The COVID-19 pandemic shows how much we rely on vaccines to save lives

Opinion article by Pieter Bult, UNICEF Representative in Romania

UNICEF
Little girl is being vaccinated in Bacau country, Romania, 2019
UNICEF Cybermedia
30 April 2020

Well into our second month of lockdown, the main topics which command our attention in the news are: the heroic lengths doctors and nurses go to for their patients, how the economy, and implicitly our lives, will regroup after this unexpected standstill, and when the vaccine for COVID-19 will be available.

We have all watched Governments around the world ask their citizens to stay at home and flatten the infection curve, in an attempt to relieve the pressure on the health system, while the vaccine is being developed.

The COVID-19 outbreak has revealed not only our priorities, as we have all become more aware of our need to be safe, to protect and provide for our families and loved ones, but also what is at stake when communities do not have the protective shield of immunization against an infectious disease.

In its absence, we all must cope with the reality of social distancing. We are starkly reminded how fast an outbreak can spread without a vaccine to protect people and communities.

Which is why, as the frontline fight against the pandemic continues in hospitals and scientists are accelerating the vaccine development for COVID-19 in laboratories around the world, we must also make sure ground is not lost in the fight against vaccine-preventable diseases.

The pandemic is over-stretching the health system, diverting health workers to support the emergency response. Sometimes, health workers themselves get infected. For some children, and particularly for the most vulnerable, these disruptions mean reduced access to health services and missing out on critical vaccines, which, in turn, is putting them at greatest risk of outbreaks of other diseases.

Despite unprecedented progress in child rights in the last 30 years, 40 per cent of Romania’s children run such risks, especially rural poor children, Roma children, and children with disabilities. The poverty and vulnerabilities faced by Romanian children are still among the highest in the EU, and major disparities persist.

In a regrettable turn of events, measles and rubella, two preventable diseases almost completely eradicated in Romania, made a large comeback since 2016, with 19,088 cases confirmed until January this year. 64 people, among which 61 children, died. 

With a two dose vaccination protocol, measles broke out after substantial declines in immunization coverage in the last decades. It was only after UNICEF joined efforts with the Ministry of Health that the drop-in immunization coverage was stopped. It is currently up to 90 per cent from 2016 for the second dose, but still behind WHO recommendation of at least 95 per cent.

UNICEF worked with the Ministry of Health and WHO to raise the public awareness on immunization via TV, radio and social media, to rethink the national measles programme and the National Electronic Vaccination Registry, to improve the local health workers’ behavior and communication skills and conducted catchup immunization campaigns in areas with extremely low coverage: remote communities with vulnerable families.

To help parents understand the importance of vaccines and plan around it, the campaigns relied on door-to-door communication.

In the past years, UNICEF in Romania has worked with partners, national, regional and local authorities, to bring the minimal package of services services to 45 communities in Bacau, reaching over 46,000 households, including 21,000 children, with health, education, social and child protection services

The external evaluation showcased how the minimal package of services, relying on home visitation, generated fantastic results for the children, their families, and the entire community: 93 per cent of previously unregistered children are currently listed with a family physician and the percentage of unvaccinated children decreased with more than 40 per cent.

As authorities mobilise resources to for the nationwide crisis response and ask us all to contribute by staying at home, the pandemic is having us revisit an essential lesson: preventing outbreaks not only saves lives but requires fewer resources than emergency response.

In the case of vaccine preventable diseases, preventative actions such as vaccinations  also help reduce the burden on a health system already strained by the COVID-19 pandemic.

While the vaccine for COVID-19 is still in early stages, we are fortunate to have immunization for diseases like measles, rubella, tetanus or polio. Many of us grew up without seeing family or friends die or suffer life-long disabilities from such diseases. Vaccines have eliminated them, along with the visible and shocking impacts that make us fear infection.

Immunization is, in fact, globally recognized as one of the most successful and cost-effective public health interventions, the key to ending vaccine-preventable child deaths and giving children a chance to grow up healthy and reach their full potential. Just to come back to measles; globally measles immunizations have saved the lives of over 23 million children since 2000.

As the response to COVID-19 continues, we need to ensure the minimum package of services, including the community health nurse and Roma health mediator, and essential health services, including routine immunizations, are protected during the pandemic, to minimize the risk of further disease outbreaks and loss of life.

For that purpose, we must ensure the safety of health and community workers, parents and children, strong supply chains, and trained health workers.

We must also start rigorous planning now, based on an analysis of interruption of essential MCH services, including immunization, so we can intensify immunization programmes once the pandemic is under control. Thus, we can close the immunity gap for once and for all and avoid outbreak of other vaccine preventable diseases.

We are also happy to note that the normative framework ensuring the prerequisites for this to happen – promoting the minimum package of services – in now in the Chamber of Deputies for its approval.

Parents may feel overwhelmed with uncertainties and worries about the COVID-19 outbreak, about how it has changed their daily lives. As a parent of young children myself, I strongly urge parents to make sure children receive their routine immunizations and follow the guidance on preventive measures: physical distancing, hand washing and proper coughing and sneezing hygiene.

Last but not least, we must remember immunization is the right of every child and should reach every child. We need to continuously ensure that our commitment to child rights is matched with action for every Romanian child, particularly the most vulnerable.

Vaccines are safe, effective and life-saving tools to control and prevent the outbreak of infectious diseases. Routine immunizations save children’s lives.

And now more than ever, is vital to act to keep children safe and healthy.