A Vaccine is Only as Good as its Ability to Reach People
On Dr. Albert B. Sabin’s birthday, his legacy is a reminder that vaccination and health equity go hand-in-hand
Each year, on August 26, the Sabin Vaccine Institute (Sabin) recognizes the birthday of our organization’s namesake, Dr. Albert B. Sabin; scientist, public health advocate and inventor of the trivalent oral poliovirus vaccine. His groundbreaking research and development work and unwavering commitment to humanitarianism continue to inform vaccination programs around the world today. This year, as the world grapples with a global pandemic and vaccine developers sprint to create a safe and effective COVID-19 vaccine, we reflect on Dr. Sabin’s legacy and what we can learn about global distribution from the oral polio vaccine.
Polio, or poliomyelitis, is an infectious disease caused by the poliovirus and can lead to muscle-wasting, paralysis and death of infected individuals, most often children. At the time that Dr. Sabin introduced the live oral polio vaccine, Dr. Jonas Salk’s injectable inactivated polio vaccine was already available. Through his research, Dr. Sabin discovered that poliovirus resided in the gut of infected individuals, and might be attacked there, leading him to develop a live vaccine that could be administered orally, with only two drops per dose. By doing so, he hoped the vaccine would reach more people; an oral dose was more practical because it could be transported with greater ease, stored for longer periods of time and delivered to children by individuals with limited or no health care training.
The innovation of the polio vaccine therefore eased longstanding distribution barriers, including those in the supply chain and those resulting from an insufficient number of trained frontline health care workers, making it possible to inoculate millions of people around the world in mass immunization campaigns. Today, polio is close to being eradicated, with only 102 wild poliovirus cases reported in 2020. In addition, on August 25, 2020, the World Health Organization (WHO) African Region was declared free of wild poliovirus, bringing the world closer to achieving global polio eradication.
This huge feat is only possible thanks to effective, safe and scalable vaccines and the willingness of dedicated stakeholders – from private industry to governments to the public sector and more – to collaborate and coordinate on mass immunization campaigns.
The success of the oral polio vaccine’s distribution shows us the importance of everything that comes after a vaccine is developed. As a global health community, we must remember that it is not the development of a vaccine alone that will end the COVID-19 pandemic, but the successful coordination, distribution and deployment of such a vaccine that will ultimately enable the world to gain control over the virus.
To guarantee that a future COVID-19 vaccine reaches those who need it most, including in remote and difficult-to-reach areas, health equity must be prioritized. The concept that everyone, everywhere deserves a fair and just opportunity to access quality health care must be folded into the fabric of all vaccination programs. Dr. Sabin believed deeply that no person should be denied his vaccine simply by circumstance of birth and worked tirelessly to distribute his vaccine and connect global actors to advance mass immunization campaigns, and ensure that no child was left unvaccinated.
As COVID-19 vaccine candidates advance into clinical trials, it is imperative that “vaccine nationalism” – the “my nation first” approach to distributing a vaccine – be addressed head-on. Any vaccine that is not able to reach the most vulnerable among us will only allow the pandemic to continue.
Equitably distributing and allocating a COVID-19 vaccine will require immense collaboration and support, particularly for the people who are on the frontlines administering vaccines. At Sabin, we recognize that the systems through which vaccines are administered must be strengthened. Sabin’s Boost Community, an online network that enables immunization professionals around the world to connect, learn and lead, is delivering trainings and resources and creating space for immunization professionals to support one another. These connections will be critical to ensure successful delivery and uptake of a COVID-19 vaccine.
Vaccines are one of the greatest tools for health equity today, with the potential to free all people from the burden of vaccine-preventable disease. But for vaccines to fulfill their full promise and potential, health equity must be prioritized from the start. This will require collaboration and coordination; from the researchers who develop the vaccine, to manufacturers and suppliers who bring it to scale, to the governments and funders who determine vaccine policy, to global health stakeholders who create guidelines for successful delivery and uptake. Dr. Sabin recognized the critical nature of each one of these forces and how by working together they could potentially eliminate diseases. We must continue to draw on his legacy to work toward a future free from vaccine-preventable diseases for all people, everywhere.