Vaccinations Save Lives: A Conversation with Global Health Experts

The world has made incredible strides to expand access to vaccines, saving 154 million lives in the last five decades alone. That’s about six people saved every minute of every year.

But access to vaccines has always been uneven. Now progress closing gaps in immunization coverage has stalled. In 2023, 14.5 million kids never received a single dose of any vaccine.

Every child should be protected from vaccine-preventable diseases — no matter who they are or where they live.

Dr. Cecilia Mundaca Shah, Vice President of Global Health Strategy, and Elizabeth Thrush, Senior Officer for Polio and Immunization Advocacy, sat down for a wide-ranging discussion on the lifesaving power of vaccines, where we’re falling short, and how misinformation is eroding progress and leaving communities behind.

The conversation has been edited for clarity and length.

The Progress Made Possible by Vaccines

Megan: Vaccines are one of humanity’s greatest achievements. What progress has been made possible by vaccines?

Liz: Absolutely. Vaccines have been around for a long time. The first vaccine was created in 1796 for smallpox. But vaccines have only been widely available for the last 50 years, and that’s when we’ve really seen how they can change — and save — lives.
Thanks to vaccines we eradicated smallpox, a disease that once killed millions and wiped out entire communities. We don’t have to worry about it anymore. We don’t even have to be vaccinated against it because it’s been eradicated, which means it’s completely gone.

And we’re on the brink of eradicating polio, a disease that used to cause so much fear for parents and children everywhere. When polio was at its peak in the United States in the 1950s, before the vaccine was created, parents were afraid to let their children go swimming in the summer. Kids could be exposed to the virus while swimming with friends and wake up the next day unable to walk. That was a real threat. And that was not that long ago. We don’t think about it today because most people have never seen polio. But if you ask polio survivors, like my uncle, they wish they could have been vaccinated.

We’re so lucky that vaccines exist.

Ceci: Yes, and because vaccines exist, we can also prevent severe cases of many other diseases. There’s a misconception that if you get vaccinated, you won’t get the disease. And that can create a lot of mistrust, because people don’t understand why they got the flu after getting the flu vaccine. But vaccines protect you from getting sicker and potentially dying from a disease. And that’s especially true for people with underlying conditions whose bodies would not be able to tolerate an infection.

Vaccines are a very powerful tool, but they are also an entry point to other critical health services. When a child gets vaccinated, the health care worker can also check the child’s growth and nutrition and identify other health conditions that refer those children to get appropriate care. Vaccines do even more than prevent disease and death; they support so many other services that help communities stay healthy.

Childhood Vaccination Saves Lives

Megan: Why are we seeing so many outbreaks of vaccine-preventable diseases right now, like measles and polio?

Liz: There’s a simple reason we’re seeing these outbreaks: gaps in childhood vaccination coverage. I’ve always loved the quote, “Vaccines don’t save lives. Vaccinations save lives.” Because it’s not enough to have a vaccine. We need to make sure children are immunized. And when we don’t have sufficient immunization levels, outbreaks occur.

Measles is so infectious that one person can infect up to 18 other people. A person with measles only has to spend a few minutes in a room to infect someone else in that same room two hours later. It is so contagious that it takes 95% of a community to be vaccinated to keep people safe. But the global average is only 83%, which of course means a lot of countries have less coverage. Even small communities within a country that are under-immunized present a risk, which is what we’re seeing in the U.S. with the latest measles outbreak.

We’re also seeing polio come back in countries that had previously eliminated the disease, which means there were no new infections occurring naturally in a community because the virus was no longer present in the environment. Last year, a child in Gaza was paralyzed from polio for the first time in 20 years, and the virus was detected in wastewater in five European countries in the last year alone. That means poliovirus is present in the environment, so any child that is not vaccinated is at risk.

Access to Vaccines Protects Public Health

Megan: We often hear that an outbreak anywhere is a threat everywhere, but what does that really mean?

Ceci: We saw very clearly during the COVID-19 pandemic that diseases don’t respect borders, especially respiratory viruses that can be quickly transmitted from one person to another.

And our world is changing. We have more conflict. We have climate change. We have economic instability. And it’s all driving record levels of displacement. And migrant and refugee populations often don’t have access to health services, which makes it easier for diseases to spread without being detected or stopped.

That’s why when we think about vaccines, we need to think about them as global public goods. And like Liz said, it’s not enough to develop a vaccine. What’s critical is getting vaccines to the people that need them the most.

Megan: What is being done to leave no one behind when it comes to vaccines?

