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In 2016, WHO took the exceptional decision to fraction available vaccines into multiple lower doses so as to immunize a greater number of people — a 10-dose vial was used to vaccinate up to 50 people. This was enough to tackle the outbreak and reduce spread of the disease, but not to ensure life-long immunization, as a full dose would.

Improving immunization coverage

“The yellow fever vaccine program with Gavi has been hugely successful. It's a really critical vaccine. It's one that we value very highly,” Gavi’s Nguyen said.

However, significant gaps remain in vaccination coverage, and manufacturers must be incentivized to innovate further around vaccine production. WHO recommends 80% vaccination coverage in at-risk areas to prevent outbreaks. But, as per WHO estimates in 2018, the coverage reached only 49%.

In response to the Angola outbreak, WHO, UNICEF, and Gavi in 2017 launched the Eliminate Yellow Fever Epidemics campaign, known as EYE, to deliver 1.4 billion vaccine doses in 40 countries by 2026, increase routine immunization campaigns, prevent future outbreaks, and improve outbreak response.

“When we think about the global supply that we're going to need over the next 10 years, we're going to need an equivalent amount of dosage for 1.3 billion people. That's pretty much the population of sub-Saharan Africa and South America in total, so this is really a program that needs to be thought of at scale,” Nguyen said.

Managing vaccine supply for routine immunization campaigns is difficult, UNICEF’s Deehan said. In the past, some countries haven’t always had the capacity to follow through on their plans for immunization campaigns, resulting in high numbers of vaccine doses being rerouted to other countries in order to avoid waste. This exposes endemic countries, most of which are located in sub-Saharan Africa, to higher risks of outbreaks.

“In working with global partners and with countries to reinforce those messages around good planning, and then working with partners such as Gavi in ensuring the financing is there, we're getting to a better place in the way that we are preventing and controlling yellow fever outbreaks,” Deehan said.

“The yellow fever vaccine program with Gavi has been hugely successful. It's a really critical vaccine. It's one that we value very highly,” Gavi’s Nguyen said.

However, significant gaps remain in vaccination coverage, and manufacturers must be incentivized to innovate further around vaccine production. WHO recommends 80% vaccination coverage in at-risk areas to prevent outbreaks. But, as per WHO estimates in 2018, the coverage reached only 49%.

In response to the Angola outbreak, WHO, UNICEF, and Gavi in 2017 launched the Eliminate Yellow Fever Epidemics campaign, known as EYE, to deliver 1.4 billion vaccine doses in 40 countries by 2026, increase routine immunization campaigns, prevent future outbreaks, and improve outbreak response.

“When we think about the global supply that we're going to need over the next 10 years, we're going to need an equivalent amount of dosage for 1.3 billion people. That's pretty much the population of sub-Saharan Africa and South America in total, so this is really a program that needs to be thought of at scale,” Nguyen said.

Managing vaccine supply for routine immunization campaigns is difficult, UNICEF’s Deehan said. In the past, some countries haven’t always had the capacity to follow through on their plans for immunization campaigns, resulting in high numbers of vaccine doses being rerouted to other countries in order to avoid waste. This exposes endemic countries, most of which are located in sub-Saharan Africa, to higher risks of outbreaks.

“In working with global partners and with countries to reinforce those messages around good planning, and then working with partners such as Gavi in ensuring the financing is there, we're getting to a better place in the way that we are preventing and controlling yellow fever outbreaks,” Deehan said.