1. Fall 2015teachunicef.org
Ambassador
Edition
#VaccinesWork for
the eighty percent of
children globally who’ve
been vaccinated. How
can we close the gap
and immunize the rest?
Closing
the Gap
Immunizations:

2. 2 UNICEF ACT n Fall 2015
M
illions around the world
are alive and thriving today
because of the diseases
they didn’t get as children. Polio, once a
feared, crippling disease, is now under
control. And a worldwide immunization
campaignlastcenturyfinallyeradicated
the disease smallpox in 1980.
At that time, only one in five children
worldwide was immunized against other
preventable diseases. Vaccines, while
inexpensive and extremely effective,
just weren’t widespread in developing
countries.
In the 1980s, UNICEF was part of
a major effort to vaccinate children. By
the end of that decade, nearly four in five
children worldwide were immunized.
Over the next 25 years, this improvement
contributed to a halving of the number of
children under five who die each year.
Still, over 6 million children died in
2013 from preventable causes. Many of
those children were among the one in
five still not immunized. We have the
power to save even more by vaccinating
that fifth child. There’s a Global Vaccine
ActionPlanthatcallsforgettinghalfway
thereby2020.AndthenewSustainable
Development Goals call for an end to
epidemics of major diseases by 2030. We
already did it for smallpox and largely for
polio.Wecandoitfortherest,everywhere,
with a simple tool: immunization. n
NEWS
IN BRIEF
Contents
Fall 2015
News in Brief
Immunization:The
(Nearly) Universal
Life Preserver 2
Turning Point in
History:The 1980s 3
IN FOCUS
The Immunization
Gap 4
Observer’s Notebook:
What I Saw 5
FINDING SOLUTIONS
Closing the Gap 6
Meanwhile at
Home 7
KIDS HELPING KIDS
Profile: Annajulia
Santa Elena 8
UNICEF ACT is a publication
ofTeachUNICEF, the Education
Department of U.S. Fund for
UNICEF. VisitTeachUNICEF.org
for additional resources.
© U.S. Fund for UNICEF,
unicefusa.org
COVER PHOTO: © UNICEF/
NYHQ2015-1540/Mugabe
UNICEF works in more
than 190 countries to
help kids survive and
grow. UNICEF supplies
medicines and
vaccinations, clean
water, nutrition, shelter,
and education. UNICEF
also responds when
emergencies occur, such
as earthquakes, floods,
and war.
©UNICEF/NYHQ2011-2159/Esteve
©UNICEF/NYHQ2006-1800/Estey
Developing countries: Countries
still working to develop good
health, clean water, electricity,
and industry
Eradicate: Destroy completely
Immunization:Treatment to
protect from a disease
Smallpox: A disease marked by
fever and a skin rash
Sustainable Development
Goals: Set of 17 commitments
made by UN members in 2015
to end poverty and improve lives
measurably by 2030
Vaccine: Drug that protects
against a disease or infection
TERMS TO KNOWDisease
Dossier
Severely weakens the immune
system, causing disabilities
and death
1,042,000Lives saved by vaccination (annual)
643,000Lives saved by vaccination (annual)
51,000Lives saved by vaccination (annual)
Here are some of the
diseases that vaccines
protect us against:
Triggers coughing spells that
cause labored breathing and
life-threatening complications
Causes severe muscle spasms;
while adults recover, most
infants die a painful death
Damages nerve cells, causing
paralysis of limbs and
sometimes breathing muscles
A health worker vaccinates
a toddler against measles
in Indonesia.
Immunization:
The (Nearly) Universal
Life-Preserver
1,237,000Lives saved by vaccination (annual)
Measles
Tetanus
Pertussis
(whooping
cough)
Polio