Ceci: Partnerships have driven so much of the immunization success we’ve seen around the world. Gavi, the Vaccine Alliance is one of the most transformative examples. Gavi has vaccinated over a billion children since 2000 and was instrumental in making sure poor countries were able to access COVID-19 vaccines.

Another example that the UN Foundation is proud to support is the Global Polio Eradication Initiative (GPEI). It’s a collaboration between the World Health Organization (WHO), UNICEF, and the U.S. Centers for Disease Control and Prevention and nongovernmental partners like Gavi, the Gates Foundation, and Rotary International. There has been a 99.9% reduction in polio cases since GPEI was launched in 1988.

The success of these partnerships really hinges on the strength of their local partners. In communities, nothing happens without trust, and it’s the health workers on the front lines of this effort who have earned their community’s trust to be able to deliver the vaccines.

Liz: At the UN Foundation, we launched a new fund to help middle-income countries with their vaccination response. We set a goal of raising $15 million when we launched the Outbreak Prevention and Preparedness Fund last year and so far we have raised $8 million. The funds go to WHO and UNICEF to help middle-income countries respond to vaccine-preventable disease outbreaks.

There were not a lot of ways for middle-income countries to find support before the launch of the fund. While they often have some funding available for their own response, there usually isn’t enough, and they can’t always access the funds quickly enough. The Outbreak Fund can help kick-start a response, and that’s important because we know that time matters. The faster the response, the more lives saved and the sooner the disease stops spreading. I’m really excited about the fund and the impact it’s having, and will hopefully continue to have, as we bring in new private sector donors.

Vaccine Research Leads to New Achievements

Megan: Have there been any recent vaccine breakthroughs or advancements that give you hope?

Ceci: Yes, vaccine research has led to achievements we didn’t think were possible. The first-ever malaria vaccines are being rolled out, giving children an opportunity to have a healthy childhood. And we saw breakthroughs during the COVID-19 pandemic, when new mRNA technology led to the development of a vaccine in record time. And now, there is a new effort to ensure we can develop safe and effective vaccines for future pandemic threats within just 100 days.

Liz: One thing that I’m excited about is the research being done on what’s called the cold chain. For most vaccines to be effective, they need to stay cold. Some of them need to stay very cold. But research is underway on increasing temperature stability for vaccines so they can be effective even when they’re not cold. And that’s important because a lot of places don’t have electricity and power outages can happen anywhere, but right now if a vaccine breaks the cold chain, it’s likely not going to be effective. If we can get to a point where we have cheap, effective, and reliable temperature-stable vaccines, we’re going to be able to close a lot of gaps in coverage. We’re still a bit far away from that breakthrough, but we’re getting there.

Ceci: COVID-19 revealed a lot of challenges that still need to be addressed when it comes to transporting vaccines and getting them where they need to go. During the pandemic, high-income countries were able to buy up all the vaccines while poorer countries went without. That is changing. Countries across Africa and Latin America are taking steps to procure vaccines in a way that is faster and fairer, and part of that is bringing vaccine manufacturing closer so they can access those critical tools as soon as they’re developed.

The Impact of Vaccine Misinformation

Megan: Vaccine misinformation is on the rise. What concerns you the most?

Ceci: I hope that we can recognize how much has had to happen for us to have access to these vaccines that we take for granted. It takes a lot to give a kid the opportunity to not get sick or die from a preventable disease, and to have a productive life that benefits their whole community. It’s very hard for those of us in public health to see how much progress we’ve lost because of mistrust in communities about these incredible tools that do so much for us.

Liz: Here’s another quote: “Vaccination is a victim of its own success.” We don’t see these diseases anymore, so we don’t realize how much we’ve overcome. And that’s why the spread of misinformation is a problem. People are like, “Wait a second, why do I need to vaccinate my child against these diseases that don’t exist? There’s no polio, there’s no measles, there’s no diphtheria.” Well, the reason you don’t see those is because of vaccines.

All vaccines carry minimal risks. But those risks are so incredibly low and the gains are so incredibly high.

Ceci: And we can experience side effects with anything. Every painkiller has side effects. I have a medical background, and while everyone should understand the risks, they should also consider the benefits. You take a painkiller for your fever because you know it’s bad for your health, and reducing it is worth the very low risk of minor side effects. It’s the same for vaccines.

Liz: The spread of misinformation is unfortunately on the rise. And social media is giving it a megaphone. So we need people to speak up in support of vaccines to help counter the spread of misinformation. Because progress is fragile. And as children are born every year, they need to be protected, so we can’t say, “We’re good, we’ve vaccinated enough.” We have to keep going. We have to keep vaccinating children every year to save lives and end diseases.