Investments in polio eradication in Africa improved overall immunization systems and increased coverage of routine vaccinations

A systematic review of 8 African countries that had wild polio virus transmission and significant polio eradication activities found evidence that the huge investments made in polio have strengthened capacity in almost all aspects of the overall immunization systems, especially in the areas of microplanning, service delivery, capacity-building (especially supportive supervision and on-the-job training), and program management. This led to substantial increases in coverage of other routine vaccinations – BCG, DPT, measles – in all 8 countries over a 25-year period (1989-2014), including a more than a 3-fold increase in DPT3 coverage in 2 countries and a more than a 2-fold increase in 3 other countries.

Efforts to eradicate polio have also led to improved access to other vaccines

The expertise and assets gained through efforts to eradicate polio at least partially explain the improvement between 2013 and 2015 in vaccination coverage of DPT3 in six out of ten “focus” countries of the Polio Eradication Endgame strategic plan. This includes substantial increases in vaccination rates in India, Nigeria, and Ethiopia, which, combined, reduced the number of children not fully vaccinated with DPT by 2 million in 2 years.

Integrating vitamin A supplementation during vaccine campaigns increased coverage and effectiveness for both interventions

In an effort to reach children with vitamin A deficiency in the African countries of Angola, Chad, Cote d’Ivoire, and Togo, vitamin A supplementation was administered during Polio vaccine campaigns. This led to a minimum coverage of 80% for vitamin A and 84% for polio vaccine in all of the immunization campaigns. During the second year of vitamin A integration into the polio vaccination campaign, coverage exceeded 90% for both vitamin A and polio vaccination in all four countries.

Vaccines are most cost-effective in low income countries

An analysis of the impact of rotavirus vaccine in 25 countries found that the rates of vaccination in all countries were highest and risk mortality lowest in the top two wealth quintile’s coverage. Countries differed in the relative inequities in these two underlying variables. Cost per DALYs averted in substantially greater in the higher quintiles. In all countries, the greatest potential vaccine benefit was in the poorest quintiles; however, reduced vaccination coverage lowered the projected vaccine benefit.