“Leaving no one behind – saving lives through immunization” exhibit
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15 March 2018 marked the 7th anniversary of the conflict in Syria. Disruption of immunization services and outbreaks of vaccine-preventable diseases, including polio and measles, have been among the many tragic consequences of this crisis. Since circulating vaccine-derived polio was detected in 2017, nearly 1200 polio vaccination teams working from a field office in Gaziantep, Turkey, have fanned out across northern Syria to vaccinate over 750 000 children.
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An outbreak of measles in late 2017 in displacement camps in Idleb and Aleppo, Syria, spurred an emergency response from the WHO Gaziantep field office to protect at-risk children with UNICEF-procured vaccines.
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More than 48 000 children aged 5–15, in 275 camps, have already been vaccinated with the measles-containing vaccine, and a campaign to reach 688 000 children under the age of 5 was launched in April 2018.
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Vaccination against polio dropped by half in Ukraine between 2007 and 2014, from an estimated 98% coverage with the third dose in 2007 to a low of 45% in 2014. On 1 September 2015, Ukraine’s Minister of Health announced that circulating vaccine-derived polio had been identified as the cause of paralysis in 2 children living in south-western Ukraine. This outbreak was a threat not only to Ukraine, but to the entire European Region, which was declared polio-free in 2002.
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In response to the polio outbreak in Ukraine, 3 rounds of supplemental immunization were conducted to protect millions of un- or undervaccinated children. Timely procurement of vaccines and outreach to vulnerable populations were also key to ensuring that no child was left behind. Experts concluded in May 2016 that the virus was no longer circulating in Ukraine.
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An outbreak of measles that began in Romania in 2016 has spread across the entire country affecting thousands of people of all ages and killing over 40. In response to the outbreak, the recommended age to receive the first dose of measles-containing vaccine was lowered from 12 to 9 months, routine immunization was enhanced and an information campaign was launched to raise awareness.
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To protect a whole community and reach measles elimination, sustained 95% routine coverage with 2 doses of measles-containing vaccines is needed. Coverage in Romania had fallen to 76% nationally and even lower in some areas in 2016. Community health-care providers play a key role in stopping the outbreak by identifying unvaccinated children, advising parents and encouraging them to register their children with health services.
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Vaccinator Tabo Anthony gives a dose of oral polio vaccine to 7-month-old Bassil, being cradled by his mother, Angelina Dominic, outside the family home, in Juba, South Sudan. Vaccinators went door to door to immunize children during the polio National Immunization Days (NIDs) campaign that took place in March 2017. NIDs are mass campaigns to deliver supplemental doses of polio vaccines in areas that could be at risk of outbreak. No cases of wild poliovirus have been reported in South Sudan since 2009. However, recent cases in Nigeria, disruption in routine health services and low routine immunization coverage have put the country at risk.
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UNICEF health worker, Chris Otti, brings vaccine carriers containing tetanus and polio vaccines to a pick-up truck outside a hospital, ahead of a rural vaccination drive in Koch County, in Bentiu, South Sudan. In May 2017, UNICEF and WHO conducted a vaccination campaign to protect children and pregnant and lactating mothers against polio and tetanus. It is vital that vaccines be stored at the appropriate temperature from the time they are manufactured up until the moment they are used. High temperatures or a drop in temperature below 0 ˚C, for freeze sensitive vaccines, can cause vaccines to lose their potency – that is, their ability to provide protection against diseases.
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A child watches as a health volunteer administers a tetanus vaccine to a woman in the village of Buaw in Koch County, South Sudan. Last May, UNICEF and WHO conducted a vaccination campaign to protect children and pregnant and lactating mothers against polio and tetanus. According to the Health Management Information System, a data collection system, only about 45% of children received polio and pentavalent vaccines before the age of 1, in 2016. Pentavalent vaccines protect children against hepatitis B, pertussis, diphtheria, tetanus and haemophilus influenzae type b (Hib). Collecting and managing data is an essential component of good vaccine delivery.
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Sajeda Begum, 27, prepares 1 of the 2 vaccines for Mohammed Hassan, 13 weeks, in Paschim Panerchara, Ramu, a rural subdistrict of Cox’s Bazar, Bangladesh. Mohammed Hassan is receiving a pneumococcal conjugate vaccine (PCV) and a pentavalent shot – 2 vaccines included in Bangladesh’s routine immunization programme that will protect him against several diseases including diphtheria and hepatitis B. Sajeda Begum has been a community health worker in Ramu for over 8 years. Four times per week, she takes a tuk-tuk and walks up to 10 km with her vaccine carriers to raise awareness about routine immunization and vaccinate children. “When I started, most people had never heard of vaccination. Now, they often bring their children to me before I go to them,” says Sajeda Begum.
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Ameena, 20, receives a tetanus shot at the Balukhali refugee camp health centre in Cox’s Bazar, Bangladesh. Ameena is pregnant. The community health worker who tours the camp to raise awareness about primary health care and vaccination advised her to get vaccinated against tetanus. Ameena and her family fled violence in Myanmar’s Rakhine State last August. It took the family over 10 days to walk to Bangladesh. Since August, more than 668 000 Rohingya refugees – about 400 000 of them children – have fled Myanmar for camps over the Bangladesh border.
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A Rohingya refugee child grimaces as he is administered a vaccine for diphtheria by a health worker at an immunization centre in Bormapara makeshift settlement, Cox’s Bazar, Bangladesh. A diphtheria outbreak swept through the Rohingya refugee camps of Cox’s Bazar last November. The Government of Bangladesh, with the support of UNICEF, WHO, Gavi – the Vaccine Alliance – and health sector partners, launched a campaign to vaccinate more than 475 000 children in Rohingya refugee camps, temporary settlements and surrounding areas. Three rounds of vaccination with diphtheria containing vaccines took place between December 2017 and March 2018.
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The photo and video exhibit “Leaving no one behind – saving lives through immunization” opened in UN City in Copenhagen, Denmark, on 23 April 2018, to coincide with the start of European Immunization Week. It was created jointly by WHO/Europe and UNICEF.
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Her Royal Highness, The Crown Princess of Denmark, WHO/Europe’s patron, visited the exhibit prior to its launch. She has been the patron of WHO/Europe since 2005. In this role, she advocates for health promotion and disease prevention, including immunization.
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“By ensuring ourselves and our children are vaccinated we prevent the spread of dangerous infections, and by seeking and sharing credible and trustworthy information we empower ourselves and others to make the right decisions,” said Her Royal Highness, The Crown Princess of Denmark, WHO/Europe’s patron, in a statement released during European Immunization Week.