In September 2017, Hurricanes Irma and Maria devastated the island of Puerto Rico. The island’s healthcare system was crippled by the storms, leaving millions of Puerto Ricans vulnerable to disease.

“Electricity outages caused refrigeration to fail, destroying 90 percent of Puerto Rico’s flu vaccine,” said Lilliam Rodriguez, president and founder of the Vaccination Coalition of Puerto Rico (VOCES), a community nonprofit dedicated to national vaccination efforts. “The threat of an outbreak of vaccine-preventable infectious diseases was a grave concern.”

Faced with a potential health crisis, VOCES reached out to local, federal and international authorities for help. Through the critical support of its donors and partners, the CDC Foundation was able to link the Puerto Rico Department of Health with VOCES to mobilize a large-scale island-wide immunization campaign called Voices on Wheels.

Using a mobile unit, VOCES staff conducted as many as 40 vaccination clinics each week, setting up services in schools, parks, public plazas, community centers and private homes across the island. With the support of the CDC Foundation, VOCES and the Puerto Rico Department of Health reached more than 110,000 people with immunizations against influenza, hepatitis and pneumonia.


“The immunizations took place in more than 540 locations throughout the island,” Rodriguez said. “In addition, 77 out of the island’s 78 municipalities had vaccination access points, and we also conducted disease prevention education, which aligns with CDC’s vaccination recommendations after a disaster.”

The impact of the vaccination campaign was profound. According to a report by the Puerto Rico Department of Health, the island saw 30 percent fewer cases of influenza, 33 percent fewer hospitalizations and 65 percent fewer deaths in June 2018 than it had during the same period the previous year—the peak of the island’s flu season. Despite the challenges posed by Irma and Maria, Puerto Rico did not reach epidemic levels of influenza during the 2017–2018 season for the first time in four years.

“VOCES is thankful that the CDC Foundation was the first organization to provide funds for the initiative,” Rodriguez said. “It was very important to work in collaboration, because everyone brings something, and we are able to maximize resources when we work together.”

But vaccinations were only one part of restoring health to Puerto Rico after the storms. For instance, working closely with CDC, the CDC Foundation also helped restore lab capacity at the Puerto Rico Department of Public Health by shipping over 3,200 lab specimens to CDC for testing—help that would not have been possible without the support of CDC Foundation philanthropic and private-sector partners.


Today, Puerto Rico is still recovering. Some health facilities remain closed, and a migration of health professionals from the island has caused a shortage of specialists. But the efforts of VOCES in the wake of the storms have borne fruit. Despite its damaged healthcare infrastructure, Puerto Rico experienced fewer flu-related illnesses and deaths in the months after the storms. Education campaigns also bolstered local knowledge about preventable diseases and public health issues. Going forward, Rodriguez says, VOCES will continue to serve the people of Puerto Rico.

“VOCES, in collaboration with its allies, keeps working hard to assure access to vaccination island wide,” Rodriguez said. “Health is a human right that should always be protected.”

Following the 2017 hurricanes, the CDC Foundation served as an integral partner to the Centers for Disease Control and Prevention (CDC), the Puerto Rico Department of Health (PRDH) and USVI Department of Health (VIDOH) in implementing response and recovery activities aimed at shoring up and restarting critical public health infrastructure. Utilizing donor support, the CDC Foundation was able to work collaboratively with PRDH, VIDOH and a range of stakeholders in the region and beyond to ensure vital public health work could continue in these territories.

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