Scale up immunisation for better resilience

**Two and half year old Magret Waithera receives polio vaccine in the second phase at Moi Lane, a backstreet in Nairobi on July 19, 2021.** [Denish Ochieng, Standard]

As we marked World Immunisation Week last week, it was a good time to remind ourselves of some of the lessons learnt from the Covid-19 pandemic. The crisis could provide useful lessons for longer-term change to build greater resilience.

When vaccination services are disrupted, even during emergencies, the risk of vaccine-preventable disease outbreaks increases. Without vaccines, outbreaks of these diseases may result in increased illness, worsen malnutrition and even deaths among children, and further burden the health system already under pressure due to Covid-19.

Official data published by World Health Organisation and United Nations International Children's Emergency Fund (Unicef) showed that a majority of countries experienced drops in childhood vaccination rates in 2020 due to global service disruptions caused by the Covid-19 pandemic. With many resources and personnel diverted to support the Covid-19 response, there were significant disruptions to immunisation service provision in many parts of the world. Without the relevant vaccinations, outbreaks of vaccine-preventable diseases may result in increased illness, deteriorating malnutrition and even deaths among children. This will, in turn, place a greater burden on the health system, which is already stressed as a result of Covid-19.

According to Tedros Adhanom Ghebreyesus, WHO Director-General, it is more urgent than ever to invest in childhood vaccination to ensure every child is reached, as multiple disease outbreaks would be catastrophic for communities and health systems already battling Covid-19. Community Acquired Pneumonia (CAP) exerts a substantial burden on older adults, with incidence rates varying from about 200 to 7,000 cases for every 100,000 people in some countries. CAP is a serious disease that has a large impact on both the healthcare system and individuals and is by far more common in sub-Saharan Africa than in Europe or North America.

A rise in the aging population in Kenya is increasing the need for pneumococcal adult vaccination in Kenya. The most common risk factors for acquiring CAP and invasive pneumococcal disease (IPD) included Diabetes mellitus, alcohol misuse disorders, chronic obstructive pulmonary disease (COPD), asthma, smoking, cancer, cerebrovascular disease, chronic kidney disease and HIV infection. These comorbidities and risk factors are on the rise in the Kenyan adult population. Having two or more comorbid conditions drastically increases the incidence of pneumococcal CAP. The incidence of pneumococcal pneumonia among adults is often underestimated as many affected people are treated outside of a hospital setting, and it is challenging to collect samples to identify the cause of the infection. Even within the hospital, diagnosing what is causing the infection can still be difficult.

While children need immunisation, it is clear that adults need protection too, whether it is in the form of an annual flu vaccine or where they may be at risk of vaccine-preventable diseases as a result of their age, job, lifestyle, travel or health conditions.