Despite the increasing efforts to improve immunization coverage, there has been limited progress in reducing the number of children who do not receive any vaccines, commonly referred to as “zero-dose children.” This challenge highlights the ongoing need to reach every child with life-saving vaccines.
In the annual report, the State of the World’s Children 2023, UNICEF says failing to vaccinate children puts their lives and health at risk, but the consequences go beyond individual well-being. It also hinders the growth and development of societies as a whole.
When we do not vaccinate children, we risk their lives and health – as well as our societies’ growth and development. Vaccines help children thrive, support families and caregivers, and benefit the health of the wider community.
ZERO DOSE VACCINATION
The disparity in vaccination rates is particularly pronounced among different socioeconomic groups. In the poorest households, slightly over one in five children remain zero-dose, while in the wealthiest households, it is just one in twenty. These inequalities are even more pronounced in certain regions, such as West and Central Africa, where nearly one in two children in the poorest households are zero-dose compared to around one in sixteen in the wealthiest households. Low- and middle-income countries face the greatest challenges, with approximately one in ten urban children and just under one in six rural children remaining zero-dose. In contrast, there is minimal disparity between urban and rural children in upper middle-income countries.
Between 2019 and 2021, UNICEF estimates that approximately 67 million children missed out entirely or partially on routine immunization. This highlights the urgency of addressing the barriers to immunization and ensuring that every child receives the necessary vaccines for their well-being.
THE REPORT
The report focuses on the imperative of ensuring universal protection against vaccine-preventable diseases for every child, regardless of their location. The report highlights the importance of strengthening primary health care systems to effectively support immunization services.
One of the key areas addressed in the report is the issue of trust in vaccines. Building and maintaining trust in vaccines is essential to ensure high immunization coverage. The report explores the factors that influence vaccine hesitancy and offers insights on strategies to address these concerns. By understanding and addressing the underlying reasons for vaccine hesitancy, it becomes possible to promote confidence in vaccines and improve vaccine uptake.
In addition, the report sheds light on various innovations in vaccine development, delivery, and financing. It explores new approaches and technologies that can enhance vaccine effectiveness, accessibility, and affordability. From novel vaccine formulations to innovative delivery methods, these advancements have the potential to overcome barriers and reach even the most marginalized populations.
Furthermore, the report emphasizes the importance of adequate financing for immunization programs. Sustainable funding is crucial to ensure the availability and accessibility of vaccines, strengthen health systems, and support the delivery of comprehensive immunization services.
By examining these key areas, the report provides valuable insights and recommendations to guide efforts in achieving universal protection against vaccine-preventable diseases. It highlights the significance of strengthening primary health care systems, addressing trust issues, embracing innovation, and ensuring sustainable financing for immunization programs. Through concerted efforts and collaborative action, it is possible to safeguard the health and well-being of every child worldwide.
UNICEF Executive Director Catherine Russell said, “Despite decades of progress in childhood immunization, our collective efforts are falling short. Put simply, we are not meeting our goal to vaccinate every child. While new vaccines have been introduced that broaden protection against disease, none has managed to reach more than 9 out of 10 children. Many are not even coming close – only one in eight girls have received the human papillomavirus (HPV) vaccine, which protects against cervical cancer.”
“In the years to come, we can achieve even more. New vaccines are already helping in the war against malaria. There will likely be more soon, including against chronic diseases such as cancer and Alzheimer’s disease.
STRENGTHEN PRIMARY HEALTH CARE
Many children miss vaccination because they live in places where there is no or limited primary health care – a health-care approach that includes health promotion, disease prevention and treatment. · Vaccine campaigns play a powerful role in reaching many of these children, and they will continue to do so. However, campaigns are, by definition, short-lived, and they have inherent limitations because they do not necessarily offer continuous and predictable services. · Integrating childhood immunization into strengthened primary health is essential to sustainably reach the goal of vaccinating every child.
CONFIDENCE IN VACCINES IS SLIPPING IN SOME COUNTRIES
Data collected before and during the COVID-19 pandemic indicate declines in the perception of the importance of vaccines for children in many (but not all) countries for which data are available. Confidence levels appear to have declined more in younger than in older age groups. · Vaccine confidence is notoriously volatile, and any trends are time and location specific. However, any signs of broader loss of confidence need to be taken seriously.
CONSEQUENCES OF FAILURE
Failure to protect children against disease has serious consequences. Put bluntly, children die, and many more suffer lifelong disabilities. Unfortunately, the world continues to see far too many outbreaks of vaccine-preventable diseases. In 2022, for example, the number of measles outbreaks was double the total in the previous year. Meanwhile, the discovery of poliovirus in Israel, the United Kingdom of Great Britain and Northern Ireland, and the United States of America in 2022 was a reminder that even remarkable progress against a disease like polio can be put at risk if we fail to vaccinate every child.
The consequences of failing to vaccinate children may become more severe in years to come. Climate change risks exposing new communities to infectious diseases such as malaria, dengue and cholera, and may alter seasonal disease patterns. Increasing risk of overlapping climate crises, including droughts, heat waves and floods, will put further strain on children’s access to essential services, including clean water and primary health care. Also of long-term concern is the rise of drug-resistant infections. Failure to immunize children undermines their right to what the Convention on the Rights of the Child describes as “the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health.
Recommendations
- Vaccinate every child, everywhere
- Strengthen demand for, and confidence in, vaccination
- Spend more and spend better on immunization and health
- Build resilient systems and shock-proof them for the future
