Special focus on challenges and opportunities for the development and use of vaccines in Africa
Shabir A Madhi1,2,3, Helen Rees3,4
1a Faculty of Health Science, Medical Research Council: Respiratory and Meningeal Pathogens Research Unit , University of the Witwatersrand , Johannesburg , South Africa.
Insights
Childhood immunization is crucial for public health, yet millions remain unvaccinated. Addressing the complex, multi-factorial reasons for under-immunization in sub-Saharan Africa is vital for reducing child mortality and achieving health equity.
Area of Science:
- Public Health
- Epidemiology
- Global Health
Background:
- Childhood immunization is a highly effective public health intervention against vaccine-preventable diseases.
- Globally, approximately 19.9 million infants are under-immunized or unvaccinated annually.
- Sub-Saharan Africa faces a disproportionate burden of vaccine-preventable diseases and stagnant vaccination coverage.
Discussion:
- Analysis of District Health Surveillance data from 35 countries reveals challenges in improving vaccination rates in sub-Saharan Africa.
- Vaccination coverage for the primary infant vaccine series in sub-Saharan Africa has stagnated around 72% over the last decade.
- Under-immunization in the region is multifactorial, with variations occurring between and within countries.
Key Insights:
- The complex reasons for childhood under-immunization necessitate tailored, country-specific strategies.
- District or sub-regional level analysis is crucial for understanding and addressing localized barriers to vaccination.
- Improving vaccination coverage is essential for reducing under-5 morbidity and mortality.
Outlook:
- Targeted interventions are needed to overcome barriers to childhood immunization in sub-Saharan Africa.
- Addressing under-immunization is critical for achieving Universal Health Coverage and Sustainable Development Goals.
- Further research into context-specific factors influencing vaccination uptake is recommended.
Abstract:
Immunization of children against vaccine-preventable diseases is one of the most cost-effective and potentially equitable public health interventions. Nevertheless, approximately 19.9 million of the world's annual birth cohort are either under-immunized or have not been vaccinated at all. Understanding the factors contributing to under-immunization in settinsg such as sub-Saharan Africa which bears a disproportionate burden of vaccine preventable diseases is key to unlocking the full potential that vaccines offer in reducing under-5 morbidity and mortality. The series or articles in this issue of the Journal, mainly through systematic analysis of District Health Surveillance data bases from 35 countries, highlight the challenges faced in improving vaccination coverage rates in sub-Saharan Africa which has stagnated at approximately 72% for completion of the primary series of infant vaccines over the past decade. The reasons for under-immunization of children is sub-Saharan Africa is identified to be multi-factorial and may differ between and within countries. This highlights the need for country-specific, possibly at a district or sub-regional level, interrogation of factors contributing to under-immunization of children, to work toward providing Universal Health Coverage as envisioned in the Sustainable Development Goals.
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