WHO 'big catch up' to close vaccine gap

'The Big Catch Up' is hoping to offset the immunisations that weren't given during the COVID pandemic
28 April 2023

Interview with 

Kate O'Brien, WHO


A globe lying on a facemask with a syringe stuck into it.


They’re dubbing it “the Big Catch-up” – it’s an initiative to vaccinate millions of children and restore immunisation progress lost during the Covid-19 pandemic which has seen millions of children miss essential jabs for lethal diseases like diphtheria and polio, setting back vaccination progress in many place by decades. Kate O’Brien, Director of the World Health Organisation's Department of Immunisation, Vaccines and Biologicals, has been speaking about why it's so important…

Kate - The first thing to say is this is not a concentrated problem. This is not like there's a small number of countries where this happened. There's over a hundred countries where there's backsliding. And really we call it historic backsliding. We've never seen something like this before. In 2021 alone, there were 25 million children who missed out on at least one essential vaccine. 18 million of them didn't get a single dose, not one dose at all of immunisation through the routine program. This takes us backwards to levels of immunisation that we were getting in 2008. So in three short years, we have basically lost the performance that was built over a 15 year period.

James - That's enormous. And as Bill Gates puts it, in short, 'vaccines work'. They save millions of lives and improve the quality of life of millions more. So I wonder if you could kind of speak to the potential consequences, if there's a failure to react to the millions that have missed out on vaccinations over the past few years.

Kate - We see a rising number of outbreaks of diseases like measles, diptheria, polio, yellow fever, for instance. In the past 12 months alone, there are 33 countries around the world that have had what we call large and disruptive measles outbreaks. Those are the big ones. There are smaller measles outbreaks that are also occurring. But that's just one example of what this means for families, what it means for kids, what it means for a community. Children are dying as a result of this. Even if they're not dying, they're getting serious illnesses that impact their life going forward. They may have long-term consequences from diseases that they get. Paralysis from polio, neurologic deficiencies, neurological impacts from meningitis. So those are some of the things that are happening, these rising number of outbreaks. And they're spreading into additional countries that these are the lives and the wellbeing of kids for the future.

James - Yeah, I mean, you've outlined there just how important it is that we close this immunity gap. So that's where 'The Big Catch Up' comes in, isn't it? This year's world immunisation week dedicated to responding to this deficit.

Kate - So we really have rung the alarm bell, and we're calling this the big catch up. And there are three things that we really want countries to do and we want people to do. So the first is to catch up those kids who missed out on vaccines during the course of the pandemic period, setting up programs that will immunise kids even if they're a little bit older than the age at which they would otherwise have been vaccinated. The second thing that the big catch up entails is restoring the immunisation program. So for the kids being born in 2023, we want to make sure that the immunisation programs in every country around the world are performing at least at the levels that they were before we went into the pandemic. And then the third thing that the big catchup is really pointing to is that every single country can do better on their immunisation program. And we had already set a goal with every country around the world for what we would achieve by the end of this decade, by 2030. And so we're really asking for countries to get back on track to reach that trajectory. And it does mean that individuals have actions that they can take. It means parents should ensure that their children are up to date, that they didn't miss vaccines during the course of the pandemic years. And also being advocates with your family, with your friends, with your community, sharing information that is accurate information about vaccines. And then at the national level, it's really about using resources of governments and redirecting those resources to support doing more through the immunisation program.

James - I think what you're saying, everyone can get behind. I just wonder if, given the sort of long-term nature of this sort of project, how it's going to be determined whether it's been a success. What will it mean to have been caught up?

Kate - The most complete data that we have is for 2021. And in 2021, three quarters of the world's children who didn't get any doses through the routine immunisation program, were living in 20 countries. We're going to be paying special attention to those 20 countries to give all the support that we can, both financial support, technical support, advocacy. The way that we're going to know whether or not this is working is, first and foremost, the evidence that the countries have, the data that the country has. So we'll have a pretty good feel for the impact of the big catch up as we go through 2023. The second thing is that we will start to see a quietening down of some of the outbreaks. We monitor outbreaks really carefully, and so we do see over time whether outbreaks are increasing in number, increasing in spread, increasing in size. So this is something that we track really, really carefully.


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