It’s very hard in a page to highlight the enormous benefits of vaccination, however they do range from saving millions of lives, to complete eradication of infectious agents, to promoting equity and even world peace.
Vaccination programs have eradicated small pox worldwide and eliminated polio and measles from large parts of the globe. It is estimated that vaccines prevent more than six million deaths per year and we now have a significant list of vaccine preventable diseases that were the major killers less than 50 years ago. By preventing infection, vaccines also prevent the consequences of those infections. The prevention of Human Papilloma Virus infection by vaccination (an Australian development) prevents the possible consequent cervical cancer, and the prevention of Hepatitis B infection by vaccination prevents the possible sequelae of cirrhosis and liver cancer. The cost benefit ratio of vaccines is extraordinary. Direct savings across the world are in the tens of billions and outdo most other public health inventions apart from clean water. Vaccines contribute to our extension in life expectancy, but importantly they prevent death, predominantly in early childhood. This leads to women choosing to have smaller numbers of children, improving maternal mortality rates, literacy and education. Vaccines generally require a broad-based population approach and are often delivered for free. These programs are therefore inherently equitable and promote health equality. This understanding was an important motivation for Melinda and Bill Gates to engage the Gates Foundation in its huge investment in vaccination. This very important impact of vaccination programs on female wellbeing can be linked to a peaceful world. There is a very strong correlation between a country’s maternal mortality rate and female literacy and the likelihood of civil unrest and war. There are, however, a number of significant infectious diseases that haven’t been conquered by vaccines. The big three are HIV, TB and malaria. Of these three we are closest to the development of a malaria vaccine. We have the BCG vaccine for TB but it’s not very effective and we urgently need an effective alternative with increasing numbers of outbreaks of multi-resistant TB. HIV is the biggest challenge and will require at least another decade of the best minds and significant resources to start getting close to an effective vaccine. We also need to improve they way we administer our current vaccines; an oral single dose multi-valent vaccine would dramatically improve the acceptance of vaccines to children and parents. It would also reduce the infrastructure requirements – no needles, no cold chain and less health staff required. We have new technologies that should allow us to move closer to this goal. We are very lucky in Australia to have a national, well-funded, evidence-based immunisation program, which is evidenced by our very low rates of vaccine-preventable infections. However we do need to do more. We need to improve coverage, particularly in marginalised communities. We need to reduce the impact of misinformation about vaccines and we need to use all mechanisms available to encourage the uptake of vaccines. This probably should include a requirement for up-to-date vaccination documentation to attend preschool or school. In this brief article I have highlighted one outcome of health and medical research that has immeasurably improved wellbeing across the globe. In order to continue to have this type of impact we need to continue encouraging and resourcing our best research minds to target key health needs and develop solutions, whether it is by vaccination, new treatments for heart disease or better diets to prevent chronic illness. Professor Steve Wesselingh is the Executive Director of the South Australian Health and Medical Research Institute (SAHMRI) and an internationally recognised infectious diseases physician with research interests in neurovirology, HIV and vaccine development. He has consistently worked towards the integration of high-quality medical research with healthcare delivery, leading to improved health outcomes for Australia and the poorly resourced countries of the region.
