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European Biopharmaceutical Review

Vax Populi

Imagine a world before vaccines… communicable diseases extracted a massive toll in human suffering and economic losses. Now, in our lifetime, global polio eradication efforts have wiped out the disease in the EU, US, and other developed regions. The number of reported cases has been reduced to 33 globally in 2018. Smallpox is gone. The last known case was observed in 1977, and the overall number of tetanus cases has declined since widespread vaccination in the 1950s, although it still accounts for over 5% of neonatal mortality worldwide. At the middle of the last century measles, mumps, and varicella (chickenpox) were common childhood diseases, even in advanced economies. Now that the DPT vaccine is a standard for all young children, most of us living in the EU or US have never actually known anyone who suffered from diphtheria, whooping cough, or tetanus. Not so with influenza, which recurs annually and almost all of us have experienced at some point in our lives.

Today, with modern vaccines available, WHO estimates that immunisation prevents about 3 million deaths from infectious disease per year. For example, global measles mortality has decreased by 80%, yet there’s still a long way to go – 20 million children under one year of age have not received basic vaccines. Many industrialised nations have achieved vaccination rates of 99%. However, there are still regions with alarmingly low rates of vaccination in developing countries, where economic hardship and civil strife impede the progress of universal vaccination programmes. The spread of infectious disease through a population is dependent on the fraction of individuals that have immunity either through prior exposure or through vaccination. As not every individual can be vaccinated, for medical reasons, it is important to achieve a vaccination rate in the population that is sufficient to suppress the spread of contagion. When this threshold vaccination rate is achieved, the protective effect on a population as a whole is called ‘herd immunity’.

The exact threshold of herd immunity depends on the virulence of the disease and on the number of social contacts. For a disease such as measles, where one contagious individual could infect more than a dozen others, herd immunity would need a 90- 95% vaccination rate. Another less contagious disease like polio would require around 80-85%. Success in this regard protects individuals at risk – young babies, immune-compromised individuals, or people who are not able to receive or tolerate immunisation.

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Emile Bellott is a member of the EBR Industry Advisory Board, a graduate of the Harvard Business School, US, and an industry consultant with experience in the biotech and biopharma industry.
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