3. UNICEF ACT n Fall 2015 3
What’s the BOTTOM LINE?
Use the text
and graphs
to answer
thefollowing
questionson
theimpactof
vaccines:
Between which two bars on which graph is shown
the single greatest numeric decrease in deaths?
What was the decrease?
Of the two diseases shown, which shows the
greatest percentage decrease between 1980 and
2013? What was the decrease?
1
2
The evidence is overwhelming: Immunizations are the
most effective way of preventing deaths affordably. While
widespread in industrialized countries, immunizations
did not keep pace in the developing world for most of the
last century. As recently as 1980, measles was still causing
2.6 million deaths each year. But in the 1980s, developing
countries vastly prioritized immunization. The payoff?
Reductions in illness, disability, and death from numerous
diseases, and an immensely increased quality of life.
Before 1980:
A Silent Emergency
The average level of
immunization in most
developing countries
was still between
10 percent and 20
percent. Despite
great advances in
health care, 15 million
children were dying
each year before their
fifth birthday.
The 1980s:
UNICEF and its partners
began calling for
immunization as part of
a new effort to prevent
child deaths. Developing
countries began an all-
out drive to vaccinate
every child.
End of the 1980s:
The immunization
coverage rate rose
to about 76 percent.
It was described as
perhaps the greatest
mobilization, or rallying
of efforts, in peacetime
history. An estimated
12 million children’s
lives were saved.
Since then:
Diseases such
as measles
and tetanus
have seen huge
drops, and
polio is nearly
eradicated. With
immunization
saving up to 3
million children’s
lives each year,
it is clear that
#VaccinesWork!
1980 19861975 1989 2015
Turning Point in History:
The 1980s
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
Measles Neonatal Tetanus
■ 1980
■ 1990
■ 2002
■ 2013
# of Deaths
2,600K
1,500K
760K
145,700
660K*
430K
180K
49,000
*Figure for
1980-1981
Total Deaths from
Leading Diseases
©UNICEF/NYHQ1991-0293/Asabe
©UNICEF/NYHQ2012-1642/Pietrasik
©UNICEF/BANA2006-00173/Noorani

4. 4 UNICEF ACT n Fall 2015
IN
Focus
The Immunization Gap
F
our-fifths. What could
that stand for? Four-
fifths of the school
week means one day until the
weekend. Eighty percent on a
hard test is an admirable grade.
In football, it’s a 12–3 record and
leads to a spot in the playoffs. All
good things.
When it comes to children’s
health, though, four-fifths means
one out of every five infants still
missing out on basic vaccines.
That’s over 22 million at risk of
catching preventable diseases.
Four-fifths means hope for most,
and that’s good. But good is not
good enough when children’s
health and lives are at stake.
The immunization gap
is the space between those
four children who receive
immunizations and the fifth,
who remains unprotected. In the
picture below, the health worker
(syringe box in hand) may be
pondering that gap on
herjourneytohelp
vaccinatechildren in the
village across this wide
valley. Read below some
of the main reasons why
the gap exists:
Exclusion of some groups: Taking measles as an example, vaccine
coverage tends to be very low among groups suffering discrimination—for example, poor
urban migrants and indigenous* populations.
• Distance from health centers:Insomecountries,thecoverageofthe
measlesvaccineinruralareascanbe33percentlowerthaninurbanareas.Forpeopleinthe
countryside,gettingtoahealthcentermightinvolveahalf-daywalk.
Weak immunization systems: Vaccines must be preserved by a
cold chain—the technology that keeps them at a steady, low temperature. Expensive
equipment and long, treacherous delivery routes make cold storage a challenge.
Mothers with low education levels: Sadly, girls are frequently denied
a full education in developing countries. Without it, they may not know vaccines are available
or understand the importance of them.
* Indigenous refers to the original population, who are often pushed out by newcomers.
The immunization gap means vulnerability to killer diseases—that is, an increased
risk. There’s a saying in football, “The best defense is a good offense.” We need to go on the
offensive against preventable child deaths. We must make sure all children—especially the
poorest and hardest to reach—have access to the vaccines they need. We must close the gap. n
Fazila, a female
health worker,
looks downhill
to trace her
long journey
through the
mountains
in northeast
Afghanistan.
©UNICEF/AFGA001269/Slezic
REASON #1
REASON #2
REASON #3
REASON #4

