In the past hundred years, life expectancy has increased remarkably. This result is due not only to improved living conditions and social and economic determinants but also to the availability of vaccines. This was highlighted by Stefano Vella, Adjunct Professor of Global Health at the Catholic University of Rome, during a recent meeting organized by Cittadinanzattiva – Active Citizenship Network in Brussels. The meeting brought together representatives of civic and patient associations from 12 European countries to discuss key immunization topics.
Diseases that once caused high mortality rates, such as smallpox and diphtheria, are now under control. And measles should not be underestimated
In his speech, Vella began: “Diseases that once caused high mortality rates, such as smallpox and diphtheria, are now under control. Even mortality from measles, which once severely affected the paediatric population, has drastically decreased. This has significantly contributed to increased life expectancy, as fewer children die today from preventable diseases.”
The Diversity and Evolution of Vaccines
Currently, 27 vaccines are available worldwide, with many others under development. These vaccines fall into different categories: sub-unit, live attenuated, recombinant, and the most recent mRNA vaccines. Science and vaccine research have made great strides. For example, the polio vaccines developed by Sabin and Salk represented a monumental breakthrough. Among the more recent vaccines, those against pneumococcus, effective against many subtypes, and against herpes zoster, now available in recombinant form, ensure greater safety compared to live versions.
Currently, 27 vaccines are available worldwide, and many others are in development
The RSV (Respiratory Syncytial Virus) vaccine also represents an important research evolution. “This vaccine,” explained Vella, “is administered to pregnant mothers to transmit antibodies to the baby through breast milk. Additionally, monoclonal antibodies are available to protect especially premature babies, offering protection for the first six months of life when RSV can cause significant damage. This virus also affects adults, making extended vaccination coverage essential.”
Old Epidemics: Successes and Ongoing Challenges
Vella recalled how the eradication of human smallpox in 1979 and the near-complete elimination of poliomyelitis are historic vaccination milestones. However, influenza remains a challenge due to its annual mutations, necessitating a new vaccine each year. WHO recommendations suggest prioritizing vaccination for pregnant women, healthcare workers, children under five, the elderly, and people with chronic conditions.
The case of Ebola is also noteworthy: “Ebola represents an example of a disease whose vaccine was developed quickly. The disease originates from bats and never ‘succeeded’ in becoming a pandemic due to its high lethality: the virus is so potent that it kills rapidly, preventing widespread transmission. Currently, two vaccines are available, created with great speed. It’s important to emphasize this aspect to highlight that, even before the Covid-19 emergency, it was possible to develop vaccines quickly, dispelling doubts about the efficacy of Covid vaccines, often questioned due to their rapid development.”
Inequalities in Vaccine Coverage
The Covid-19 pandemic has exacerbated inequalities in vaccine distribution, highlighting an issue that also affects other essential vaccines such as those against HPV and hepatitis B
One of the major global challenges is inequalities in vaccine coverage. Vella continued: “Vaccine distribution in Africa is still very low, despite efforts by international initiatives such as GAVI (Global Alliance for Vaccine Immunization). This results in dramatic consequences, such as high measles mortality in areas without vaccines. The Covid-19 pandemic has accentuated inequalities in vaccine distribution, highlighting a problem that also affects other essential vaccines like those against HPV and hepatitis B.”
Innovation in Vaccine Production
Vaccine production has also seen a revolution, moving from analogue methods to digital ones. Today, thanks to virus sequencing, vaccines can be developed quickly, as in the case of mRNA vaccines. This progress has also accelerated regulatory processes, as seen during the Covid-19 pandemic, when regulatory authorities greatly accelerated research by allowing different development phases to overlap.
Priorities for Health Institutions
Information is a fundamental tool to combat vaccine misinformation and increase awareness of their social and global utility. Vella emphasized: “Vaccines, like all medicines, can have side effects, but they are among the safest drugs. It’s essential to increase vaccine coverage, especially for basic paediatric vaccines and for the elderly, for example, against influenza. We must prepare for future pandemics by strengthening health infrastructures and following health authority recommendations.”
The paradox of vaccines: when they work, the disease disappears, and the importance of vaccination is forgotten
Vella, who has also held institutional roles in public health, recalled that the Italian Ministry of Health has long developed an important vaccination project that must be constantly applied and updated: “Generally, general practitioners and paediatricians adhere to the vaccination schedule; sometimes what is lacking are the tools to assess the importance of vaccination in the elderly. Additionally, reintroducing the school doctor would be useful, as they could play a crucial role in children’s vaccination.”
The Situation in Europe
Italy is part of the ECDC network, the European Center for Disease Control, which provides precise and valid information that must be followed by national institutions. However, there is a paradox with vaccines: when they work, the disease disappears, and the importance of vaccination is forgotten. Objections to vaccinations often arise from this lack of awareness of the risks of preventable diseases.
The Impact of Vaccines on Sustainable Development Goals
A recent study by Rappuoli et al. highlighted that vaccines positively influence almost all sustainable development goals. They have a significant impact on health, the economy, and poverty. For this reason, Vella concluded: “Vaccine protection against major pandemics is crucial for the future. The Pandemic Fund, led by the World Bank and WHO, is an example of how we are preparing for future pandemics.”
Conclusion
Vaccines represent one of medicine’s most extraordinary discoveries, capable of preventing millions of deaths and significantly improving global quality of life. For health decision-makers, it is essential to continue investing in research, equitable vaccine distribution, and accurate information to ensure optimal vaccine coverage and effectively prepare for future health challenges.
The active involvement of citizens and patients in vaccination policies and decision-making processes is crucial for addressing public health challenges and fostering trust
The active involvement of citizens and patients, along with their organizations, in vaccination policies and decision-making processes is crucial for addressing public health challenges and fostering trust. The next European meeting organized by Cittadinanzattiva – Active Citizenship Network will be held on October 15 in Brussels for leaders of civic and patient associations. This event is designed for those committed to intensifying their efforts on this issue in their respective contexts.
