A cholera vaccination in Malawi. ©WHO
WHO’s contributors are supporting the “Big Catch-Up” – a push to get countries back on track with vaccinations after disruptions brought on by the COVID-19 pandemic, natural disasters and armed conflicts.
WHO estimates that 25 million children missed out on vaccination in 2021, six million more than in 2019 and the highest number since 2009.
To mark World Immunization Week (24-30 April), we visit campaigns to stop flood-related cholera outbreaks in Kenya, Malawi, and Mozambique; polio and measles campaigns in Syria in the aftermath of a massive earthquake; and the quest to reach “zero-dose” children caught in Somalia’s years-long drought.
This issue celebrates vaccination successes in Africa, where a grant from the European Union helped push a group of countries with very low COVID-19 vaccination coverage closer to, or in some cases above, the continent’s average.
Also read about stopping COVID-19 in the Americas, HPV vaccination to end cervical cancer in Sierra Leone, Montenegro’s Health Caravan project and work to vaccinate vulnerable people ahead of Lao PDR’s National Games.
Also see:
All about World Immunization Week 2023
New cholera cases in Africa surging fast, reach a third of 2022 total in a month
Polio and measles vaccinations are deployed in Syria’s earthquake zones
This month’s polio and measles vaccination campaign comes a month after a drive that administered cholera vaccine to nearly 1.7 million people. ©WHO
This month, WHO and partners are working to administer polio and measles vaccinations to 800 000 small children in the northwest of the country where a February earthquake damaged or destroyed 67 health facilities.
The 10-day campaign involves about 3 000 health workers, many of whom have themselves been affected by the massive quake.
“The earthquakes have already disrupted so many lives and livelihoods … vaccinating children under the age of 5, we can prevent a secondary disaster in the form of a disease outbreak,” said Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean.
Close to 100 000 people newly displaced by the disaster are living in overcrowded camps, where insufficient clean water and sanitation have heightened the risk for the spread of infectious diseases. Read more
Also see:
Syria’s recent cholera-vaccination campaign
PAHO issues update on poliovirus in the Americas
Sierra Leone introduces HPV vaccination to end cervical cancer
“We are in the era where no one should suffer or die from diseases that are preventable with the use of vaccines,” said Dr Steven Velabo Shongwe, WHO Representative in Sierra Leone. ©WHO
An old adage in Sierra Leone says that “what goes on under the cloth should remain under the cloth.”
Most women are not willing to be screened, or even talk about cervical cancer, health authorities say, although it is the country’s leading cause of cancer death among women.
But the government has introduced another way to fight the disease. Starting this year, girls ages 9 to 15 can receive the vaccination for human papillomavirus (HPV), a sexually transmitted infection that causes more than 95% of cervical cancer cases.
WHO, Gavi, the Vaccine Alliance and UNICEF are supporting the work. Read more
Also see: African leaders declare commitment to build momentum for routine immunization recovery
Vaccinations make National Games safer in LAO PDR
The campaign in Lao PDR boosted COVID-19 vaccination rates and helped babies catch up on their routine shots. ©WHO
WHO worked with the government of the Lao People’s Democratic Republic to shore up vaccinations in the province hosting the country’s annual National Games, reaching out to villages where previous vaccination campaigns had not been well received.
“The National Games provide an amazing opportunity to come together and see the best of Lao’s athletes,” said WHO Health Emergency Specialist Satoko Otsu, “but also an opportunity for the spread of COVID-19 and other diseases.”
The campaign’s focus was to administer routine catch-up vaccinations to babies and COVID-19 vaccinations to at-risk groups such as people with disabilities, older people and ethnic communities. The effort reached nearly 39 000 people.
“The things that seemed to be the most persuasive in changing people’s views, were simple - talking to them in a non-hierarchical way, spending time to discuss the vaccine and listen to concerns and views, and identify and persuade influencers – whether village representatives, religious leaders, or close neighbours and friends,” said WHO Community Engagement Team Lead Shogo Kubota. Read more
Spending the time to provide facts and listen to concerns increased vaccination acceptance in Lao PDR villages. ©WHO
“Zero-dose” children receive vaccinations as Somalia’s deadly drought persists
Fadumo Mohamed Ibrahim and her baby, Khaliye, at the Raama Cadey camp for internally displaced people. ©WHO/Abdulkadir Zubeyr
When her crops failed in the drought, Somali farmer Fadumo Mohamed Ibrahim set out on foot to find help, carrying her baby daughter, Khaliye. Twenty-five days later, sick and exhausted, she stumbled into the Raama Cadey camp for internally displaced people.
Khaliye entered the camp as a zero-dose child, which means she had never received an immunization of any kind; half of vaccine-preventable deaths occur among such children. A community outreach health team supported by WHO made sure that Khaliye promptly received her shots for measles, polio and pneumonia.
In recent months, WHO has vaccinated more than 3.2 million children in Somalia for measles, nearly one million people for cholera, and provided other vital health services.
Read more about the Raama Cady camp and WHO’s effort to reach zero-dose children.
Also see: Zimbabwe tackles measles outbreak through intensive vaccination campaigns
Stopping cholera
WHO disburses US$ 6 million from its Contingency Fund for Emergencies for cholera responses in Kenya, Malawi and Mozambique.
Kenya
Kenya’s first-ever cholera vaccination campaign deployed cars with loudspeakers to let people know how to obtain the vaccine. Above: India Zakaria, who heard the announcement and got the vaccine. ©WHO/Billy Miaron
India Zakaria lives close to Madogo Health Centre near the Tana River in eastern Kenya. She went to the centre to get vaccinated after her husband fell sick with cholera.
