Gavi statement in response to comments made by the United States Secretary for Health and Human Services at the Global Summit: Health and Prosperity through Immunisation, Brussels, 25 June 2025.
Gavi appreciates U.S. Secretary for Health and Human Services Robert F. Kennedy Jr’s acknowledgment of the progress Gavi has made, in partnership with the United States and other donors, towards making vaccines available in low-income countries.
In response to comments on the safety of the DTP or DTPw (diphtheria-tetanus-whole cell pertussis) vaccine, and Gavi’s commitment to vaccine safety, we wish to make the following points:
- Gavi’s utmost concern is the health and safety of children.
- Any decision made by Gavi with regards to its vaccine portfolio is made in alignment with recommendations by WHO’s Strategic Advisory Group of Experts on Immunization (SAGE), a group of independent experts that reviews all available data through a rigorous, transparent, and independent process. This ensures Gavi investments are grounded in the best available science and public health priorities.
- DTP vaccines protect against three infectious diseases that primarily kill children. Diphtheria is a highly contagious bacterial infection that kills 5% to 10% of those infected, mainly children aged under five. Neonatal tetanus is a major killer of newborns. Pertussis (whooping cough) is a highly contagious and serious respiratory disease that spreads easily and is fatal in 1 in 200 cases among infants.
- There are two types of vaccines that exist to protect infants against diphtheria, tetanus and pertussis:
- DTPw (whole-cell pertussis) tends to produce a stronger, longer-lasting immune response but can cause temporary side effects such as redness and swelling at the site of injection, or fever.
- DTaP (acellular pertussis) is considered to cause fewer such reactions than DTPw, but evidence also suggests it offers less long-lasting protection, requiring more regular booster shots.
- Having reviewed all available data, including any studies that raised concerns, global immunisation experts continue to recommend DTPw for infants in high-risk settings.
- The disease burden for diphtheria, tetanus and pertussis in lower-income countries is much higher than in high-income countries, and health systems are far less equipped to offer frequent booster doses. For these reasons, SAGE recommends the use of DTPw which offers longer-lasting protection.
- By contrast, DTaP is more commonly used in high-income countries, where the disease burden is far lower and healthcare systems can support booster doses to extend protection.
- In places where access to hospitals is limited and disease risk is high, the stronger protection from DTPw against these life-threatening diseases far outweighs the temporary side-effects this vaccine may cause, such as fever or swelling at the injection site (which are signs the immune system is responding).
- For these reasons, both countries supported by Gavi as well as other lower-income countries, use DTPw instead of DTaP.
- The DTPw vaccine has been administered to millions of children around the world for decades, and is estimated to have saved more than 40 million lives over the past 50 years. The independent vaccine experts convened by WHO carefully review and consider the entire multi-decade evidence base when making decisions about the public health impact and safety of a vaccine.
Based on a full assessment of the science available, Gavi continues to have full confidence in the DTPw vaccine. As an important element in our routine vaccine portfolio, it has played a key role in helping halve childhood mortality in Gavi-supported countries since 2000.
Gavi fully concurs with the Secretary for Health and Human Services on the need to consider all available science, and remains committed to continuing an evidence-based and scientific approach to its work and investment decisions, as it always has done.
We look forward to further engagement and to a continued partnership with the U.S. government.
RESOURCES
- According to a recent Lancet study, DTP-containing vaccines have saved over 40 million lives globally in the last 50 years by preventing diphtheria, tetanus and pertussis. Since 2000, Gavi implementing countries have ensured over 1.4 billion children have been protected with the vaccine.