Vesta Richardson
Vesta Richardson is a pediatrician and the Minister of Health for the State of Morelos in Mexico. Previously, she served as general director of the National Center for Child and Adolescent Health in the Mexican Ministry of Health, which works to decrease infant mortality through Mexico’s Immunization Program and the National Immunization Council.
Dr. Richardson has conducted seminal research on rotavirus vaccines. She co-authored a study on the impact of rotavirus vaccination on diarrhea mortality in Mexican children and in a separate study, examined the risk of intussusceptions risk and health benefits of the rotavirus vaccination in Mexico and Brazil.
From 2004 to 2007, Dr. Richardson was medical director of the Hospital Infantil de México Federico Gómez. In 2003, she founded the Clínica Londres Cuernavaca and in 1995, she founded and directed the Hospital del Niño Morelense in the city of Cuernavaca, Mexico.
Dr. Richardson was the director of the University of Baja California Pediatric Residency Program for six years. She also served as co-director of the Boston University Residency Program for three years and as the director of the University of Morelos Pediatric Residency Program for seven years.
She has published more than 40 scientific papers in specialized journals and books. Dr. Richardson has given dozens of lectures, coordinated several panel discussions and has been invited as a consultant and member of numerous evaluation committees.
Dr. Richardson earned her MD at La Salle University Medical School in Philadelphia, Pennsylvania in 1980. Her medical experience and pediatric skills were acquired at the Hospital Infantil de México and the Hospital General de México. She completed her pediatric residency at Boston City Hospital and Massachusetts General Hospital in Boston, Massachusetts.
“The challenge now is to get children up to date on their shots by bringing the vaccines out of the medical units and into safe, open air public places.”
What data signaled the need for rotavirus vaccine in Mexico?
When I joined the National Center at the end of 2006, rotavirus was a large burden to the health system and a major cause of death in young children. Diarrheal disease was the fourth leading cause of hospitalizations in children <5 and the second leading cause of outpatient medical visits.
What’s more, 7% of all deaths in children <5 were due to diarrheal disease—up to 2,000 deaths per year. At least 4 out of 10 of these deaths were due to rotavirus.
Although there was a marked reduction in deaths since Mexico introduced oral rehydration, and when water chlorination became mandatory in 1990, there were still peaks of deaths, especially during the winter. Deaths plateaued until we introduced rotavirus vaccine.
Did you know? WASH interventions are critical to reduce diarrheal disease cases, hospitalizations, and deaths, but only rotavirus vaccines will prevent this form of severe diarrheal disease, prevalent in low- and high-income countries alike in the absence of vaccination.
How did advocates make a case for rotavirus vaccination in Mexico?
As the head of Mexico’s National Center for Child and Adolescent Health, my role was to advocate with input from a group of national experts. We gathered evidence to support universal introduction of rotavirus vaccine, not only in the poor municipalities but for all children under a year old. Advocacy from the Minister and the vice minister really made a difference and the vote to introduce rotavirus vaccine was unanimous at the National Vaccination Council.
How did you fund the rotavirus vaccine?
Mexico had a Minister of Health that besides being a public health expert was a great economist, and he had figured out that there should be a pocket of resources from cigarettes, soda, and junk food taxes to allocate for public health measures. This idea may help other countries: tax what’s harmful for public health to finance crucial vaccines like rotavirus.
Was the vaccine well received by the public?
Rotavirus vaccine was very well received. Mothers and grandmothers in Mexico have seen several diseases disappear thanks to vaccines—first smallpox, then diphtheria, then wild poliovirus, and endemic measles. So, mothers and grandmothers love vaccines, and they trust doctors and nurses.
My mother used to tell me how she was the first one in line when the polio vaccine got into Mexico. One of her best friends had a child who had suffered polio and she didn’t want me to get it, so she was the first one in line.
How has the pandemic affected the provision of routine immunization for children?
During this pandemic, people have avoided going to health centers and hospitals because they don’t want to risk getting COVID disease. Coverage rates have declined, probably under 80%. The challenge now is to get children up to date on their shots by bringing the vaccines out of the medical units and into safe, open air public places.
What was the impact of rotavirus vaccine in Mexico?
I am proud that Mexico was the first country to publish evidence of the impact of rotavirus vaccine on infant mortality, with support from Manish Patel and Umesh Parashar at the CDC. Together we were able to prove in a couple of years, that there was a 41% reduction in gastroenteritis mortality in children <1, 29% in children 12-23 months, and an overall 35% reduction in children under 5. And the reductions have been progressive and sustained for at least 10 years. Especially during rotavirus season—see peaks on graph below—deaths have decreased 67% in children <5. This means saving at least 1,000 lives every year.