Humans have been living with infectious diseases, some quite deadly and contagious for centuries. People have weathered severe health crises – from smallpox, Ebola, measles, cholera – and one of the turning points was the discovery of vaccines. Within living memory, smallpox, a highly contagious disease and one of the most brutal killers in human history claimed countless lives. It was finally declared eradicated in the 1980s because of the effectiveness of smallpox vaccine. Nowadays, a range of vaccination campaigns are continuing to safeguard public health worldwide.
"Our medical teams have seen many times how a vaccination campaign has stopped an outbreak. It is kind of a miracle, that in 10 to 14 days, you stopped receiving patients," said Miriam Alia, MSF vaccination and outbreak response advisor. MSF has learnt from experience that when there are outbreaks like measles, meningitis, cholera and diphtheria, mass vaccination campaigns help tackle the transmission. It is also an effective preventive measure against outbreaks in crowded, constricted camps where people take refuge during crises.
While vaccines are effective in managing outbreaks, such protection is not readily accessible to everyone. Miriam recalled an example of her colleagues working in town of Mingala, Central African Republic (CAR) that she supported in the headquarters in 2019. The town was under siege for more than two years and our medical teams were prevented from getting to the trapped communities. After a year-long negotiation, the team was finally allowed to enter and managed in only a few days to vaccinate almost 1,000 children born during the siege against nine diseases. It's such an important first step that protects against so many hazards.
Not only kids were vaccinated, pregnant women also received their jabs against tetanus and diphtheria and provided curative consultations and antenatal care. "They told the team they had not seen a doctor for more than two years. They were really pleased that we vaccinated their kids. And it was telling that they knew very well the importance of the vaccination."
Today, mass vaccination campaigns against the diseases that kill the most children under five were disrupted not only by challenges posed by conflict and security issues where MSF works, but also by the COVID-19 pandemic. Our field teams have been trying to respond to the current pandemic and to deal with existing medical humanitarian needs, which certainly includes preserving the continuity of care for patients affected by other fatal diseases.
"Due to lockdowns, the transport of medical goods was very difficult," said Miriam. "Even when cargo planes are available, they are dedicated to supplies for COVID-19 response, such as personal protective equipment." Other supplies that fall outside of the pandemic response are not a priority, making vaccines for other diseases even less accessible to people who need them most. Across Africa, at least 110 planned vaccination campaigns by Ministries of Health have been delayed, and some of them were yet to be implemented at the beginning of this year. These measures were taken to avoid overcrowding that would increase COVID-19 infections.
Miriam reveals that MSF has adapted a new approach in the Democratic Republic of Congo in order to reach children and communities safely. Measures had to include reducing the number of people to be vaccinated by each team on each day and maintaining social distance in the queue. We also went door-to-door to give oral cholera vaccines in Niger to try to keep people protected from the disease. Our teams implemented these measures even before the World Health Organization issued its own, similar recommendations for conducting vaccination campaigns in COVID-19 settings.
However, the pandemic continues to slow down our ability to vaccinate more children. Our medical teams are concerned with the surges of measles infections we are seeing in countries like Mali, Niger and Democratic Republic of Congo due to children being left unvaccinated. It's inevitable that vaccine-preventable epidemics will show themselves soon.
Access to vaccines against COVID-19 and all other diseases are equally crucial. All of us will need to adapt to this new normal and carry on effective vaccination campaigns to protect more people from the threats of epidemics.