WMJ_2025_04_Life-Course Vaccination_ A Global Call to Action for Equity, Resilience, and Strong Health Systems

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Life-Course Vaccination
Vaccination has long been
recognized as one of the most
successful and cost-effective public
health interventions in human
history. This preventive medicine
approach has eradicated smallpox,
nearly eliminated polio, and
significantly reduced the burden of
infectious diseases worldwide [1].
Yet despite this progress, inequities
in access, insufficient investment,
and under-recognition of the
importance of immunization
across the life course continue to
hinder the realization of its full
potential [2]. On 4-5 November
2024, a coalition of international
health and community-based non-
government organizations (NGOs)
gathered in Geneva, Switzerland,
to reaffirm a shared commitment:
to strengthen advocacy for
life-course vaccination. The resulting
call to action, endorsed by leading
global associations representing
physicians, nurses, pharmacists,
social workers, ageing networks,
students, and patient advocates,
urges policymakers and health
systems to view vaccination not
merely as a childhood intervention,
but rather as a lifelong necessity
that safeguards individuals, health
systems, and societies [3].
This article will explore the
rationale, scientific evidence, and
pathways for implementing life-
course vaccination strategies in
global health systems. It will
emphasize the vital role of health
and social care professionals as
both beneficiaries and advocates
and situate vaccination within the
broader fight against inequity and
non-communicable diseases. Finally,
it will outline concrete actions
for governments, international
organizations, and communities to
advocate for making vaccination
accessible to everyone, at every
stage of life.
Vaccination Beyond Childhood:
Why the Life-Course Approach
Matters
Historically, immunization has
been framed largely as a paediatric
intervention. Childhood vaccination
programs have been remarkably
effective, achieving high coverage
rates for diseases such as measles,
diphtheria, and pertussis. However,
focusing exclusively on children
fails to recognize the complex
epidemiology of infectious diseases
and the vulnerabilities that arise
at every stage of life. For example,
adolescents and young adults
require protection against
human papillomavirus (HPV),
meningococcal disease, and
hepatitis B, which carry long-term
health risks if left unchecked [4].
Adults benefit from vaccines against
influenza, pneumococcal disease,
coronavirus disease (COVID-19),
and pertussis boosters, which can
reduce absenteeism, maintain
workforce productivity, prevent
transmission to vulnerable groups,and
protect during pregnancy [5]. Older
adults, particularly those with
frailty or chronic conditions, face
a heightened risk of severe
outcomes from influenza,
pneumonia, shingles, and
respiratory syncytial virus (RSV);
vaccination at this stage helps
maintain independence, reduce
healthcare utilization, and extend
healthy life expectancy [6-8]. Since
a life-course approach recognizes
that immunity wanes, exposures
change, and comorbidities
Life-Course Vaccination: A Global Call to Action
for Equity, Resilience, and Strong Health Systems
Michael Moore Bettina Borisch Julia Tainijoki-Seyer
Marta Lomazzi
2
accumulate, vaccination must
therefore be continuous, adaptive,
and equitable to ensure protection
for all [9].
The Burden of Vaccine-Preventable
Diseases in Adults
Global data highlight a pressing
need to expand immunization
beyond children. Influenza
alone causes up to 650,000
respiratory deaths annually, with
disproportionate impacts on older
adults, pregnant women, and
people living with chronic
conditions [10]. Pneumococcal
disease contributes significantly
to morbidity and mortality in
adults over age 65, while pertussis
outbreaks continue to threaten
both adults and infants [11,12].
Moreover, the COVID-19 pandemic
underscored the vulnerability of
health and social care professionals,
where frontline workers were
exposed daily to pathogens, not
only risking their own health but
also becoming potential vectors
of disease transmission. Hence,
vaccination has a dual importance:
safeguarding essential workers
and protecting the patients and
communities they serve [13].
Infectious Diseases and the
Cascade of Non-Communicable
Diseases
Immunization is not only critical
for preventing communicable
diseases, but also plays a major
role in preventing or limiting the
progression of non-communicable
diseases (NCDs). Infections
can trigger or worsen chronic
conditions, creating a cycle of
health decline. For instance, influenza
and pneumonia increase the risk
of cardiovascular events, including
myocardial infarction and stroke [14].
Chronic respiratory diseases, such
as chronic obstructive pulmonary
disease, are exacerbated by
recurrent infections, often resulting
in hospitalizations [15]. Also,
HPV infections are directly
linked to cancers, including
cervical, oropharyngeal, and anal
cancers [16]. Finally, new vaccines
are being researched and developed
to target other chronic conditions,
including hypertension, diabetes,
and obesity [17]. Protecting
populations against infectious
diseases is dually a matter of acute
prevention and a vital strategy
for reducing the global burden of
NCDs.
Equity as a Central Principle
Access to vaccines remains
profoundly inequitable. The
World Health Organization
reports that millions of adults
worldwide lack access to basic
immunizations. Low- and middle-
income countries (LMICs) face
particular challenges, including
limited supply chains, under-
resourced health systems,
and competing health priorities.