5. UNICEF ACT n Fall 2015 5
W
e drove under the hot sun on dirt
roads filled with potholes. Many of the
villages we passed lacked electricity.
But we knew the immunization teams were
managing to get vaccines from cold storage to the
most remote villages, by whatever means it took:
motorcycle, camel, whatever.
We saw teams of Nigerian women (above)
pick up vaccine carriers in the morning. They
literally went to one house after another looking to
vaccinate every single child. After immunizing the
children, they marked their pinkies purple.
They literally
went to one
house after another
looking to vaccinate every
single child.
There was so much positive energy there.
Twelve-year-old Omar (below), despite having a
polio-weakened
leg, rides his
bike everywhere.
His father builds
special adult-
size tricycles
so other polio
survivors can
get around.
And thousands
upon thousands
of Nigerian
volunteers are
not giving up
until every child is immunized against polio.
Nigeria achieved a year without polio on July
24, 2015. With continued
efforts, I am confident that
UNICEF and its partners will
#EndPolio in all of Africa.
At press time, the last case
in all of Africa was August 11,
2014. If no new cases arise
three years after that, Africa
will be declared polio-free. n
In spring 2015, Nigeria was about to be polio-free for one year.
The U.S. Fund for UNICEF’s Michael Sandler (right) traveled
to the last polio-affected area in northern Nigeria to document
the end of the fight there. This is what he saw.
Observer’s Notebook:
What I Saw
Why would purchasing more vaccines not be enough to
close the immunization gap?
How are the different parts of the immunization gap being
addressed in Nigeria? Which way is the most impressive
to you? Why?
THINK, WRITE, DISCUSS...
1
2
©U.S.FundforUNICEF/2015/Sutter
©U.S.FundforUNICEF/2015/Sutter
CourtesyofMichaelSandler

6. 6 UNICEF ACT n Fall 2015
Finding
Solutions
Closing the Gap
Closing the Gap in ...
Expanding childhood immunization programs in 72 of the world’s poorest countries has
benefits that vastly outweigh the cost. It could save 6.4 million lives and over $150 billion
in treatment costs and lost work over a decade. For that to happen, the immunization gap
must be bridged in the following ways:
Getting the
vaccines:
This is no simple effort.
It takes much know-
how to determine
how many vaccines
are needed, to buy the
vaccines, and to get
them into countries.
Maintaining the
cold chains:
These systems must
be provided and
strengthened, and
then readied for many
years of service when
handed over to local
authorities.
Training health
workers:
Local professionals are
key to success. They
must be recruited,
trained, and motivated
to deliver vaccines
even when children are
hard to find or get to.
Confronting
resistance:
Traditional or religious
beliefs may lead people
to be suspicious of
modern medicine.
Efforts must be made
to reassure people with
these beliefs.
We know how to get the right vaccines to the right children at the right time. New techniques and strategies are
being deployed to increase vaccine coverage and improve health systems in the process. We are closing the gap!
Promote the right to
health—and your right
to free speech—in a
letter to the editor. On
a separate sheet, write
a letter urging people to
make donations to help
close the immunization
gap. Use both evidence
and emotion in your
writing.
UNICEF workers cross
a makeshift bridge
in eastern Ghana
to monitor a polio
eradication campaign.
©UNICEF/GHAA2015-01044/Quarmyne
Exercise
Your RightsSUB-SAHARAN AFRICA | Country:
Democratic Republic of the Congo (pop.: 79.4 million)
Engaging the whole community
around vaccination: In a huge
country with a weak government,
it takes a whole village to make
vaccination happen. There’s a new
emphasis on encouraging vaccination wherever
local populations assemble: church, school, even
funerals. Emmanuel (pictured here) even gives
his sixth-graders notebooks just for information
they can share about upcoming immunization
activities.
SOUTHEAST ASIA | Country:
Laos (pop.: 6.2 million)
Real-time digital
monitoring of the
cold chain: What if
you improve the technology that
chills vaccines, but one link in that
cold chain fails? With monitoring
devices like the one pictured
here, help is on the way. It sends
temperature data on vaccines to
health authorities, activating a
response to keep vaccines cold.
CourtesyofDanielToole,UNICEFEAPRO
@UNICEF/DRC/MARTINO/2014

