A world without vaccines?

Weekender
HEALTH
Vaccines help in not only preventing infection but ultimately eliminate disease-causing organisms.

By GELINDE NAREKINE
JUST imagine for a moment, if there were no vaccines.
What would it be like to live in a world without vaccines? What if the world had no vaccines against infectious diseases at all?
The most likely scenario would be that many of us could probably have died at half our lives. Or worst still, we would have been long gone before we had the opportunity to make any reasonable sense and meaning of the physical world. Many of us would have died of preventable infectious diseases in early childhood.
Imagine a world in which everyone is at risk of contracting a contagious disease with no prevention or cure. A world in which billions of people live in fear of a disease that is fatal to many, and that has the power to shut down entire economies.
For many, such a frightening scenario would have been confined to the realms of creative imagination just a couple of years ago.
And yet, this is the reality we live in today as a result of the Covid-19 pandemic, which has in less than three years, infected over 510 million people and claimed more than 6 million as its victims.

What would happen if vaccine stocks disappeared overnight?
One of the things that vaccines have made possible is the eradication of disease. So far, the global community has eradicated one human disease, smallpox, and now really close with polio. Polio is on its last legs now that it has been cornered into just a couple of final populations in the world. That is only possible through the use of vaccines and therefore, requires everybody to use them for the whole world to benefit.
It would certainly be terrifying for parents if vaccine stocks disappeared overnight. And for the scientific community, experts will be working overtime because the consequence would be that, millions of women, children and adults will suffer needlessly from preventable diseases.

What diseases would resurge without vaccinations?
Today, more than 17 million people are walking, who would have been paralysed. The world populace is nearly to the point where there is not a single person paralyzed from the polio virus anywhere in the world.
Without vaccines, that would come back, and we would have needless, countless numbers of people paralysed by a virus that can be prevented today. There would also be a resurgence of the epidemic diseases that not only kill or disable people, but strike fear in the hearts of people the world over.
Imagine a world without the measles vaccine. That disease would spread quickly. If you dropped immunity to measles everywhere without a vaccination, you would rapidly get huge outbreaks in which 80 per cent (or more) of people would become infected with measles.
They would have severe fevers and rashes. Many of them would be hospitalized, some of them would die, and some of them would have life-long disabilities like blindness
Imagine the social environment in which those kinds of diseases are running rampant, where people are afraid to be in contact with other people, where parents hold children back from playing with other children.
We don’t have to turn back the clock that long to actually find that period of time in the 1950s in the United States before we had polio vaccines. That is what really happened. When there was a case of polio in the community, community swimming pools were shut down, and children stayed inside at home.
The fear of paralysis, severe illness, or death from polio, smallpox, and other dreadful infectious diseases was a very real and pervasive reality for people worldwide within living memory. Today, we take for granted the protection provided by vaccines. This allows us that kind of freedom of interacting with people that the terror and fear of vaccine-preventable diseases would take away from us.
Before vaccines, smallpox had affected the human population for three millennia, infecting the young, the old, the rich, the poor, the weak, and the resilient. Spread by a cough or sneeze, smallpox caused some deadly symptoms. An estimated 300 million people died from smallpox in the 20th century alone, and more than half a million died every year before the launch of the global eradication program.
We do not have to go back in history any further so to appreciate the dilemma of coping with an infectious disease that is highly transmissible. The outbreaks of SARS-CoV-2 showed us for months, what it feels like to be at the mercy of a pandemic without an appropriate antidote.
Covid-19 pandemic is a clear example of what a world without a vaccine would look like. Without vaccines, another outbreak of Covid-19 could be beyond the magnitude we now experience. It would likely be catastrophic
However, thanks to the use of safe and effective vaccines. There is continued life-long protection from infections for children and even adults.

Which populations are at highest risk without vaccines?
These diseases pick out vulnerable people first, and so babies and young children would be first. Other groups of people whose body’s defences are weakened would be next, like those who are malnourished or people living with conditions such as HIV and AIDS infection.
It should be remembered that some of these diseases are deadly. Meningitis is the kind of disease that would slay an athletic-fit teenager, or lead to an amputation, regardless of how energetic he or she was the day before.
Cervical cancer and liver cancer are devastating illnesses that would come back, though more slowly because it takes a longer time to develop cancer. Now, those are two things that the global community is starting to control. Without vaccines, they would surely come back.
Why is World Immunisation Week important?
Most people in rich countries have never seen the impact of infectious diseases like measles, diphtheria, meningitis or whooping cough. They do not fear them because they have not seen them firsthand, because of high vaccination coverage.
Diseases like epiglottitis have disappeared from America and Europe because of one of our bacterial meningitis vaccines (the ‘Hib vaccine’).
A lot of those ‘classic diseases’ are gone now because of vaccination. People are not afraid of them any more in places like the US, Europe, and in other well-to-do nations. It thus, important and necessary to remind ourselves on the realities of infectious diseases and the significance of vaccines in protecting us from these diseases.

