Positive signs of post-pandemic rebound in global immunization rates have emerged, with new data from the World Health Organization (WHO) and UN Children’s Fund (UNICEF) indicating that some countries are making progress in restoring immunization services. Despite this improvement, overall coverage is still below pre-pandemic levels, especially in low-income countries, putting millions of children at serious risk of disease outbreaks.
The data for 2022 shows that four million more children received immunization services compared to the previous year, thanks to increased efforts by countries to combat the setback in immunization caused by the COVID-19 pandemic.
FAILED MILLIONS
However, the numbers reveal that 20.5 million children in 2022 failed to receive one or more diphtheria, tetanus, and pertussis (DTP) vaccines, highlighting the coverage gap. This figure is higher than the 18.4 million children who missed vaccinations in 2019 before the pandemic’s disruptions.
Although there’s progress, recovery rates vary across countries. While well-resourced countries like India and Indonesia show improvement, middle and low-income countries continue to face slower recovery or even decline in vaccination rates.
Vaccination against measles, a highly infectious pathogen, has not recovered as well as other vaccines. In 2022, 21.9 million children missed their routine measles vaccination in their first year of life, and an additional 13.3 million didn’t receive their second dose, heightening the risk of outbreaks in under-vaccinated communities.
REGIONAL DISPARITY
The data also reveals that countries with sustained immunization coverage before the pandemic have better stabilized their services. South Asia demonstrated a more rapid and robust recovery compared to regions like Latin America and the Caribbean, which suffered declines. However, the African region faces additional challenges due to population growth, requiring increased efforts to maintain adequate coverage levels.
“These data are encouraging, and a tribute to those who have worked so hard to restore life-saving immunisation services after two years of sustained decline in immunisation coverage,” said Tedros Adhanom Ghebreyesus, WHO Director-General.
“But global and regional averages don’t tell the whole story and mask severe and persistent inequities. When countries and regions lag, children pay the price.”
INTERNATIONAL EFFORTS
To address the situation, support from Gavi, the Vaccine Alliance, has led to a rise in DTP3 vaccine coverage in lower-income countries. However, many low-income countries are yet to see significant increases in coverage.
Efforts are underway to improve routine immunization services globally. WHO, UNICEF, Gavi, The Bill & Melinda Gates Foundation, and other IA2030 partners launched “The Big Catch-Up” campaign in 2023, urging governments to reach children who missed vaccinations due to COVID-19. The movement aims to secure financing, develop new policies, strengthen routine services for marginalized children, and build vaccine confidence.
“It is incredibly reassuring, after the massive disruption wrought by the pandemic, to see routine immunisation making such a strong recovery in Gavi-supported countries, especially in terms of reducing the number of zero-dose children,” said Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance.
“However, it is also clear from this important study that we need to find ways of helping every country protect their people, otherwise we run the risk of two tracks emerging, with larger, lower-middle-income countries outpacing the rest.”
While there are positive trends, UNICEF’s Executive Director, Catherine Russell, issues a warning. Until countries bridge the gaps in routine immunization coverage, children worldwide remain vulnerable to preventable diseases. Urgent efforts are needed to catch up children who missed their vaccinations and restore and enhance immunization services beyond pre-pandemic levels.