7. UNICEF ACT n Fall 2015 7
Y
ou probably hate
injections. But shots
have taken away the very
real fear of death from childhood
disease in the United States.
Shots may be unpleasant, but
they’re far better than the misery
and deadliness of diseases such
as measles.
We succeed together.
It’s a relief to be immunized
against a disease. It also helps
your community. For reasons
including poverty and lack of
access to health care, it’s unlikely
everyone will get all their shots.
But if a high level of vaccination
is reached, there aren’t enough
people to infect, and a disease
loses steam. Effectively, the
whole community is protected by
achieving herd immunity.
That’s important, especially
for babies who are too young
to get shots.
Measles misinformation.
Measles is one of the most
infectious diseases around. In
places such as California, though,
misinformation has led some
parents to refuse or delay their
kids’ vaccination. This reduced
herd immunity and sparked
a measles outbreak in 2014
centered at the Disney theme
parks in California. It was the
largest measles outbreak in the
U.S. since 2000, and it affected
8 states. Among California’s
110 measles patients, 49 were
completely unvaccinated,
including 12 infants. The outbreak
even took one Washington State
woman’s life, the first measles
death in the U.S. since 2003.
The measles vaccine is
safe, effective, and nothing
new—we’ve had it for more
than 50 years. But 17 U.S. states
have measles vaccination rates
lower than the recommended
90 percent. Measles and other
diseases are still here. How
much risk do we want to take by
avoiding vaccinations? n
Meanwhile
at Home
The UN Convention on the Rights of the Child establishes the right to a safe and
healthy environment for all kids everywhere. Parents have the right, too, to question
the drugs going into their children’s bodies. Should vaccination be mandatory for
all children to achieve herd immunity?
Complete each sentence below with the appropriate vocabulary term from the term bank.
cold chain eradicated herd immunity immunized
mobilization smallpox vaccines vulnerability
Before _________________, childhood diseases caused much death and suffering.
_________________ protects an entire community, even if everyone’s not vaccinated.
The __________________ preserves vaccines, from storage to delivery.
Immunization _________________ a killer disease in 1980.
TEST YOUR VOCAB
1
2
3
4
It’s Up
For
Debate
Term Bank
A girl smiles
for the camera
after a “Hug
Me, I’m
Vaccinated”
event in Las
Vegas, Nevada.
©JamieBernstein,CCBY-NC-ND2.0(https://creativecommons.org/licenses/by-nc-nd/2.0/),viaFlickr

8. 8 UNICEF ACT n Fall 2015
T
he Eliminate Project is
UNICEF and Kiwanis’
fundraising campaign
to eliminate maternal and
neonatal tetanus (MNT). MNT
is a disease caused when bacteria
come into contact with open cuts
during childbirth. MNT kills one
baby every 11 minutes, and it kills
mothers, too.
But it’s easy to save lives
from MNT; in fact, it takes only
$1.80 to buy the vaccines that
protect a mother and her baby.
As an MNT Eliminator, I share
this information around my
school. I also collect donations
from my classmates by having
a coin drive at my school; the
change from anyone’s pockets
can easily be enough to protect a
family or more.
It’s easy to make a difference!
Kiwanis International (kiwanis.org) has
been dedicated to serving the children
of the world since 1915. Its more than
600,000 members raise money and
volunteer their time to benefit their
communities and
The Eliminate Project.
Kids Helping Kids
Annajulia Santa Elena is a senior at Del Lago
Academy in Escondido, California. She is a member
of her school’s UNICEF High School Club, as well as
the Key Club, the service organization for teens
offered by Kiwanis International. In her words …
More Kids Helping Kids,
through…
Share Voices for Vaccine’s “Kick the Flu out of School” toolkit
(at bitly.com/KickFlu) with a teacher and get started!
Visit shotatlife.org and read about the many ways to help provide
vaccines where they are most needed.
Join your local Rotary Interact or Kiwanis Key Club.
Have a UNICEF fundraiser for lifesaving items at inspiredgifts.
unicefusa.org. For example, each $31−$37 contributed can provide
100 measles vaccines, 200 polio vaccines, or 400 tetanus vaccines.
It’s Your
Turn to
CourtesyofAnnajuliaSantaElena
RotaryInternational(rotary.org):Rotaryhasbeen
tacklingtheworld’smostpressinghumanitarianchallenges
since1905.Itsglobalmembershipof1.2millionvolunteers
helpsfamiliesinneedintheirowncommunities,and
itworkswithUNICEFtowardapolio-freeworld.Its
“Interact”serviceclubsareorganizedandsponsored
byRotaryclubsforyouth12–18yearsold.