The resurgence of measles and the concerning state of adult vaccination rates have shed light on persistent gaps in global immunization efforts. Walter Orenstein, a renowned expert and recipient of the IVI-SK bioscience Park MahnHoon Award, warns that countries are failing to prioritize the delivery, public trust, and follow-up of vaccine programs.
In an insightful interview, Orenstein, a former leader of the U.S. National Immunization Program, emphasizes the critical distinction between vaccines and vaccinations. While vaccines are developed to prevent diseases, it is the act of vaccination that ultimately saves lives. This subtle yet crucial difference highlights the importance of policy implementation and ensuring that vaccines reach the intended populations.
The Measles Comeback
Measles, a highly contagious disease, serves as a stark reminder of the consequences of inadequate immunization. Orenstein points out that national coverage figures can be misleading, as they often fail to capture under-vaccinated communities or age groups. This creates immunity gaps, allowing measles to resurge quickly. Even countries like Korea, which hold WHO certifications for measles elimination, are not immune to outbreaks. The 78 measles cases reported in Korea in 2025 demonstrate the vulnerability that arises when neighboring countries experience outbreaks.
Beyond Borders
Orenstein commends Korea's efforts, acknowledging their success in controlling measles. However, he emphasizes the interconnectedness of global health. When pathogens circulate in other countries, they pose a risk not only to their own populations but also to Korea, highlighting the need for a comprehensive and collaborative approach to vaccination.
Understanding Vaccine Hesitancy
One of the key challenges identified by Orenstein is vaccine hesitancy. He believes that education systems are currently inadequate to address this issue effectively. Younger generations, who have not witnessed the devastating impact of vaccine-preventable diseases, may be more susceptible to misinformation and skepticism. Overcoming hesitancy requires a multifaceted approach, including stronger advocacy, political engagement, and support from donor groups and charitable organizations.
Adult Vaccination: A Global Concern
Adult immunization is a pressing global issue, with coverage often lagging behind childhood vaccination rates. Orenstein expresses disappointment that the COVID-19 pandemic, which could have served as a catalyst for improving adult vaccination, failed to deliver on this front. The political controversies surrounding COVID-19 vaccination further exacerbated the problem, creating a backlash against vaccines.
Practical Implications for Korea
Korea's ongoing expansion of its vaccine program provides an opportunity to learn from these insights. The introduction of free PCV20 for children and HPV shots for boys is a step in the right direction. However, maintaining high vaccination rates among both children and older adults is crucial. The success of Korea's national influenza program, which achieved coverage of 69.5% among children and 82.5% among older adults in the 2023-2024 season, serves as a positive example.
Regional Collaboration
Orenstein highlights the importance of regional cooperation, citing Singapore and Thailand as countries that are setting useful examples. The International Vaccine Institute (IVI) also emphasizes the value of collaboration, data sharing, and information exchange among experts from different countries. This collaborative approach is essential to address the complex challenges of vaccine access and public health.
A Life Highlight
For Orenstein, the IVI-SK bioscience Park MahnHoon Award, which recognizes contributions to vaccine access and public health, is a career highlight. It serves as a testament to his dedication and impact in the field of immunization.
In conclusion, the resurgence of measles and the gaps in adult vaccination rates serve as a wake-up call for countries to prioritize and strengthen their immunization efforts. By addressing issues such as vaccine hesitancy, improving education, and fostering collaboration, we can work towards a future where diseases like measles are a thing of the past.
