Vaccines save millions of lives every year. But in the World Health Organization (WHO) Western Pacific Region, an estimated 1.3 million children missed out on basic vaccines in 2023, with most never receiving a single dose. In Pacific island countries, two out of 15 children are missing out on one or more childhood vaccines. To address the barriers to vaccination and make sure children do not face life-threatening illness from vaccine-preventable diseases, health workers in many countries go to incredible lengths. Melaia Tuiwara, a nurse supervisor in Fiji, is one of them.
“There are remote communities and hard-to-reach places that need our help,” says Melaia, who works in the remote areas of Lautoka and the Yasawa Islands. “Most of the islands are far from the [health] facility. It’s very expensive for [people] to travel and most of the time, it’s not safe.”
So instead of waiting for people to come to the health facilities to be vaccinated, Melaia and her colleagues take the vaccines into the communities. Using portable coolers to keep the vaccines at the correct temperature, teams of health workers regularly take long boat trips to administer vaccines and other health services to people living on remote islands. The weather can easily turn bad on these boat trips, creating dangerous conditions. “I always take extra clothes just in case the sea gets rough and I have no choice but to sleep over,” she explains.
These efforts often take a toll on Melaia and her two children. “My daughter always questions me − Mum, why do you have to go? Why, every time, they have to choose you to go?” For Melaia, being able to reach these communities to give life-saving vaccines makes the sacrifice worth it. She explains patiently, “I always tell her, it’s my calling, it’s my work. I have to go.”
A life saved every six minutes
It is clear that the hard work of health workers like Melaia have made a real difference. A major landmark study published by the Lancet in April 2024 reveals that global immunization efforts have saved an estimated 154 million lives – or the equivalent of six lives every minute of every year – over the past 50 years. The vast majority of lives saved – 101 million – were those of infants.
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A baby is vaccinated at Nacula Nursing Station in the Yasawa Islands, Fiji. Credit: WHO / Tom Vierus
However, despite these successes, many people continue to be left behind by national immunization efforts, with the number of unvaccinated people even increasing in some countries. Many children have missed routine immunizations due to health service disruptions and postponed immunization campaigns during the COVID-19 pandemic. At the same time, urbanization, migration and cross-border population movements have resulted in communities of people who are unprotected by vaccines. The ensuing immunity gaps have led to the resurgence of some vaccine-preventable diseases. For example, measles cases went up 305% from 2022 to 2023 in the Western Pacific Region, exposing many people to this serious disease that can lead to severe complications and death.
WHO is working closely with countries in the Western Pacific Region to close these gaps in immunization. The WHO Regional Director for the Western Pacific has laid out a vision for the next five years that includes targets to harness the transformative potential of primary health care, increasing the health-care workforce and moving towards 90% immunization coverage for key diseases including measles. This vision complements the Regional Strategic Framework for Vaccine-Preventable Diseases and Immunization in the Western Pacific 2021–2030, which aims for the Region to be free from vaccine-preventable morbidity, mortality and disability by 2030. The Framework lays out 18 strategies for countries, with support from WHO, to expand the scope of immunization, further accelerate control and achieve and sustain the elimination of vaccine-preventable diseases.
In line with this Framework, WHO recently supported the Fiji Government’s review of its National Immunization Policy and Strategy, which led to the addition of new vaccines to the country’s immunization schedule and enhanced integration of vaccination with other primary health-care services such as nutrition and deworming.
Health workers are key
WHO in Fiji also supports the Government to build the capacity of health-care workers to deliver vaccination. More than 200 health workers have been trained between 2022 and 2024, ensuring they are confident in administering vaccines and conducting surveillance for vaccine-preventable diseases.
Such capacity-building is key, because attaining the goal of a Region free from vaccine-preventable morbidity, mortality and disability would be impossible without the dedication of health workers like Melaia, who are on the front lines every day, administering life-saving vaccines.
For Melaia, the work can be challenging, but it is rewarding as well. “I just love to mingle with communities and try to see how I can help them in terms of health,” she explains. “I always tell myself, when you do your work, you do it with a good heart and it will reward you.”
The WHO Division of Pacific Technical Support works closely with Fiji’s Ministry of Health and Medical Services to ensure remote communities in Fiji have access to essential health services, especially vaccination, thanks to financial contributions from the Australian Department of Foreign Affairs and Trade, the Government of Japan and the United States Centers for Disease Control and Prevention.