Why is vaccine awareness important in poorer regions?
There is a part of Africa that is so impacted by epidemics of bacterial meningitis, its nickname is the “Meningitis Belt.” It is a belt in the dry region of Africa that has been prone to huge epidemics of bacterial meningitis every three to five years.
And now, as a result of the hard work of many people, an Indian vaccine manufacturer has created a vaccine specifically for the cause of that epidemic. Its widespread use is supported by the Global Vaccine Alliance (GAVI) funding so that now. That initiative has virtually eliminated that cause of epidemic meningitis from Africa.
That was done by doing big campaigns in the affected countries. And what was amazing is when those campaigns were held, people would stand in line in temperatures over 40 degrees Celsius, or hotter, for hours, to be sure that they and their family members got vaccines against epidemic meningitis, because every one of those communities had been affected by meningitis. Every one of those families, every one of those parents knew how important it was to get this protection.

How large an effort is needed to roll out vaccinations everywhere?
Global vaccinations work to protect women, children, and communities every day from about 2-3 million preventable deaths a year right. That success depends on a huge coordinated effort. We need manufacturers to make the vaccines.
We need national governments to buy the vaccines. We need donors to help subsidise that in some places. We need communities that demand the vaccines. And we need a huge health worker force to be able to deliver those vaccines at the right time in the right places.
It is mind blowing if you think about it, that the magic moment, that moment when a parent sits in a clinic with a health worker, that moment of vaccination, it typically takes about a minute.
When you think about how much went into making that magic minute possible, it is mind blowing. And the fact that we do it tens of millions of times around the world every day is all the more incredible.
Why are vaccines indispensable?
The discovery of vaccines was pure genius. Although improved sanitation, hygiene, and antibiotics may have saved more lives, vaccination represents the most cost-effective and potent life-saving devise in the whole of human history. Vaccines are among the most imaginative and ingenious of public health interventions.
It all started with the English country doctor Edward Jenner, who administered the first vaccination against smallpox, one of the worst infectious diseases of all time, at the end of the 18th century.
Around 170 years later, in an unprecedented vaccination campaign, the World Health Organsation succeeded in eradicating the disease.
It is a far-fetched fact that few interventions in public health can compare with the global impact of vaccination. It has significantly reduced disease, disability, and death from a variety of highly infectious diseases. Many of the diseases that were previously responsible for the majority of childhood deaths have essentially disappeared.
With millions of children and adults being vaccinated the world over, our expectation of death associated with infections has dramatically changed. Millions of lives are being saved each year due to use of vaccines.
Before vaccination became an integral and essential global public health programme, it has been estimated that one-third of all children died before age 15.
Today, thanks largely to vaccines, less numbers of children die from preventable infectious diseases. When a child is born today, parents need not fear the scourges of smallpox, paralysis from polio, mental retardation and profound hearing loss from Haemophilus influenzae B meningitis, or any number of other frightening, often life-threatening infections, including, diphtheria, pertussis, tetanus, measles, mumps, and rubella.
Smallpox, polio, tetanus, diphtheria, and measles – described as the five most dangerous diseases in the last century, have been totally or nearly eradicated. The widespread vaccinations have clearly demonstrated what vaccines can achieve.
Without the life changing impact of vaccines, our world as we see, know, and appreciate today, would have been a very different place indeed.
Source of information:

  1. Levine, O 2018, What would happen in a world without vaccines?, World Economic Forum, viewed 2 April 2022, https://www.weforum.org>agenda>2018/04
  2. The world without vaccines, Polio Global Eradication Initiative, 2018, viewed 02 May 2022, https://www.polioeradication.org
  3. Why the world is at risk without immunization, VaccinesWork, 2020, viewed 02 May 2022, https://www.gavi.org

Gelinde Narekine is a technical officer at the Discipline of Medical Laboratory Science, School of Medicine and Health Sciences of the University of PNG.