Go big and go fast — vaccine refusal and disease eradication

Disease eradication is an attractive public health goal. In addition to eliminating illnesses and deaths, eradication can lead to substantial cost savings. Eradication has been attempted for many human and animal diseases, such as smallpox, malaria, hookworm disease, polio, rinderpest, yaws, dracunculiasis (guinea worm disease), and yellow fever, and many tools have been employed in these efforts. But in the two diseases that were successfully eradicated, smallpox and rinderpest, the main tool was a vaccine. Eradication strategies for polio (a major current focus of global eradication efforts) and measles (whose eradication is being considered) rely on high vaccination coverage through routine and supplementary immunization.