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CSU 10/2008: THE GLOBAL IMPACT OF VACCINATION

Monday, 10th of March 2008

CSU 10/2008: THE GLOBAL IMPACT OF  VACCINATION
 
Thanks to reader Francis André for pointing out this discussion  article on vaccination from the Bulletin of the World Health Organization.  Full text of the article is available online to Internet users at
http://www.who.int/bulletin/volumes/86/2/07-040089/en/index.html

The authors' discussion on elimination and eradication is quite timely:
 
 "Diseases can be eliminated locally without global eradication of the
 causative microorganism. In four of six WHO regions, substantial progress
 has been made in measles elimination; transmission no longer occurs
 indigenously and importation does not result in sustained spread of the
 virus.11 Key to this achievement is more than 95% population immunity
 through a two dose vaccination regimen. Combined measles, mumps and rubella
 (MMR) vaccine could also eliminate and eventually eradicate rubella and
 mumps.11 Increasing measles immunization levels in Africa, where coverage
 averaged only 67% in 2004, is essential for eradication of this disease.
 Already, elimination of measles from the Americas, and of measles, mumps
 and rubella in Finland has been achieved, providing proof in principle of
 the feasibility of their ultimate global eradication.12 It may also be
 possible to eliminate Haemophilus influenzae type b (Hib) disease through
 well implemented national programmes, as experience in the West has shown.
 13
 
 "Local elimination does not remove the danger of reintroduction, such as
 in Botswana, poliofree since 1991, with importation of type 1 poliovirus
 from Nigeria in 2004,14 and in the United States of America (USA) with
 measles reintroduced to Indiana in 2005 by a traveller from Romania.15
 
 "For diseases with an environmental reservoir such as tetanus, or animal
 res­ervoirs such as Japanese encephalitis and rabies, eradication may not be
 possible, but global disease elimination is a feasible objective if
 vaccination of humans (and animals for rabies) is maintained at high
 levels."