This World Immunization Week, the EU should step up for humanity

For thousands of years, human history has been shaped by infectious disease.

For much of this time, we have been in an evolutionary arms race with viruses and bacteria, sometimes winning and occasionally losing spectacularly.

In the thirteenth century, Europe lost a third of its population to the Black Death – the bubonic plague. The 1918 influenza pandemic killed about 50mn people worldwide. Tuberculosis bacteria has been found in the mummy of Pharaoh Tutankhamun and still kills 1.5mn people per year.

The best weapons in our defence arsenal are vaccines. Eight infectious diseases were responsible for about 600mn deaths in the twentieth century. They can now all be prevented through vaccines.

Mostly administered in early childhood, vaccination creates a defensive line that stops infections by bacteria and viruses. Infant vaccination saves 3mn lives each year, but there are still 1.4mn children under five that die annually because of lack of access to vaccines.

This shameful statistic shows the best of humanity, of what we can achieve, and the worst of an unequal world. We have cheap and effective ways of preventing children from getting sick and dying, but we have not prioritised the manufacture, distribution and delivery of vaccines worldwide. In developed countries, generations of children have survived into adulthood, contributing to their societies and economies. Countries without the infrastructure or funds to run comprehensive vaccination programmes lose these opportunities. This is political and market failure to meet our fundamental human needs.

Vaccines will also be key in tackling cancer. Up to 90% of cervical cancers can be prevented by the HPV vaccine. Vaccines against Hepatitis B are highly effective in preventing liver cancer. The next frontier will be vaccines to treat cancer – there is huge potential in the new technology of messenger RNA vaccines, being deployed for the first time in some COVID-19 vaccines.

Emerging research shows even more benefits from vaccinating older people. Regular flu shots cut deaths from heart disease and together with vaccinations against pneumonia, they reduce risk of Alzheimer’s disease, for which we have no treatment.

“There is no medication, lifestyle change, public health innovation, or medical procedure ever developed that has even come close to the life-saving, life-extending, and primary prevention benefits associated with vaccines,” argues Leonard Hayflick, a biologist whose WI-38 human cell strain was made freely available in 1962 and is still the basis for vaccine production against 10 diseases. His work is estimated to have saved 1mn lives and averted 455mn cases of disease in Europe alone.

As the world struggles to control the current pandemic, Hayflick’s words ring truer than ever. COVID-19 vaccines developed in record time show high effectiveness in preventing disease transmission, hospitalisation and deaths. They were made possible through massive injections of public cash, as well as exceptional collaborations between scientists, industry and regulators.

Despite the extraordinary benefits that vaccination has delivered, there is growing mistrust and reluctance to get vaccinated. To achieve herd immunity, meaning that everyone is protected, high proportions of the population need to be vaccinated. For the most infectious diseases – like measles – this means between 90% and 95% of the population. But a toxic mix of conspiracy theories and misinformation is undermining the progress achieved through four decades of immunization.

The WHO calls this the infodemic, which is facilitated through digital platforms and enhanced through their content algorithms.

Pandemics are more likely, as climate change and destruction of natural habitats signals greater risk from zoonoses, diseases that can jump from animals to humans. Future threats could come from any continent and we need to ensure that we are ready for the next pandemic. The EU’s big One Health European Joint Programme is a first step towards a human, animal and planetary health approach.

Here are some prescriptions for change that Europe should champion.

COVID-19 demonstrated that we need much more vaccine manufacturing capacity around the world. The world’s largest vaccine producer is the Serum Institute in India, which cannot deliver doses for other countries through the COVAX facility while the virus remains out of control domestically. More secure and diverse supply chains could avoid some of the ugly vaccine nationalism of export controls and hoarding of raw materials needed for production.

Increased investment in open and transparent science should include ramping up genomic sequencing capacity and data sharing. This will build public trust and enable scientific collaboration to analyse data in real time. The European Centre for Disease Prevention (ECDC) and European Medicines Agency (EMA) are getting bigger mandates and resources, and they should also step up their communication towards the general public.

Some of the most prolific anti-vaccine activists are in Europe. Social media giants need to acknowledge their role in facilitating the infodemic and commit the resources needed to stop the spread of false information. The EU must treat the infodemic as a strategic risk to societal wellbeing and should tackle it head on.

• Friends of Europe: Africa Europe Foundation call for action on vaccines
• #CriticalThinking: Alternative and flexible approaches to delivering health care in COVID times, by Erin Webb and Cristina Hernández-Quevedo
• Debating Europe: Should we have a European healthcare system?