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Building trust in vaccines is essential for global health

January / February 2020 | Volume 19, Number 1

File photo of Dr. Maharaj (Raj) K. Bhan and Dr. Roger I. Glass.

File photo: Dr. Maharaj (Raj) K. Bhan was my longtime
collaborator and close friend. His legacy endures in
the lifesaving rotavirus vaccine he developed.

Opinion by Fogarty Director Dr Roger I Glass

One of the terrible ironies in global health is that in many parts of the world, parents are desperate to secure lifesaving vaccines for their children, while here in the U.S. a significant number of wealthy parents spurn them.

This was on my mind recently, as I traveled to India to pay tribute to my late colleague, Dr. Maharaj (Raj) K. Bhan, who lost his courageous battle with cancer in January. As I gathered my thoughts for his eulogy, I felt admiration for my close friend and collaborator of three decades, remembering all he had accomplished. Most significantly, we developed an Indian rotavirus vaccine - from an Indian strain, produced by an Indian company and embraced by the Indian government. This inexpensive vaccine has probably saved more than 50,000 lives in its first two years of use. In 2019, we celebrated delivery of its 125-millionth dose. What greater achievement could there be for a pediatrician but to save the lives of the world’s most vulnerable children?

And yet, as fears of coronavirus sweep the globe, false rumors emerge that somehow the outbreak was caused by a vaccine attempt gone wrong. Meanwhile, researchers worldwide are working tirelessly to develop a vaccine that could halt the epidemic’s spread.

Hysteria surrounds this new health threat but little attention is paid to influenza, which this season has already taken 14,000 lives, nearly 100 of them children. Many continue to avoid flu shots, despite the considerable body of evidence that shows the vaccine can offer significant protection.

This lack of faith in scientific evidence is also the reason why measles is once again an urgent public health threat. Infections have increased 30% globally and a number of European countries have even lost their official measles elimination status. Here in the U.S., there were 1,282 cases of measles in 2019, the highest number in decades. Nearly 130 of these cases led to hospitalization and almost half had complications, including pneumonia and encephalitis. These are not trivial matters.

While the global community has given this a neutral and unexciting name - vaccine hesitancy - the WHO rightly claims this to be among the world’s top 10 health problems! It is incredibly frustrating, since vaccination has long been one of our most powerful, cost-effective ways of preventing disease. Each year, as many as 3 million lives are saved by vaccination.

In our ongoing battle against cancer, we now have a vaccine that has been proven effective in preventing cervical cancer - one of the most difficult forms of cancer to detect at its earliest stages. About 570,000 cases were diagnosed globally in 2018 and 311,000 deaths occurred. Even so, many parents’ irrational fears have kept them from having their children inoculated against the virus that causes this cancer - with only about half of American teens having received both recommended doses of the HPV vaccine.

For those of us who are old enough to remember successful elimination of the dreaded polio in the U.S. and eradication of smallpox worldwide - both through the miracle of vaccines - it is astonishing that these achievements are disregarded and vaccines are now being shunned by some. We rely on herd immunity for vaccine-preventable diseases to be contained. As we’ve seen with measles, diseases can quickly reemerge when vaccine levels drop.

As I continue to grieve the loss of my friend, I take comfort in the knowledge his great achievement - the new rotavirus vaccine Rotavac - will save countless lives in the years to come. This new addition to the global arsenal of vaccines is an important tool to improve childhood survival among the world’s most vulnerable and stands as Dr. Bhan's enduring legacy.

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