Measles is a highly infectious disease that
needs 95% of the community to be immune to
protect the individual but also to stop transmission
in the community.
There’s meningitis.
There’s pneumonia.
There’s diarrhea.
All of those are vaccine-preventable and are
amongst the most common causes for childhood
morbidity and mortality, especially in children
under the age of 5.
So, the solutions to consider in a situation
where healthcare workers might feel exposed
if they run vaccination campaigns, or parents
might feel reluctant to go to immunization
clinics — and we’re seeing this in the
U.K., as well — we need to really, first
and foremost, have a commitment that the delivery of vaccines
to populations remains a high priority for health services.
Then we can possibly break down the interventions
that could be done into —
some of them being purely logistical.
For example, flights are suspended all across
the globe, and flights bring vaccine supplies to countries.
Maybe extra flights need to be chartered to
bring vaccines to countries.
And, for example, in the Gambia, we have already
run out of oral polio vaccine for one reason
or another, and that’s already shown a bottleneck.
Our own group has, for example, mapped out
the consequences of vaccination services not
being delivered, even without the presence
of a pandemic.
And we already showed that there’s a plateau
of about 80% of vaccination, and that is not
enough for herd immunity for diseases, for
example, like measles, that need to have a
cover of up to 95% in the community 
to prevent outbreaks.
And just to give a recent example, during
the Ebola outbreak in the DRC, about three
times as many people died from measles as
did end up dying from Ebola.
So the consequences of not vaccinating and
providing the essential services in the immunization
programs are really, really rather devastating.
I think it’s crucial that we have data collection
tools that will allow us to capture what is
going on in the immunization system, who has
received vaccines and who hasn’t, because
it’s not just now that the children and
anyone in the community will suffer from preventable
infectious diseases, it’s in a little while,
when the herd immunity or the community immunity
has either dropped or there are new birth
cohorts of children who then, because of suspension
of immunization programs, would have never
seen a vaccine.
And the health systems need to put in place
records for that to be feasible, and the data
collection systems really need to be fit for
purpose.
And we really probably need to think about
new models of delivering vaccines and to have
more platforms, and maybe not just restricting
them to the usual EPI clinics.