Within high-income countries,
marginalized groups – such as
migrants, ethnic minorities, and
persons in precarious employment
– also face barriers in accessing
vaccination [18]. Equity must be
at the heart of any life-course
immunization agenda, including
ensuring that health and social
care professionals in all contexts
can access recommended vaccines,
recognizing their right to
protection and their
role as trusted advocates
for immunization.
Health and Social Care
Professionals: Protectors and
Advocates
Health and social care professionals
occupy a unique position at
the intersection of personal
vulnerability and community
responsibility, and evidence
consistently shows that their
attitudes toward vaccines
strongly influence patient uptake.
Empowering these professionals
to advocate for immunization
requires ensuring they are fully
protected through comprehensive
vaccine access, providing training
and resources to communicate
effectively with hesitant populations,
and embedding vaccination into
occupational health programs.
Prioritizing the health workforce
in this way safeguards their own
health, strengthens the resilience of
health systems, and fosters greater
confidence in the communities
they serve [19].
The Ten Action Points
The Call to Action outlines ten
concrete steps for advancing life-
course vaccination, providing a
clear roadmap for operationalizing
immunization in diverse contexts
[3]:
1. Ensuring full access to
recommended vaccines to
protect health and social care
professionals: Mandatory
occupational health programs,
workplace vaccination campaigns,
and subsidized or free access
to vaccines can safeguard the
workforce and reduce risks of
disease transmission to patients
and the wider community.
2. Guaranteeing equitable access
to vaccines throughout all
stages of life: Governments
and health systems can
implement policies that remove
financial, geographic, and
social barriers, such as offering
vaccines at community
clinics, mobile health units,
at pharmacies, and through
school- and workplace-based
Life-Course Vaccination
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programs. Ensuring affordability,
particularly in LMICs,
is essential for reducing
disparities and achieving broad
coverage.
3. Mobilizing the health
workforce for vaccine delivery:
Health systems can provide
healthcare professionals
with up-to-date guidance,
communication training,
and resources for addressing
vaccine hesitancy, and logistical
support, such as cold-chain
infrastructure and mobile
vaccination units.
4. Establishing comprehensive
adult vaccination schedules for
life-course protection: National
immunization programs can
define standardized schedules
and integrate immunizations
relevant to adult populations
into routine primary care
visits, including influenza,
pneumococcal disease, HPV,
and COVID-19 boosters.
5. Developing interoperable
immunization registries: Digital
platforms that link primary
care, pharmacies, hospitals, and
public health authorities can
identify gaps, support timely
reminders, enable real-time
monitoring of vaccine uptake
and coverage, and facilitate
targeted interventions.
6. Integrating vaccination into
multi-sectoral health priorities
and strategies: Collaboration
between ministries of health,
education, labor, and social
protection can position vaccines
as essential tools for its
broader public health value,
including healthy ageing,
maternal and child health,
non-communicable disease
prevention, and workforce
productivity.
7. Expanding and simplifying
vaccination pathways: Strategies,
such as walk-in clinics,
community pharmacies, outreach
campaigns, and telehealth
scheduling, can make vaccines
more accessible, particularly
for professionals working in
underserved areas.
8. Raising awareness and building
vaccine confidence: Increasing
health literacy and awareness
requires culturally sensitive
communication, educational
campaigns, and leveraging
trusted community leaders.
Tailored messaging that
addresses misinformation
and emphasizes the benefits
of vaccination across the life
course can strengthen public
trust.
9. Embedding community
engagement into vaccine
development and delivery:
Participatory approaches,
including focus groups,
community advisory boards,
and co-design of vaccination
campaigns, can be responsive
to local needs and priorities
and ultimately enhance uptake
and relevance.
10. Leveraging youth and ageing
organizations to champion
vaccination: Engaging
student networks, professional
associations, and senior
advocacy groups can amplify
advocacy, mentor future health
leaders, and create community-
based champions who promote
immunization at every stage
of life. It can build capacity
and influence across generations.
The Time for Integrated Action is
Now
Vaccination saves lives, reduces
inequities, strengthens health
systems, and contributes to social
and economic resilience. Life-course
vaccination is not optional, but
rather a necessity. Investment,
integration, and innovation, guided
by equity and solidarity, are
essential to build resilient health
systems, ensure universal access to
vaccination, and protect people’s
health across all stages of life.
Implementing the ten action points
outlined in the Call to Action will
ensure protection at all stages of
life and contribute decisively to
global health resilience, starting
with health and social care
professionals.
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Life-Course Vaccination
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Authors
Michael Moore, AM, PhD
Past President (2016-2018) &
Chair of the International
Immunization Policy Taskforce,
World Federation of Public
Health Associations
Geneva, Switzerland
mimomph@gmail.com
Bettina Borisch, MD, MPH, FRCPath
Chief Executive Director,
World Federation of Public
Health Associations
Geneva, Switzerland
bettina.borisch@unige.ch
Julia Tainijoki-Seyer,
MD, MSc (MIHMEP)
Senior Advocacy and Medical Advisor,
World Medical Association
Geneva, Switzerland
julia.seyer@wma.net
Marta Lomazzi, PhD, PD
Chief Operating Officer,
World Federation of Public
Health Associations
Geneva, Switzerland
marta.lomazzi@wfpha.org
Life-Course Vaccination