The impact of vaccines on urban health

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In 2018, nearly 20 million children were not given vaccines to prevent life-threatening illnesses

It is well known that vaccines were one of the major revolutions in human history. During the twentieth century, they eliminated childhood diseases that used to cause millions of deaths, and still remain the most effective tool for preventing and combating diseases. Backed by innovations derived from new technologies, vaccines meet the needs of a 21st century society characterized by increased life expectancy, the proliferation of emerging infections and poverty in low-income countries¹.

To clarify ​​its effectiveness we must go back in time. Over the last century, immunization has helped drastically to reduce the impact of diseases, with about 2.6 million people dying of measles each year. With its first vaccine created in the 1960s there was an 80% reduction in measles deaths between 2000 and 2017, according to data from the World Health Organization – WHO. Nor was it long ago that millions of children were at risk of dying or suffering from paralysis from polio. Nowadays, this disease has been virtually extinct thanks to vaccines².

Despite its success, the scenario is worrying today. According to WHO, this year’s numbers are discouraging – as for measles, occurrences are now four times bigger. In their annual report, it was shown that by 2018 nearly 20 million children were not given vaccines to prevent life-threatening illnesses³. “This means that more than one child in ten does not get all the vaccines they need,” said WHO Director of the Immunization and Vaccines Department, Kate O’Brien.

For the first time, annual UN statistics are taking into account the human papillomavirus vaccine (HPV), used to protect humans from cervical cancer. Over the past year, 90 countries – mostly developed ones – have integrated HPV into their national programs, meaning that the vaccine is now available to one girl in three worldwide. Despite signs of progress on HPV, vaccine data shows that there is a “dangerous stagnation in vaccination rates worldwide due to conflict, inequality and complacency”, the UN adds.

The worldwide coverage rate for basic diphtheria, tetanus and pertussis (DTP) and measles vaccination has been stagnant since 2010, at 86%. This rate remains “high” but “insufficient,” according to the UN, concerned above all about the extent of the measles epidemic. Last year, 350,000 measles cases were reported worldwide, twice more than in 2017. The first numbers for 2019 are alarming. Measles cases worldwide quadrupled in the first quarter of 2019 compared to the same period last year. “The reasons for these epidemics are very diverse, but the first cause is that children live in communities where the anti-measles vaccine is insufficient, and that individual children are not immunized,” said O’Brien.

Therefore, it is up to municipalities to understand which areas are most at risk and which populations suffer most from the lack of adequate care. In Brazil, measles vaccines are freely available by the Unified Health System (SUS), but many citizens are still unable to access the service because they live in isolated areas or without health facilities. Indicators used by Bright Cities are an alternative for mapping and understanding which regions most require healthcare. In that way, our platform is an accurate tool to help public policy deliver a service – that is everyone – to everyone.

[1] Nature Reviews Immunology, Vaccines for the twenty-first century Society, 2011.

[2] BBC News Brasil, 22, junho2019.

[3] Exame, 15 jul 2019.