Vaccination as a Health Equity Issue

By Paige Hammond and Renata Schiavo ​

 "Life or death for a young child too often depends on whether he is born in a country where vaccines are available or not.” - Nelson Mandela

Vaccines are one of the greatest achievements of public health, and thanks to various public health heroes, the threats from many dangerous diseases have been minimized - and in some countries, fully eradicated - as a result of vaccination. Vaccines play an integral role in keeping us healthy and safe, yet we often take them for granted in countries like the United States where vaccination rates are high. 

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A look back in history will remind us of how fortunate we are to have various life-saving vaccines available to us today. Many people may not remember that prior to the invention of the polio vaccine, patients with respiratory paralysis were breathing through the iron lung - a machine that was less than ideal for patients, especially those who suffered over the long-term from the disease. Measles spread rampant amongst children, and levels of fear and anxiety were high among parents and communities as a result. Most recently, the COVID-19 vaccine allowed the world to effectively re-open. A recent study showed that among people infected with COVID-19 in the United States, those who were unvaccinated were 2.46 times more likely to die from the infection in comparison to those who had received the vaccine (1). Thanks to the effectiveness of the COVID-19 vaccine, as a society we were more comfortable emerging from our homes, visiting our family and friends, and returning to our work and life. Overall, we owe to vaccines our optimism about life. Vaccines have contributed to the health and well-being of our loved ones, and children and families in the United States and around the world.

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According to the CDC Morbidity and Mortality Weekly Report from August 2024, in the United States, the routine childhood vaccinations of children who were born during 1994-2023 “will have prevented approximately 509 million cases of illness, 32 million hospitalizations, and 1,129,000 deaths, resulting in direct savings of $540 billion and societal savings of $2.7 trillion.” (2) 

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​Vaccine Equity
Looking at one of the most vulnerable groups - children - helps to determine where we are in terms of achieving equity in vaccine distribution globally. The numbers show us that we are far from equitable distribution. Vaccines do more than keeping children healthy - they keep children alive. Yet 1 in 5 children don’t have access to lifesaving vaccines (3). When comparing children who received life-saving vaccines to children with no history of vaccination in 2024, the former group is 40% more likely to live to their next birthday (4). 

The number of zero-dose children in lower-and middle-income countries has increased drastically after the pandemic, by close to 3 million (3). “Zero-dose” children refer to children who haven’t received basic vaccines. According to WHO, 2023 data shows that we still have not returned to 2019 pre-pandemic immunization levels (5). Collaborative effort from across the globe is necessary to provide increased access to vaccines and reduce the number of zero-dose children. Programs like GAVI, The Vaccine Alliance have been providing life-saving vaccines to children in lower-income countries. They have helped to vaccinate over 1 billion children and thus have prevented over 18 million deaths (6). 
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Recent regulatory and funding changes at the U.S. Federal Government level are jeopardizing children’s ability to thrive and grow older. We need to continue to recognize, protect, and fund programs and agencies like GAVI, USAID, the CDC’s Global Immunization Division, and many other organizations to expand vaccine access globally. 

As the COVID-19 pandemic has demonstrated, health is social, and infectious diseases are just a plane ride away. Vaccines contribute to stopping the spread of infectious diseases, effectively preventing disease outbreaks and epidemics.  Vaccines also contribute to overall global health outcomes, as well as peace and security, by strengthening solidarity and global alliances, and rallying key decision-makers around the common goal of making sure children and families have the opportunity to thrive.

As a reminder, immunization averts an estimated 4.4 million deaths each year (7). Therefore, it’s a moral imperative to continue to advocate for increased and equitable access to vaccines. It’s a simple way to save so many lives - a quick pinch can make a world of a difference! 

References

1. Ikeokwu, A. E., Lawrence, R., Osieme, E. D., Gidado, K. M., Guy, C., & Dolapo, O. (2023). Unveiling the Impact of COVID-19 Vaccines: A Meta-Analysis of Survival Rates Among Patients in the United States Based on Vaccination Status. Cureus, 15(8), e43282. https://doi.org/10.7759/cureus.43282 
2. Zhou, F., Jatlaoui, T. C., Leidner, A. J., Carter, R. J., Dong, X., Santoli, J. M., Stokley, S., Daskalakis, D. C., & Peacock, G. (2024, August 8). Health and economic benefits of routine childhood immunizations in the era of the vaccines for Children Program - United States, 1994–2023. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/73/wr/mm7331a2.htm  
3. Centers for Disease Control and Prevention. (n.d.). Fast facts on global immunization. https://www.cdc.gov/global-immunization/fast-facts/index.html#:~:text=Overview&text=Download-,1%20in%205%20children%20globally%20do%20not%20have%20access%20to,%2D%20and%20middle%2Dincome%20countries   
4. Shattock, A. J., Johnson, H. C., Sim, S. Y., Carter, A., Lambach, P., Hutubessy, R. C., Thompson, K. M., Badizadegan, K., Lambert, B., Ferrari, M. J., Jit, M., Fu, H., Silal, S. P., Hounsell, R. A., White, R. G., Mosser, J. F., Gaythorpe, K. A., Trotter, C. L., Lindstrand, A., … Bar-Zeev, N. (2024). Contribution of vaccination to improved survival and health: Modelling 50 years of the Expanded Programme on Immunization. The Lancet, 403(10441), 2307–2316. https://doi.org/10.1016/s0140-6736(24)00850-x 
5. World Health Organization. (2024, July 15). Immunization coverage. https://www.who.int/news-room/fact-sheets/detail/immunization-coverage 
6. GAVI, the Vaccine Alliance. (n.d.). About our alliance. https://www.gavi.org/our-alliance/about  
7. Unicef. (2024, July). Immunization. https://data.unicef.org/topic/child-health/immunization/ 

Image Credit
Pexels, CDC: https://www.pexels.com/photo/boy-getting-a-vaccine-3997722/  
Canva
Pixabay, lukasmilan: https://pixabay.com/photos/coronavirus-mass-testing-covid-19-5739918/ 

Authors' Bios
Paige Hammond is the Freelance Project Coordinator for Health Equity Initiative. She graduated with a dual degree in Public Health and Communication Studies from The College of New Jersey.
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Renata Schiavo, PhD, MA, CCL is a global health practitioner and a public health/sociomedical sciences academic. She is the Founder of Health Equity Initiative and serves as Board President on the organization’s Board of Directors. She has 25+ years of experience on addressing vaccine hesitancy, building trust, promoting immunization behavior, and preventing vaccine inequities among a variety of groups and communities in the United States and globally. 

Disclaimer
The views and opinions expressed here are those of the authors only and do not necessarily reflect the views and positions of any of the organizations/entities with which the authors are affiliated. No endorsement of the authors’ opinions in this blog post by any of these organizations/entities is implied here.