Paul Auwaerter, MD, MBA, President IDSA
Paul Spearman, MD, FPIDS, President PIDS
Keith Kaye, MD, MPH, FSHEA
World Immunization Week from April 24-30 gives us the opportunity to celebrate one of the greatest achievements of modern medicine. Safe and effective vaccines that protect individuals against diphtheria, hepatitis B, measles, mumps, pertussis, rubella, human papilloma virus, and polio have drastically limited the incidence of these serious, sometimes life-threatening diseases in many parts of the world. Immunizations against infectious diseases that cause severe illness, disability and death save from 2 million to 3 million lives annually and prevent the spread of infections that can be resistant to treatments. This week also is a time to reflect on the public health benefits of immunization, with high rates of vaccination across communities providing indirect protection through herd immunity for populations including very young children, pregnant women, and people with weakened immune systems who cannot be vaccinated. Across the U.S. and globally, universal access to vaccines is critical to their optimal effectiveness. Gaps in coverage anywhere can pose threats of re-emerging diseases, particularly among the most vulnerable populations everywhere.
This year, World Immunization Week brings reminders that globally, vaccine coverage remains far from adequate. Currently, 19.5 million children lack access to basic vaccines against diphtheria-tetanus-pertussis and remain vulnerable to these preventable yet potentially deadly infectious diseases. And, while measles vaccinations have prevented more than 20 million deaths since the turn of this century, making that vaccine one of the most cost-effective investments in public health, measles remains one of the leading causes of death worldwide among children under five.
While the United States has made significant progress toward eliminating vaccine-preventable diseases among children, coverage continues to lag for adolescents and adults. Every year, more than 50,000 adults in the U.S. die from vaccine-preventable illnesses. Annually, the U.S. spends $26.5 billion treating four vaccine-preventable illnesses in adults—influenza, shingles, pertussis and pneumococcal disease. In addition, ill-informed policies allowing personal belief-based exemptions for childhood immunization requirements have contributed to depressed vaccination rates in some communities, followed by predictable measles outbreaks. Travelers continue to bring measles into the U.S. where, upon reaching communities where significant numbers of people remain unvaccinated, the disease spreads.
The Infectious Diseases Society of America, the Pediatric Infectious Diseases Society and the Society for Healthcare Epidemiology of America support universal immunization of children, adolescents, and adults, based on current scientific evidence and according to the recommendations and standards established by the National Vaccine Advisory Committee, the U.S. Centers for Disease Control and Prevention, and the CDC’s Advisory Committee on Immunization Practices. For CDC’s advisory committee to recommend a vaccine, the vaccine must demonstrate significant patient benefit and very low risk. To secure approval from the Food and Drug Administration, vaccines are often required to present more rigorous safety and efficacy data than drugs or devices. We strongly encourage states to enact and enforce laws requiring all children without medical contraindications to be fully immunized as a requirement for school or daycare. We support robust funding for CDC immunization programs that help ensure access to immunizations and respond to outbreaks of vaccine-preventable diseases. We also support improved Medicare coverage of vaccines and increased investment in vaccine registries or immunization information systems across the lifespan to increase uptake of recommended vaccines, including for pneumococcal disease, shingles and influenza for at-risk adults, including elderly individuals. We recognize the importance of policies requiring vaccination among healthcare workers to protect their health and that of their vulnerable patients.
We call on policymakers to continue investments in vaccine research and development needed to bring new and improved vaccines, including a universal influenza vaccine, to market, and to remain invested in ensuring the availability of these critical public health tools.