure the vaccines don’t go bad.
People in South Sudan don’t have much, but they have this program. “Vaccines are very important to me and my community and even to my country,” Laja says. During a large outbreak of measles that began in 2022 in the country, thousands of children suffered from the disease, and many died, leading to a nationwide vaccination campaign in 2023. “Now in our community you cannot find cases of measles,” she says.
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| In a 2014 interview with the Baltimore Jewish Times, Kamenetsky called vaccines a “hoax”
and his wife, Temi, has been a figure on the anti-vax circuit,
according to reports. A year later, the rabbi signed a letter
authorizing a major yeshiva in Lakewood, N.J. to admit unvaccinated
children. He said the "Polio vaccine is a hoax as well." |
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Signatories: Shmuel Kaminetzky, Malkiel Kotler, Mattisyahu Salomon Claims of a ‘Hoax’ - Ignoramuses of the Worst Kind In Leadership Positions - The Dangerous Nepo Babies (look it up)
In a 2014 interview with the Baltimore Jewish Times, Kamenetsky called vaccines a “hoax” and his wife, Temi, has been a figure on the anti-vax circuit, according to reports. A year later, the rabbi signed a letter authorizing a major yeshiva in Lakewood, N.J. to admit unvaccinated children. “What about the people who clean and sweep in the school?” he told the Baltimore Jewish Times. “They are mostly Mexican and are unvaccinated. If there was a problem, the children would already have gotten sick.” There is no validity to allegations that South and Central American immigrants are vaccinated at a lower rate than the rest of the U.S. population. Some Hasidic anti-vaxxers have cited Kamenetsky’s comments highlighted in an online pamphlet circulating in the community. They point out he’s a member of the esteemed Moetzes and considered one of the leading rabbis of this generation. |
Around the globe the measles vaccine has saved nearly 94 million lives over the past 50 years.
This and other vaccinations have revolutionized global health. “Immunization is the most universal innovation that we have across humankind,” says Orin Levine, a fellow at the Center for Global Development in Washington, D.C. He notes that there are people around the world without access to telephones or even toilets, but they find ways to get their children immunized. “It’s the innovation that demonstrates what is possible in terms of delivery of service to everyone everywhere.”
A May study in the Lancet estimated that vaccines against 14 common pathogens have saved 154 million lives over the past five decades—at a rate of six lives every minute. They have cut infant mortality by 40 percent globally and by more than 50 percent in Africa. Throughout history vaccines have saved more lives than almost any other intervention. And vaccines’ promotion of health equity goes far beyond preventing death. The Lancet study found that each life saved through immunization resulted in an average 66 years of full health, without the long-term problems that many diseases cause. Vaccines play a role in nearly every measurement of health equity, from improving access to care, to reducing disability and long-term morbidity, to preventing loss of labor and the death of caretakers.
“Vaccines level the playing field....But frankly, it was a really long road to get to that kind of equity.”
—Nicole Lurie Coalition for Epidemic Preparedness Innovations
“We say vaccines are one of humanity’s great achievements in terms of having furthered the lifespan and life quality for humanity in the past 50 years,” says Aurélia Nguyen, chief program officer at Gavi, the Vaccine Alliance, a public-private partnership that works to ensure low- and middle-income countries have access to vaccines against more than 20 infectious diseases. Of all the different health interventions that exist, she says, “vaccines have the widest reach across the world.” The clearest evidence of vaccines’ impact on equity is that they are often the first intervention introduced into a community with no other health-care resources.
“When you don’t have a health worker or health system, there’s nothing. If you have no money, then you want the best bang for the buck, and it’s going to be immunization,” says Seth Berkley, former CEO of Gavi. “For every dollar you invest in immunization, you get $54 of benefit. From a cost-effectiveness point of view, it’s the best investment, so it tends to be the intervention that gets out to those communities first. And once you do that, you have a health worker who’s visiting those communities on a regular basis, and then that begins to start the conversation toward more primary health care, and that leads to getting a basic clinic set up. Immunization is the vanguard of the health system.”
Every country in the world has an immunization program thanks to the World Health Organization’s Expanded Program on Immunization, which was established in 1974. “Every single country and territory” has access to at least some vaccines, says Kate O’Brien, director of the WHO’s immunization, vaccines and biologicals department. Poverty, malnutrition, underlying health conditions, overcrowding, human conflict, displacement, and lack of access to medical care, hygiene or sanitation—all of these are risk factors for infectious disease, O’Brien says. Vaccines’ ability to reduce disease in the settings most plagued by these problems gives them disproportionate power to improve equity.
There may be no greater demonstration of vaccines’ power to deliver health equity than their success with smallpox. “The magnitude of the accomplishment of having eradicated smallpox, where absolutely nobody on this earth gets the disease,” O’Brien says, “that’s the ultimate in the issue of equity.”
A version of a smallpox vaccine was developed in 1796, and in 1959 global health experts decided to pursue full eradication. In the decade that followed, it became clear that such an ambitious goal would require more than political will. Although smallpox had been eliminated from North America and Europe, frequent outbreaks continued in South America, Africa and Asia.
In 1967 the WHO started its Intensified Eradication Program, which prompted a series of innovations. The bifurcated needle, which was developed around that time, allowed for smaller doses and required less user expertise for vaccine delivery than the previously favored jet injector. Researchers created a surveillance system to better track disease and vaccinate close contacts of infected people, making mass vaccination campaigns more effective. The last documented case of smallpox occurred in Somalia in 1977, and the WHO declared smallpox officially eradicated three years later.
https://www.scientificamerican.com/article/see-how-many-lives-vaccines-have-saved-around-the-world/