“I believe he got infected from the river, which is our main water source, even though it is very polluted. For a whole week he could not take care of the family, but eventually he got well,” she said. “I heard about the campaign from a public announcement vehicle that was making the rounds in our area, and when I saw other people were getting vaccinated, I decided I should too.” Read more
Cholera vaccination teams in Kenya went door to door. Above, a team member marks a house to indicate that residents have received the vaccine. ©WHO/Billy Miaron
Malawi
Health workers in Lilongwe prepare for patients at a cholera treatment centre that WHO helped to revamp. ©WHO/Moving Minds
WHO has helped Malawi subdue a major cholera outbreak that began in March 2022, linked to flooding and responsible for more than 1400 deaths.
The Organization collaborated with Gavi, the Vaccine Alliance, and the International Coordinating Group to provide the country with nearly five million doses of cholera vaccine during the national emergency.
“Apart from the vaccination, we have intensified chlorine distribution in households for water purification and we are engaging fishing villages on water, hygiene and sanitation to ensure that we contain the cholera outbreak,” said Dr Neema Kimambo, WHO Representative in Malawi.
Cholera is an acute intestinal infection that can kill within hours if left untreated.
“The trend of cholera changed significantly in the southern region after the oral cholera vaccination campaign, and this helped the government to focus on other aspects of rebuilding the health system post-floods,” said Dr Charles Mwansambo, Malawi Secretary for Health. Read more
Mozambique
Vaccinators reached patients through health centres, mobile teams and door-to-door visits. ©WHO
Mozambique targeted about 720 000 people in a February vaccination campaign to control a cholera outbreak that had killed 37 people since the previous September.
Despite a global shortage of cholera vaccines, WHO and partners, including Gavi, the Vaccine Alliance and the Africa Centres for Disease Control, have succeeded in supplying vaccines to countries most affected by cholera in southern Africa.
“The recent rise in disease outbreaks and the risks they present demonstrate the importance of our work in funding the Global Oral Cholera Vaccine Stockpile, cholera response campaigns and access to outbreak response vaccines for diseases such as cholera, measles, yellow fever and polio,” said Thabani Maphosa, Managing Director, Country Programmes Delivery at Gavi. Read more
Also see:
WHO supports Cross River State, Nigeria, to combat cholera outbreak
Montenegro’s Health Caravan brings health checks and vaccinations straight to communities
The Health Caravan project set up mobile vaccination sites in four municipalities in Montenegro and promoted its services via television, radio and schools. ©WHO
WHO, USAID and Montenegro’s government have completed a Health Caravan project to provide communities with low vaccination rates on-the-spot access to immunizations for COVID-19, human papillomavirus, and measles, mumps and rubella.
“To increase vaccination uptake, we need collective action, partnerships, strong local community engagement and informed citizens,” said Dr Mina Brajović, WHO Representative in Montenegro. Read more
Also see: WHO and the European Union work to strengthen Tajikistan’s immunization system
Preventing COVID-19
In Liberia
A COVID-19 vaccinator at work in Liberia. ©WHO
A community-based strategy to fight COVID-19 helped Liberia join Mauritius, Rwanda and Seychelles in reaching WHO’s global vaccination target of 70% by the end of 2022.
Part of the country’s strategy to disrupt the virus’s transmission was to administer rapid tests to everyone living within 100 metres of newly confirmed COVID-19 cases. At the same time, health workers went door to door to dispel vaccine myths and misformation.
“Expanding testing in communities using the antigen tests is helping provide a better way for the country to respond to the pandemic,” said Chea Sanford Wesseh, Assistant Minister for Vital Statistics in the Liberia Ministry of Health.
Related news: COVID-19 vaccination is rising in many vulnerable African communities thanks to EU-funded, WHO-led project
VIDEO: Boosting vaccinations among African populations suffering humanitarian crises: a WHO/EU partnership
In the Americas
Supported by PAHO, youth groups provided COVID-19 information to students, joined vaccination campaigns in rural areas, produced films and radio spots, and more. Above: participants in Belize. ©PAHO
Youth groups from Belize, Peru and Montserrat have been working in vulnerable and remote communities to encourage COVID-19 vaccination as part of the Pan American Health Organization’s (PAHO) Youth as Agents of Change project.
“Their enthusiasm, passion and influence can have a huge impact on the behavior and health of their peers, families and communities," said PAHO Adolescent Health Advisor Dr Sonja Caffee. Read more
Also see:
Guyana receives 13,440 doses of the Pfizer vaccines through a collaboration between PAHO and Spain
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WHO thanks all governments, organizations and individuals who are contributing to the Organization’s work, with special appreciation for those who provide fully flexible contributions to maintain a strong, independent WHO.
Donors and partners featured in this week’s stories include:
Africa Centres for Disease Control
CARICOM
Defense Threat Reduction Agency (United States)
European Union
Gavi, the Vaccine Alliance
International Coordinating Group on Vaccine Provision
International Federation of the Red Cross and Red Crescent Societies
Korea Foundation for International Healthcare
Luxembourg
Médecins Sans Frontières
Save the Children
Syria Immunization Group
UNICEF
United States Agency for International Development (USAID)
WHO Contingency Fund for Emergencies (contributors in 2022-23: Canada, Estonia, Germany, Kuwait, Netherlands, New Zealand, Norway, Philippines, Portugal, Slovakia, Switzerland, United States of America)