In 1792, Edward Jenner demonstrated the value of immunization against smallpox. Nearly 200 years later, in 1977, smallpox was eradicated from the world through the widespread and targeted use of the vaccine. Through the 1980s, UNICEF worked with World Health Organization (WHO) to achieve Universal Childhood Immunization of the six EPI (Expanded Programme on Immunization) vaccines (tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis and measles) with the aim of immunizing 80% of all children by 1990. Progress has continued.
By 2011, 107 million children were vaccinated with three doses of diphtheria – tetanus – pertussis vaccine and global immunization rates were at 83%. The last 20 years have seen explosion in the number of new vaccines. Vaccines against Hepatitis B and Haemophilus influenza type B have been widely introduced.
An increasing number of countries are now offering pneumococcal conjugate vaccine and rotavirus vaccine in their immunization programs, thus offering protection against some of the leading causes of child deaths: pneumonia and diarrhea. Poliomyelitis is on the verge eradication, measles deaths have been reduced by 71% between 2000 and 2011, and maternal and neonatal tetanus has almost been eliminated as a public health disease.
UNICEF gives priority to ensure that children from the hardest to reach populations also have access to immunization: those with limited or no geographic access, the urban poor, minorities and children in conflict situation. Many obstacles must be overcome to bring immunization to children living in the hardest to reach community. Some live in remote villages, several days driving from health centers or cannot be easily reached due to lack of road transportation infrastructure. Others are continuously on the move, as is the case with nomadic tribes or peoples displaced due to political or economic upheaval.
Every infant in the world needs to be immunized to better protect their health, and vaccines are estimated to save the lives of 2–3 million children each year.
Immunization represents one of the 10 greatest achievements in public health of the last century and is also highly cost effective. For instance, it costs less than US$1 to protect a child against measles for life.
One and a half million children would not have died in 2011 had they been immunized. But one in five children is still not being reached with vital vaccines.
UNICEF procures vaccines that reach 36% of the world’s children. In 2012, UNICEF procured almost 1.9 billion doses of vaccine and over 500 million syringes. As the largest buyer of vaccines in the world, UNICEF works to keep vaccine prices at levels that low- and middle-income countries can afford. UNICEF and its partners supported immunization programs in over 100 countries last year.
Concentred efforts to immunize children have reduced or eliminated the incidence of devastating illnesses:
Smallpox was eradicated in 1980. Polio was recently eliminated in India and is now endemic in only three countries: Pakistan, Nigeria and Afghanistan.
Between 2000 and 2011, measles deaths dropped 71% worldwide.
29 countries eliminated neonatal tetanus between 2000 and 2013.
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Declaration of Interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.