By: Sarmitha Sivakumaran
The childhood routine immunization schedule ensures that children are vaccinated against many preventable diseases. This is something we do not think about often because a large proportion of children in Western countries are immunized. Many of the vaccines we receive during childhood offer protection against preventable diseases. In Canada, 90% of 2-year-old children were vaccinated against measles, an extremely contagious disease. However, global vaccine inequities and disparities in healthcare have left many young children at risk for these preventable diseases. The COVID-19 pandemic has resulted in a decrease in routine childhood immunization, resulting in an increase of vaccine-preventable diseases in other parts of the world.
Routine childhood immunization is extremely important. How do we know that these vaccines are effective? In Ontario, approximately half of the children that tested positive for SARS-CoV-2 were admitted to the hospital for reasons not relating to SARS-CoV-2. Officials in Canada heavily emphasized that childhood vaccinations should not be deferred due to the pandemic. However, other parts of the world where vaccinations were deferred experienced greater numbers of outbreaks. The World Health Organization (WHO) estimated that 80 million children are at risk of contracting one or more of the many vaccine-preventable diseases. Outbreaks of these vaccine-preventable diseases in conjunction with COVID-19 outbreaks may potentially overwhelm healthcare systems across the globe.
The WHO has taken many measures to ensure that children living in poorer countries are able to receive their measles vaccination. In order for the measles vaccine to be effective, the WHO suggests that 95% of the population needs to be vaccinated. Fortunately, the measles death rate decreased by 79% between 2000 and 2015, suggesting that the vaccine is highly effective. However, these routine immunizations were delayed during the beginning of the COVID-19 pandemic in 2020, resulting in a surge of measles cases in many poor countries. Pakistan often experiences outbreaks of many of these vaccine-preventable diseases. Due to the economic status of the country, Pakistan spends an underwhelming 1.2% of its GDP on its health sector. As a result, the child mortality rate was 21.3% for these vaccine preventable diseases in South Asian countries.
Fortunately, there is strong evidence suggesting that remaining up-to-date with routine immunizations outweighs the risk of deaths caused by COVID-19. It would put less pressure on healthcare systems in the event that a COVID-19 outbreak was to reoccur. The DTP3 vaccine is also very important for children to receive. What exactly is the DTP3 vaccine for? This vaccine offers protection against three fatal diseases - diphtheria, tetanus toxoid, and pertussis. In 2019, the vaccination rate for DTP3 was 78% in Canada. In comparison to measles, DTP3 vaccination rates are much lower in Canada. In many low-income countries, there is a lack of DTP3 coverage which places populations at greater risk. Individuals who suffer from other conditions such as diabetes are at particularly greater risk if they contract diphtheria, tetanus toxoid, or pertussis.
It is now evident that childhood routine immunization is important. However, many parents are still hesitant to vaccinate their children due to the lack of knowledge surrounding vaccines and their effectiveness. Some may go so far as to create fake vaccine certificates for their children to circumvent vaccine mandates. The WHO states that vaccine hesitancy is a threat to global health due to the risk of eradicated diseases threatening to resurface in the population. For example, an article published in 1998 by Andrew Wakefield in The Lancet hypothesized that the measles vaccine caused autism in children. Although the article was retracted in 2010, and his theories were eventually disproved, vaccine-hesitancy continued to increase among parents. Consequently, a surge in measles cases occurred worldwide. Although more children are now being vaccinated against measles, there is still a small proportion of vaccine-hesitant parents. It is important to educate parents about the benefits of childhood vaccines. These vaccines may come with minimal side effects, but it is important to remind parents that the benefits outweigh the risks. With proper public health interventions such as more education and awareness, we could see higher childhood vaccination rates in the years to come.
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