Controlling the spread of disease | The Children's Hospital of Philadelphia

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Global Immunization: Controlling the Spread of Disease

Because no country in the world exists in complete isolation, control of diseases must be collaborative. While communication between countries and regions must be open and disease tracking coordinated, public health approaches and vaccine schedules may vary depending upon disease rates, population susceptibility and public health resources.

Tracking disease and measuring vaccine success
Types of vaccination programs
Goals for vaccination programs
Variation among vaccine schedules

Tracking disease and measuring vaccine success

The World Health Organization (WHO) leads and coordinates issues pertaining to international health. WHO consists of 193 member countries and is organized into six regions:

The work of the WHO is carried out by experts working with health officials in regional and local offices of countries in which they are employed, and by an extensive network of laboratories around the globe. These offices and labs confirm cases of disease, track changes to viruses and bacteria, track movement of diseases throughout the world, coordinate disease control efforts and monitor the success of interventions, such as vaccine programs.


Types of vaccine programs

There are different types of vaccine programs. The best method varies depending on geography, disease prevalence, and culture. Vaccine coverage for a population can be accomplished by:


Goals for vaccine programs

The measure of success for different vaccine programs may vary, depending on the disease, geographic location and maturity of the vaccine program:

Successful meningitis vaccine program in Africa

There is significant excitement and hope surrounding a new vaccine that prevents a common type of meningitis in Africa. Meningitis A epidemics occur every 7-14 years in a region of sub-Saharan Africa known as the “meningitis belt.” During these epidemics, thousands die within a day or two of becoming ill. Of those who survive, about 15 of every 100 are left with permanent disabilities, including brain damage, hearing loss, or learning disabilities.

In 2001, the World Health Organization (WHO) and PATH, an international nonprofit dedicated to breaking the cycle of poor health, formed a partnership known as the Meningitis Vaccine Project. With support from the Bill and Melinda Gates Foundation, the partnership worked with African governments and various partners to develop a vaccine that would be effective and affordable in this region of the world.

After clinical trials showed the vaccine to be safe and effective, the vaccine known as MenAfriVac™ was made available. During December 2010, the country of Burkina Faso conducted a large-scale immunization program. Vaccine was made available for everyone in the country younger than 30 years old. The president attended kick-off celebrations, and families stood in lines to have their children immunized against the dreaded disease. Public health officials immunized about 11 million people in less than two weeks. Early disease surveillance results have excited public health officials. With the 100 millionth person vaccinated with MenAfriVac™ during the week of December 3, 2012, the Meningitis Vaccine Program is on track to accomplish its goal of immunizing 300 million people with the vaccine by 2015.

Learn more and watch videos about the project by visiting the Meningitis Vaccine Project website.

Update on polio eradication efforts

Administration of the polio vaccine has led to a tremendous decrease in the number of cases that occur throughout the world each year. During 2011, slightly more than 700 cases of polio occurred throughout the world, which was less than half the total number of cases that occurred the previous year.

There are three countries where polio transmission has never been successfully stopped. These include the African nation of Nigeria and the Asian countries of Afghanistan and Pakistan. In January 2012, India celebrated the first year in history in which no child was paralyzed by polio. Only one case was reported in that country over the one-year period.

While polio eradication efforts continue, there are different reasons for these strongholds of disease.

Nigeria - efforts in this region have suffered from vaccine safety concerns and political instability and corruption. A few years ago some people in the region refused vaccine out of unfounded concerns of contamination. Recent efforts have been hampered by a lack of government infrastructure and support as well as corruption. In 2008, Nigerian cases accounted for almost half of the worldwide total.

Afghanistan and Pakistan - the conflicts in this region have made optimal vaccine coverage difficult to achieve. In regions of both countries vaccine operations are not allowed. Similarly, even in regions where vaccine program agreements have been forged, there has been violence. In 2012, nine humanitarians working for a polio vaccination campaign in Pakistan were killed. In addition to compromising vaccine coverage, these unstable conditions have led to difficulties in monitoring disease spread.


Variation among vaccine schedules

Vaccine schedules vary from country to country and sometimes even within countries. These differences can include which vaccines are recommended, who should get them, when they are given, and how many doses are needed. There are several reasons for this variation:

Why are different vaccines recommended?

Why are different people recommended to get vaccines?

Why are vaccines given at different ages?

Why are there differences in the number of doses given?

The World Health Organization recommends the following vaccines for all infants and young children: pneumococcal, rotavirus, rubella, tuberculosis, polio, diphtheria, tetanus, pertussis, hepatitis B and measles. Yellow Fever and Haemophilus influenzae type b vaccines are recommended for some populations.

The WHO offers a useful tool for vaccine schedules around the world. You can view information based upon country or region, vaccine (referred to as "antigen") or both.


Updated: January 2013

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