Approaches to Vaccination Among Populations in Areas of Conflict

Abstract

Vaccination is an important and cost-effective disease prevention and control strategy. Despite progress in vaccine development and immunization delivery systems worldwide, populations in areas of conflict (hereafter, “conflict settings”) often have limited or no access to lifesaving vaccines, leaving them at increased risk for morbidity and mortality related to vaccine-preventable disease. Without developing and refining approaches to reach and vaccinate children and other vulnerable populations in conflict settings, outbreaks of vaccine-preventable disease in these settings may persist and spread across subnational and international borders. Understanding and refining current approaches to vaccinating populations in conflict and humanitarian emergency settings may save lives. Despite major setbacks, the Global Polio Eradication Initiative has made substantial progress in vaccinating millions of children worldwide, including those living in communities affected by conflicts and other humanitarian emergencies. In this article, we examine key strategic and operational tactics that have led to increased polio vaccination coverage among populations living in diverse conflict settings, including Nigeria, Somalia, and Pakistan, and how these could be applied to reach and vaccinate populations in other settings across the world.

Children on the Move

“…Studies with a rigorous study design must be conducted to assess interventions to successfully implement vaccination programs for migrant populations [125,126]. In conflict zones and complex humanitarian emergency settings, the implementation of mass immunization campaigns has resulted in controlling the outbreaks of wild polio virus and circulating vaccine-derived poliovirus infections, suggesting that innovative approaches to vaccinate children on the move are needed [127,128]. Cost-effective interventions to address health care disparities and provide high-quality primary and secondary health care for large numbers of recently arrived migrants remains a major priority for many high-income countries [10,11,28,[129][130][131][132].…”

New immunization strategies: adapting to global challenges

“…The new Polio Endgame Strategy for the years 2019-2023 uses intensified immunization approaches in Afghanistan and Pakistan, e.g., so-called hit-and-run vaccine delivery in conflict-affected and insecure areas [55]. At the same time, strides are being made to integrate the delivery of polio vaccination and ded-icated surveillance networks fully into NIPs [56].…”

Infectious Diseases among Refugee Children

“…Studies with a rigorous study design must be conducted to assess interventions to successfully implement vaccination programs for migrant populations [125,126]. In conflict zones and complex humanitarian emergency settings, the implementation of mass immunization campaigns has resulted in controlling the outbreaks of wild polio virus and circulating vaccine-derived poliovirus infections, suggesting that innovative approaches to vaccinate children on the move are needed [127,128]. Cost-effective interventions to address health care disparities and provide high-quality primary and secondary health care for large numbers of recently arrived migrants remains a major priority for many high-income countries [10,11,28,[129][130][131][132].…”