Recently, I received my first dose of shingles vaccine, which I realize gives away my youthful age. Admittedly following the vaccination, I had a miserable evening of chills, fever and ache. I am due for the second dose in a couple of months and as much as I am not looking forward to the potential side effects, I feel so fortunate to live in a country where life-saving vaccines are available across my entire life. My 9-year-old twins and I also eagerly received the influenza, updated COVID-19 and Human Papillomavirus (HPV)(for my kiddos) vaccines this fall.
We might be unique both in our risk perception and especially in our life circumstances, as a majority of my friends, colleagues and people particularly in Low- and Middle-Income Countries are not as fortunate as we are in having access to free vaccination across their life span.
Vaccines Beyond Childhood
In fact, thanks to a growing number of approved vaccines and opportunities to limit illness in many stages of life beyond infancy, as well as opportunities to catch up zero dose and under-vaccinated populations, there is more talk these days about Life Course Immunization (LCI). LCI is an approach to extending the benefits of vaccination and ensuring equitable access to safe and high-quality vaccinations, integrated with other life-saving interventions, across all ages and groups, including pregnant women, adolescents, health workers or older adults. (See immunization schedules from the World Health Organization and Centers for Disease Control and Prevention).
Traditionally, immunization programs have focused on vaccinating children under one year of age. Some programs also target pregnant women. However, since the recent pandemic, advancing the benefits of vaccinating people with recommended vaccines, such as HPV, influenza and COVID-19 at each stage of life has gained momentum. Moreover, there are a number of vaccines in the pipeline, such as Group B Streptococcus, malaria (next gen) vaccines which will necessitate strengthening various delivery platforms beyond the childhood immunization schedule to maximize their full potential.
Although LCI is coming into focus in an era when vaccines have become the topic of political (and not just scientific) discussion, the reasons to build strong immunization services throughout the life course are many, including preventing death and disease across age groups, reducing the burden of disease, strengthening primary healthcare and universal health coverage, and building a critical foundation for global health security. Moreover, LCI is an integral part of the global Immunization Agenda 2030 which envisions “A world where everyone, everywhere, at every age, fully benefits from vaccines for good health and well-being.”
Successful LCI approaches deliberately align the people, processes, and policies within the immunization systems to help reach audiences that may not have been reached before with integrated delivery points of contact. Revisiting immunization policies, revising upper age cut-offs, training health workers, catching up those who are eligible for vaccinations and addressing missed opportunities for vaccinations are amongst the key considerations for national officials and decision makers.
In addition to the technical challenges in expanding LCI, there are also myriad uncertainties and adaptive considerations, especially around community confidence, acceptance and uptake, and equitable access and rollout. Therefore, learning is required as there are no straightforward or technical answers to some of these adaptive challenges.
At Sabin, we are in the lead with the new 2023 “Boosting Leadership to Advance Life Course Immunization” series. Offered by Sabin’s Boost program, this dynamic, interactive series for immunization professionals, especially at subnational level, is taking a unique approach in the design and delivery of this learning solution. We recently redesigned the course and are working closely with Global South experts and implementers to integrate the LCI technical content with adaptive leadership and community organizing skills and techniques, which are essential in responding to uncertainties and unknown challenges facing immunization programs and health systems.
As the saying goes: think big, start small and act now. My hope is that this upcoming series inspires grass roots advocacy in expanding life course immunization to all ages in all settings.
Find more information on the “Boosting Leadership to Advance Life Course Immunization.”
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