Measles outbreaks and weak adult vaccination rates are a stark reminder that the world still has a long way to go in ensuring universal vaccine coverage, according to Walter Orenstein, an expert in immunology and public health. Orenstein, a former head of the U.S. National Immunization Program, warns that despite progress, many countries are failing to invest enough in vaccine delivery, public confidence, and follow-up, which are crucial for maintaining high vaccination rates.
In an interview with Korea Biomedical Review, Orenstein emphasized the importance of policy and coverage in disease prevention. He highlighted measles as a prime example of how gaps in immunity can lead to outbreaks, even in countries that have achieved elimination. Korea's recent measles cases, despite its certification for elimination, underscore the ongoing challenge of reaching vulnerable populations.
One of the key issues Orenstein identified is the lack of focus on ensuring that recommended vaccines are actually administered. Countries often prioritize adding new vaccines to their schedules without addressing the logistical and educational barriers that prevent people from getting vaccinated. Orenstein argues that "Vaccines don’t save lives -- vaccinations save lives," emphasizing the critical role of policy in achieving disease control.
In Korea, Orenstein noted that the country has made significant strides but remains vulnerable to imported infections from neighboring countries. He advocates for stronger vaccination coverage beyond Korea's borders, as the circulation of pathogens in other regions poses a risk to the entire region. Orenstein also stressed the importance of understanding the reasons behind vaccine hesitancy, which can vary due to factors like cost, distance, and missed opportunities in clinics.
He criticized the lack of education systems to address hesitancy, attributing it to the success of vaccines in eradicating diseases that younger generations no longer experience. Orenstein called for stronger advocacy, coalitions with political influence, and external support to maintain vaccine investment on the global agenda. He also highlighted the global problem of adult immunization, which has lagged behind childhood immunization, and the negative impact of the Covid-19 vaccine rollout on public trust in vaccines.
Orenstein's concerns are particularly relevant in Korea, where the vaccine program is expanding. The introduction of free PCV20 for children and free HPV shots for 12-year-old boys is a positive step, but Orenstein emphasizes the need for continuous evaluation and improvement. He praised regional cooperation models like those in Singapore and Thailand, where collaboration, data sharing, and information exchange are key to successful vaccination campaigns.
The Park MahnHoon Award, which Orenstein received this year, recognizes his contributions to vaccine access and public health. Orenstein described the award as a highlight of his career, underscoring the importance of recognizing and supporting experts in the field of immunology and public health. As the world grapples with the challenges of vaccine delivery and public trust, Orenstein's insights offer a critical perspective on the path forward.
