Our Global Voices Posts
Updated from the original posting on Vaccines Work on February 18, 2019
By getting vaccinated in pregnancy, mothers can safeguard themselves and their infants in the first few vulnerable months of life against certain diseases. This strategy is a powerful approach for reaching two stages of life often underserved by current immunization programs—pregnancy and early infancy.
Innovations are on the move and maternal immunization (MI) could soon be a long-sought answer to a widespread, but often unrecognized, cause of severe respiratory infections in young infants: respiratory syncytial virus (RSV). Numerous RSV vaccines are in development, several of which are designed for MI. Researchers are in the process of evaluating performance and potential benefits for both immunized mothers and their infants. If successful, such a vaccine would be the first-ever against RSV. But, developing a vaccine is only part of the challenge. Once a vaccine candidate is approved, the world must be ready and able to use it, including low- and middle-income countries (LMICs) where current capacity to deliver vaccines within routine antenatal care services may be limited.
A new roadmap by the Advancing Maternal Immunization (AMI) collaboration coordinated by PATH and the World Health Organization (WHO) is now available to help. It outlines activities needed to inform decision making around if and how to bring maternal RSV vaccines from the development phase into routine use in LMICs. It highlights an opportunity for immunization and maternal and child health programs to come together like never before to address remaining questions and lay the groundwork for MI strategies that strengthen vaccine and antenatal care service delivery more broadly. The real work is just beginning.
Defining the pathway forward
A maternal RSV vaccine has global potential for sure, but it would be revolutionary in limited-resource settings. Easily confused with a common cold in older children and adults, RSV can be deadly for infants—especially those younger than six months old and living in LMICs, which is where almost all RSV mortality occurs. Of the more than 30 million childhood cases worldwide, RSV causes 1.4 million hospitalizations in the first 6 months of life and 120,000 deaths before five years of age worldwide each year. Severe complications include pneumonia and bronchiolitis. If successful, RSV MI would give mothers the power to protect their babies early, which is especially important in settings where medical care is out of reach and caring for the sick can threaten livelihoods. Beyond that, mothers may also be protected from RSV, pregnancy outcomes may benefit, and the chance of a mother transmitting RSV infection to her infant after birth could be reduced.
Though MI is already used safely and effectively in many countries against diseases such as tetanus, influenza, and pertussis, delivery challenges and information gaps prevent it from being widely used in LMICs beyond tetanus prevention. With the availability of RSV vaccines for MI on the horizon, addressing these issues now is critical. Not to do so would delay, or even preclude, introduction and delivery in countries that need it most.
A roadmap to advance RSV maternal immunization
Based on a gap analysis conducted in early 2018, AMI’s RSV MI roadmap is designed to help researchers, policymakers, health practitioners, funders, advocates, and other stakeholders at global and country levels gauge when and where to direct efforts for addressing the obstacles inherent to RSV MI introduction. It also outlines the activities necessary to empower countries to make decisions about adoption amidst competing public health priorities.
The most urgent activities specifically center on supporting vaccine development and licensure; assessing RSV MI’s potential health impact and return on investment to inform policy and financing decisions; preparing for post-introduction monitoring; developing communication strategies to support awareness and uptake; and ensuring countries are equipped to deliver the vaccine routinely, efficiently, and equitably once it is available.
Beyond RSV prevention
MI can empower mothers to protect themselves from RSV and their infants at birth and for several months thereafter—highlighting the ability of vaccination to guard against disease at all stages of a person’s life. A maternal RSV vaccine, if approved soon, could make history not just as the first vaccine to protect against the virus, but as the first specifically designed for MI and possibly one of the first to target near-simultaneous availability in both high- and low-income settings. It’s also a natural opportunity to lay a foundation that extends beyond RSV prevention, since the platforms developed and strengthened for it could be used for additional MIs in the future and to strengthen antenatal care services overall.
None of this will be possible unless we can make informed decisions around if and how to introduce maternal RSV vaccine. We must act now on the roadmap to be able to deliver MI when the time comes—and work across programs to do so. Check out the report to see how you can contribute.
MI is a powerful health tool; let’s learn together how to wield it to its full potential.Posted on by
My name is Dr. Matthew Goers, an Epidemic Intelligence Service (or EIS) officer with CDC’s Division of Global Health Protection. Our division works with other countries and international organizations to respond to international disasters, disease outbreaks, and humanitarian crises. In September of 2017, Namibia began reporting sporadic cases of acute jaundice, abdominal pain, and fatigue. Read More >Posted on by
In 1988, CDC joined three other partners (World Health Organization (WHO), United Nation International Children Fund (UNICF) and Rotary International to launch the ambitious Global Polio Eradication Initiative (GPEI). The world was a dangerous place with respect to polio. A case of polio occurred every 90 seconds, meaning 350,000 children had paralytic polio every year. Read More >Posted on by
“I don’t get migraines, I don’t get dizzy spells any longer,” explains Ms. Williams, a patient at a polyclinic on the Caribbean island nation of Barbados. “It is working for me where I have no problems now with high blood pressure. Yes, I’m hypertensive, but I’m controlled.” Ms. Williams was enrolled as a patient in Read More >Posted on by
On May 17, 2018, almost two weeks after his brother died of febrile illness, a male patient in his mid-twenties visited a hospital in Kerala, India, with a fever. A day later, he was dead — but not before his doctors noticed his symptoms were consistent with encephalitis.Recognizing the potential danger, they immediately sent Read More >Posted on by
The Zambia National Public Health Institute (ZNPHI) is young but is already emerging as a leader for public health in Southern Africa. We are proud of our growth over the past four years and the increasing role we have assumed in the region. As ZNPHI Southern Africa’s first regional workshop on public health emergency management Read More >Posted on by
CDC works with countries to identify children infected with hepatitis B virus and generate the evidence for hepatitis B vaccine birth dose introduction
Around the world, approximately 257 million people are infected with hepatitis B virus (HBV), and about 700,000 die every year as result of the long-term, chronic health threats from HBV, including liver disease and cancer. But, such suffering can be prevented with a vaccine! More tragic still, newborn babies infected at birth by their mothers, Read More >Posted on by
Australia is a global leader in tobacco control, with a continuous comprehensive strategy initiated in the late 1980s that includes advertising restrictions, price increases, plain packaging, and mass media campaigns. However, after three decades, limited progress has occurred with regard to smoking prevalence among Australia’s Aboriginal and Torres Strait Islander population. Cigarette smoking prevalence among Read More >Posted on by
How Senegal is tracking the Silent Killer At a packed clinic in the middle of Dakar, Senegal, a busy nurse secures a blood pressure cuff around a patient’s arm. “After I take the blood pressure, I record it here,” the nurse says enthusiastically, showing a patient treatment card to Dr. Monica LaBelle, a CDC Foundation Read More >Posted on by
The Global Polio Eradication Initiative (GPEI) is a partnership led by five organizations: the World Health Organization (WHO), Rotary International, the U.S. Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF), and the Bill & Melinda Gates Foundation. The goal of GPEI is to eradicate polio worldwide. Based at the David Read More >Posted on by