Is measles vaccination the biggest unrecognized success in global health?

During an interview with CNN this week, Dr. Hans Rosling - iconic co-founder of Gapminder and professor of global health at the Karolinska Institutet - reflected on the state of vaccination in countries around the world.

"It's a beautiful example of global collaboration, life-saving technology, the flagship of aid, and awareness among governments and parents in even the poorest countries - and it's not known."

Rosling was referring to the fact that a full 84 percent of the world's one-year-olds are vaccinated against measles - yet American adults are woefully uninformed of this success.

Prof. Rosling's recently conducted a simple web-based survey to identify levels of vaccination awareness among a representative sample of adults in the United States. They asked Americans to correctly identify what percentage of children worldwide is vaccinated against measles. Survey participants were given three choices - 20, 50 or 80 percent. Shockingly, 83 percent of those surveyed gave the wrong answer - and the majority of those were way off. The most common response - that only 20 percent of children worldwide are vaccinated - was the most inaccurate. In fact, more than 4 times as many children are vaccinated against measles than they think, and less than 1 in 5 Americans identified the correct level.


As Director of Vaccine Delivery at the Bill & Melinda Gates Foundation, I work on a team that invests heavily in helping developing countries deliver vaccines against measles and other illnesses to all the children that need them. I am privileged to see the progress countries have made in deploying these vaccines and measles is one of the shining success stories in global vaccination, with rates of measles deaths down by more than 70 percent since 2000. So the idea that my neighbors don't also see that success was honestly discouraging at first.

But then I realized that surveys like Gapminder's Ignorance Project are telling us something important by exposing these misunderstandings. They don't take away from our successes; rather, they let us know how much we still have to do to make people aware of them. In this case, the Ignorance Project has helped underscore the need to communicate with the general public the impact of vaccines worldwide, and the vital role that their aid contributions played in achieving that impact.

I'm reminded also that lack of awareness has real consequences. Trends towards delaying or declining vaccinations in the United States can be attributed in part to growing misinformation and under-recognition of the safety and efficacy of vaccines. Sadly, as we celebrate the 50th anniversary of the development of the measles vaccine this year, we also had a recent announcement from the U.S. Centers for Disease Control and Prevention that measles cases in the US have tripled over the annual average this year, and that vaccine refusals have contributed to the largest US outbreak of deadly whooping cough cases since 1947.

As an American, I know that we are a generous people and see evidence of that around me every day, especially here at the Gates Foundation. And as Americans, we expect to see results and improvements from our efforts. The Gapminder survey provides a wakeup call that too many of us are unaware of the impact our contributions are having in expanding childhood vaccinations, fighting deadly disease and saving lives.

As someone who understands this impact, I ask you to join me in sharing the news about vaccines. Remind your friends and neighbors that vaccines are not only a miracle of science, but a "best buy" and a great example of success in global health and overseas aid - and that immunizing children protects them as well as society at large, whether here or abroad. Social media can help. Please Tweet this blog and use the #vaccineswork hashtag at least once a week to share what you're learning about vaccines so that we can narrow the ignorance gap.

From our ability to control the spread of the flu each holiday season to miraculous achievements like eradicating smallpox, evidence of the miracle of vaccines abounds for those of us close enough to the action to see it on a daily basis. But as this survey shows, being successful isn't enough. We need to take the responsibility to share what we know so that others see those successes and ironically, their role in them. Without their support we risk successful programs going unsupported because of ignorance or misinformation.