In 1954, I was 11 years old and among the 325,000 children in the United States who received the Salk polio vaccine in a clinical trial. I remember that historic day vividly, decades later. Approximately 325,000 children received a placebo, and 1.2 million other children did not receive an injection but were monitored in the untreated control group (Keogh, 2020). The efforts were funded by the National Infantile Paralysis Foundation supported by donations from the public, who were encouraged to send dimes to the White House. The Foundation later changed its name to the March of Dimes. In 1955, the world's first successful polio vaccine was declared safe, effective, and potent. When asked who owned the patent on his vaccine, Dr. Jonas Salk, physician and researcher at the University of Pittsburgh, famously replied that it belonged to the people and that patenting it would be "like patenting the sun" (Keogh, 2020, p. 1). By 1979, the United States was declared polio-free. What a miracle to have polio eradicated by a vaccine made of a killed virus!

Vaccine science has grown tremendously, especially in recent years with the global pandemic of the coronavirus (COVID-19). But of growing concern is a decrease in the percentage of vaccines received in infants in recent years globally. More and more children are at risk for increased morbidity and mortality in vaccine preventive diseases. Those who appear to be most vulnerable among World Health Organization regions (WHO) live in Southeast Asia (Rachlin et al., 2022).

It has been estimated that three dosages of coverage of diphtheria-pertussis-tetanus decreased from 86% during 2025-2019 to 81% by the end of 2021 (Rachlin et al., 2022). Globally, 25 million infants in 2021 did not receive any dose of the diphtheria-pertussis-tetanus vaccine. The first dose of measles vaccine decreased from 94% in 2020 to 81% in 2021 (Rachlin et al., 2022). The Bacille Calmette-Guerin vaccine for tuberculosis, as well as a series of influenza, Hepatitis-B, polio, and rubella vaccines were also considerably lower in 2021 compared to 2019-2020 throughout the world, with marked inequities in low- and middle-income countries and especially in Africa (Shet et al., 2022).

Many factors have contributed to the decline. Some are related to the COVID-19 pandemic and the addition of newly developed COVID-19 vaccines being added to the vaccines being administered and encouraged. Indicators of appropriate immunization coverage for the Sustainable Development Goals include diphtheria-pertussis-tetanus (all three doses), by 12 months of age, pneumococcal conjugate vaccines, and human papilloma virus vaccine (WHO, 2022). It is essential that these gaps be addressed, and that children who have not received recommended vaccine series, immigrants, and refugees receive the appropriate immunizations. There must be increased provision of quality health services, generation of more accurate data systems, and improved access through better supply chains and immunization campaigns. The 2030 World Health Agenda clearly defines strategies to reduce vaccine-preventable diseases (WHO, 2020). Reducing the risk of millions of children of contracting vaccine-preventable diseases is essential to global health (WHO, 2021). According to Rachlin et al. (2022, p. 1400), this can be achieved by "prioritizing routine immunization as an essential health service, improving access to vaccination across the life span, vaccinations as needed at every health visit, strengthening data systems, safeguards, sustainable immunization financing, and building vaccine confidence." Maternity and pediatric nurses are trusted members of the health care team to encourage vaccines. May all children throughout the world be as fortunate as I was a child.

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