WHO SAGE Meeting 2025: Global Vaccination Strategies at Crossroads - Dr S K Gupta
Introduction
A Critical Moment for Global Immunization
The Strategic Advisory Group of Experts on Immunization (SAGE), convened by WHO, held its biannual meeting from March 10–13, 2025, followed by a global press briefing on March 18, 2025.
This session addressed critical updates in vaccine policies, scientific analyses of immunization schedules, and the unprecedented risks posed by funding cuts and misinformation.
Key concerns raised during the meeting:
- Scientific updates on pneumococcal, varicella, polio, and measles vaccines.
- Concerns over the rising burden of vaccine-preventable diseases (VPDs) due to funding disruptions.
- The role of misinformation and vaccine hesitancy in derailing immunization programs.
- Global strategies to sustain and expand vaccination efforts despite challenges.
Dr Hanna Nohynek (Chair, SAGE), Dr Kate O'Brien (Director, WHO’s Department of Immunization), and Dr Joachim Hombach (WHO Senior Health Advisor) led discussions on how data-driven policies can help counteract these challenges.
1️. Scientific Advances in Vaccination Policies
Pneumococcal Conjugate Vaccine (PCV): A Revised Global Strategy
WHO now strongly endorses a 2+1 schedule for pneumococcal vaccination in children (two primary doses plus a booster).
A 1+1 schedule (one primary dose + one booster) may be effective in high herd immunity settings, cutting costs while maintaining effectiveness.
For high-risk groups with low immunity, WHO is exploring single-dose PCV strategies as a feasible alternative.
Varicella Vaccination: A Stronger Push for Universal Coverage
The latest recommendations reinforce a two-dose varicella schedule (given four weeks apart) for children.
Healthcare workers without previous varicella exposure should be vaccinated on priority to reduce nosocomial outbreaks.
Polio & Measles: The Rising Threat of Resurgence
WHO reported sustained poliovirus transmission in Pakistan & Afghanistan, requiring transformational shifts in eradication strategies.
The 30% surge in measles outbreaks across Europe and North America was highlighted as a major public health threat, linked to vaccine hesitancy and dismantling of immunization programs.
2️. The Scientific Process: How WHO Collects and Interprets Vaccine Data
During the conference, WHO scientists outlined how vaccine policies are shaped by data-driven projections. The methodology involves:
- Surveillance systems tracking disease burden in different regions.
- Mathematical modelling predicting outbreaks based on declining vaccine coverage.
- Clinical trial data and real-world evidence guiding vaccination schedules.
- Herd immunity thresholds determining the necessity of booster doses.
Dr Kate O'Brien emphasized the role of global epidemiological networks in forecasting disease patterns. The SAGE committee's updated vaccine recommendations are based on continuous data monitoring and meta-analysis of immunization outcomes worldwide.
3️. The Fallout of U.S. Funding Cuts: A Looming Global Health Crisis
One of the most pressing concerns discussed at the meeting was the U.S. withdrawal of key immunization funding, estimated at $25 million for measles surveillance and outbreak response.
Potential Consequences of Funding Cuts:
- Measles surveillance collapse in many parts of Africa and Asia.
- Increased vaccine stock shortages, leading to 500,000 additional deaths per year.
- Disruptions in polio and HPV vaccination programs, setting back years of progress.
Dr Joachim Hombach warned that if funding gaps are not addressed, we may see resurgences of diseases once thought to be controlled.
4️. Addressing Vaccine Hesitancy and Misinformation
The Role of Social Media in Spreading Anti-Vaccine Narratives
WHO expressed concerns that misinformation campaigns are undermining vaccine acceptance. Misinformation about vaccine side effects, false claims of infertility, and conspiracy theories are discouraging parents from vaccinating their children.
Proposed Strategies to Counter Hesitancy:
- Trust-building through community leaders (religious heads, local influencers).
- Fact-checking mechanisms to debunk false claims in real time.
- Stronger engagement of healthcare professionals in direct communication with patients.
- Transparency in vaccine safety data to reassure the public.
- New Research on Public Perception of Vaccines.
Studies presented at the conference suggest that:
- Vaccine refusal rates are rising due to lack of awareness, not just ideological resistance.
- People trust medical professionals more than government sources for vaccine advice.
- Localized interventions (e.g., parent education sessions) are more effective than global messaging campaigns.
WHO experts called for urgent policy shifts to counter vaccine scepticism before it results in major outbreaks.
5️. Global Call to Action: Urgent Steps to Sustain Immunization
To prevent immunization setbacks, WHO recommended:
- Governments must increase domestic health budgets to sustain programs without relying on uncertain donor funding.
- Alternative financing models (crowdsourcing, public-private partnerships) should be explored.
- Heads of state should engage in direct dialogue with the U.S. to negotiate transitional funding solutions.
- Better integration of immunization with primary healthcare services to improve accessibility.
Dr Nohynek emphasized that "vaccines are among the most cost-effective public health interventions. Scaling back now would be a catastrophic mistake."
Conclusion
A Defining Moment for Global Immunization
The WHO SAGE meeting served as a wake-up call to policymakers, global health leaders, and communities worldwide.
While scientific advances have optimized vaccine schedules, the threats of funding withdrawal, vaccine hesitancy, and policy disruptions jeopardize decades of progress.
With rising outbreaks of measles, polio, and other preventable diseases, urgent action is required to ensure that immunization remains a public health priority.
WHO calls for sustained investments, better public engagement, and stronger policies to protect global populations from vaccine-preventable diseases.
Key Takeaways from the WHO SAGE Meeting:
- Revised pneumococcal and varicella vaccination schedules for better effectiveness.
- Rising outbreaks of polio & measles linked to declining vaccine coverage.
- U.S. funding cuts threatening key global immunization programs.
- Misinformation and vaccine hesitancy, increasing refusal rates.
- Urgent need for alternative funding & stronger immunization policies.
This comprehensive report integrates the latest scientific data, expert concerns, and policy recommendations discussed at WHO's SAGE meeting.
It highlights the urgent global vaccination challenges and proposes solutions to ensure that immunization efforts remain strong despite funding and misinformation threats.
