Vaccination is the process of introducing the vaccine into the body. Many deadly diseases can be prevented with vaccination, such as measles or malaria. But vaccines are not always available or accessible, especially in many of the places MSF works. Factors like poverty and geography can prevent people from accessing the vaccines they need.

Vaccines are extremely safe. “When we look at safety in medicine, we look at risk versus benefit. Vaccines are kept to an extremely high standard of safety because we are giving them to people who aren't sick, so we can't accept side effects unless they are very minor or extremely rare,” says John Johnson, a vaccination and epidemic response advisor at MSF. 

Vaccines help the body recognise pathogens so the immune system can begin to produce antibodies to effectively fight them off.Vaccination can reduce the severity and duration of a disease, even if you still become infected afterward. A vaccinated person’s condition will be much less severe than someone unvaccinated.

Vaccines also protect the unvaccinated. If enough people in an area are vaccinated, a disease will no longer circulate in the community—this is called herd immunity. For example, outbreaks of measles and polio are extremely rare in countries with high vaccination coverage.

Immunisation is the process by which a human body becomes resistant to a disease. This can happen through vaccination, which refers to the act of introducing pathogens, or by contracting and recovering from the infection.

There are vaccines for many of the world’s common and deadly diseases, including cholera, measles, malaria, and pneumonia.

Traditionally, the routine immunisations recommended by the World Health Organization were: diphtheria, pertussis (whooping cough), tetanus, tuberculosis, measles, and polio. The past decade has seen new vaccines against hepatitis B, haemophilus influenza type B, meningitis, pneumonia, and diarrhea added to the recommended package.

Vaccines also help prevent many diseases for which there are no specific drugs for treatment, such as measles, polio, rubella, hepatitis B, rabies, rotavirus, and HPV. 

Today’s vaccines can protect against 26 potentially deadly infections. Of these, 11 are considered essential childhood vaccines that should be given according to a defined schedule during routine primary care, starting from infancy and extending into early childhood. Others, such as the meningitis and cholera vaccines, are used in high-risk regions to protect people of all ages against outbreak diseases.

As new vaccines are developed for other deadly childhood diseases, it’s crucial to add them into the basic vaccine package.  But there are many challenges in getting these life-saving vaccines to all children that need them.

Traditionally, the routine immunisations recommended by the World Health Organization were: diphtheria, pertussis (whooping cough), tetanus, tuberculosis, measles, and polio. The past decade has seen new vaccines against hepatitis B, haemophilus influenza type B, meningitis, pneumonia, and diarrhea added to the recommended package.

Global health organizations like UNICEF and Gavi have greatly boosted these programs. But some of the world’s most vulnerable children are not sharing in these gains—in 2019, approximately 19.7 million didn’t receive any routine immunisations at all. Around 60 percent of these children live in 10 countries: Angola, Brazil, Democratic Republic of Congo, Ethiopia, India, Indonesia, Iraq, Nigeria, Pakistan, and South Africa.

Conflict, costs, high temperatures, and geography are all factors that can make it difficult to access vaccines.  

Maintaining the cold chain
Nearly all vaccines require refrigeration. Shipping and storing vaccines in a "cold chain" (between 2°C to 8°C) until they are used is tremendously challenging in most poor settings, and is a major reason why many children don’t get all the shots they need. High temperatures and the remoteness of a community also present significant challenges to keep vaccines properly stored.

High costs of vaccines
Vaccines can also be costly. Just getting vaccines out to community clinics, and marshalling trained staff to inject them, requires significant costs that poor countries struggle to afford. Ten years ago, it cost countries less than $1.50 to buy the main recommended vaccines to protect a child’s life. Today, the lowest price for the recommended vaccination package is nearly $40. That’s because not only are more vaccines now included in immunisation programs, but many new vaccines cost much more than older ones.

Supply shortages
There are also global shortages of some vaccines, such as the vaccine for cholera. The shortage is due to soaring demand amid the extraordinary number of cholera outbreaks around the world and limited manufacturing capacity, with only one manufacturer of the vaccine left.

Conflict and natural disasters
Vaccination often can require multiple doses over time. This presents a challenge In places affected by conflict or natural disasters as people are displaced and health care systems are disrupted.

High price of vaccines
Ten years ago, it cost countries less than US $1.50 to buy the main recommended vaccines to protect a child’s life; today, the lowest price for the recommended package is nearly $40. That’s because not only are more vaccines now included in immunisation programs, but many new vaccines cost much more than older ones.

Getting vaccines to where the children are
Just getting vaccines out to community clinics, and marshalling trained staff to inject them, requires significant costs that poor countries struggle to afford. In conflict zones or natural disasters, when health care systems are disrupted and populations are displaced, children often have nowhere to get routine vaccinations.

Too many clinic visits
The current vaccination schedule requires that children come to a health clinic five separate times during their first year of life. For many families, traveling to a health clinic takes time or money—making it very difficult for them to get complete vaccination coverage for their children, especially when they have many children.

Keeping vaccines cold in hot climates
Nearly all vaccines require refrigeration. Shipping and storing vaccines in a "cold chain" (between 2°C to 8°C) until they are used is tremendously challenging in most poor settings, and is a major reason why many children don’t get all the shots they need.

Children who miss out on getting vaccinated according to the set schedule are often excluded from free national vaccine programs when they get older, based on their age. In areas of ongoing conflict—like Syria, Chad, Somalia, and Central African Republic—entire generations of children can miss out on vaccinations.

These challenges can also mean that not enough children get vaccinated to provide community protection from outbreaks of vaccine-preventable diseases, such as measles.