Successful newborn immunization relies on quality care more than we realize

As we see countries around the globe taking up initiatives to eradicate preventable childhood illnesses, most might picture young school aged children lined up at health centers. This World Immunization Week, we want to talk about what may be overlooked – the importance of quality care to deliver immunization to newborns, prioritizing the first 28 days of life to improve coverage.

The theme for World Immunization Week 2019 is Protected Together: Vaccines Work! promoting the use of vaccines to protect people of all ages. Yet, there are still nearly 20 million unvaccinated and under-vaccinated children in the world today. In 2016 alone, nearly 200,000 newborn babies died from pneumonia, tetanus and meningitis. The majority of these deaths could have been prevented by vaccines. How can we build on improving immunization coverage in communities and worldwide?

We know that vaccines are a direct way to reduce maternal and neonatal deaths – when mothers are vaccinated against preventable diseases, they are less likely to transmit them to their newborn babies. We also know that vaccinations given in the first 24-hours of life can dramatically reduce a newborn’s risk of dying from certain preventable diseases as well as reduce the risk of death later in life.

An important example is the hepatitis B virus (HBV). An estimated 257 million people have chronic HBV infection, and 686,000 deaths occur annually due to long-term complications. Most chronic infections are acquired during infancy, primarily through mother-to-child transmission. Since 1992, the World Health Organization has recommended a first dose of vaccine within 24 hours of birth to reduce the risk of infection; yet less than half of newborns are vaccinated that quickly (39% in 2015). Universal coverage for infant vaccination from birth could prevent 4.3 million new infections from 2015 to 2030 and prevent 84% of HBV-related deaths (learn more here).

Vaccines work and can drastically reduce maternal and neonatal deaths from diseases like measles, cholera, diphtheria as well as improve long term health. But tackling vaccine-preventable deaths requires maintenance of immunization programs as well as strengthening health systems for mothers and children. It will be important to capitalize on the rising trends in antenatal care and facility births taking place in low resource settings. As Anuradha Gupta, Deputy CEO of Gavi, states, “If nine months is not sufficient time for a health system to prepare for childbirth and mitigate these predictable risks, the system is unlikely to be well-placed to address more immediate threats to the communities that it serves.”

Ensuring mothers receive quality care during pregnancy and childbirth is a critical component to reducing mortality and improving health outcomes of both mothers and babies. When pregnant mothers have access to quality healthcare through antenatal checkups, receive nutritional support and information about their baby’s health during checkups, they are empowered to continue their relationship with health centers through facility births, postnatal checkups, exclusive breastfeeding support and immunization for their babies. To improve immunization coverage among newborns, we need to focus on strengthening and expanding service delivery in existing national systems to include maternal and newborn health, and immunization services.

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