Will the Decade of Vaccines mean business as usual?

In 2011, the story of immunisation coverage worldwide hovers between the glass half empty and the glass half full. Anticipated advances in vaccinology during this new Decade of Vaccines will only translate into reductions in global morbidity and mortality from targeted illnesses if fundamental restructuring means that the most marginalised countries (particularly in Africa and southeast Asia) gain access to new and established vaccines. Routine vaccine coverage and the introduction of new vaccines have increased enormously in the past 10 years, with 14·6 million more children receiving the routine diphtheria, tetanus, and pertussis vaccine in 2009 than in 2000.1 Yet 23 million children younger than 1 year are still missed, particularly those living in the poorest quintile of low-income countries who have not received the primary series of childhood vaccines.