Has the vaccination coverage come down globally and is there any alarming situation? At the time of Covid 19 pandemic, the world has seen a huge gap in vaccination and now the World Health Organisation and UNICEF has sounded an alarm with new data showing global vaccination coverage continuing to decline in 2021.
As per the estimates, 25 million infants are missing out on lifesaving vaccines. It is quite alarming to note that the percentage of children who received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3) – a marker for immunization coverage within and across countries – fell five percentage points between 2019 and 2021 to 81 per cent. The UN organisations say that this means that 25 million children missed out on one or more doses of DTP through routine immunization services in 2021 alone.
The WHO and UNICEF points out that the number of children who missed the dosage is two million more than those who missed out in 2020 and six million more than in 2019. This highlights the growing number of children at risk from devastating but preventable diseases. The UN Organisations attribute the decline to several factors, including an increased number of children living in conflict and fragile settings where immunization access is often challenging, increased misinformation and COVID-19 related issues such as service and supply chain disruptions, resource diversion to response efforts, and containment measures that limited immunization service access and availability.Stating that this was a red alert for child health, UNICEF Executive Director Catherine Russell said “We are witnessing the largest sustained drop in childhood immunization in a generation. The consequences will be measured in lives.” Stressing that COVID-19 is not an excuse, she said “we need immunization catch-ups for the missing millions or we will inevitably witness more outbreaks, more sick children and greater pressure on already strained health systems.”
The WHO and UNICEF confirms that 18 million of the 25 million children did not receive a single dose of DTP during the year. The vast majority are in low- and middle-income countries, with India, Nigeria, Indonesia, Ethiopia and the Philippines recording the highest numbers. Among countries1 with the largest relative increases in the number of children who did not receive a single vaccine between 2019 and 2021 are Myanmar and Mozambique.It said that over a quarter of the coverage of HPV vaccines that was achieved in 2019 has been lost. This has grave consequences for the health of women and girls, as global coverage of the first dose of human papillomavirus (HPV) vaccine is only 15%, despite the first vaccines being licensed over 15 years ago. First dose measles coverage dropped to 81 per cent in 2021, also the lowest level since 2008. This meant24.7 million children missed their first measles dose in 2021, 5.3 million more than in 2019. A further 14.7 million did not receive their needed second dose. Similarly, compared to 2019, 6.7 million more children missed the third dose of polio vaccine and 3.5 million missed the first dose of the HPV vaccine- which protects girls against cervical cancer later in life. The sharp two-year decline follows almost a decade of stalled progress, underscoring the need to not only address pandemic-related disruptions but also systemic immunization challenges to ensure every child and adolescent is reached.
HOPES NOT REALISED
2021 was hoped to be a year of recovery during which strained immunization programmes would rebuild and the cohort of children missed in 2020 would be caught-up. But the reality is that DTP3 coverage was set back to its lowest level since 2008 which, along with declines in coverage for other basic vaccines, pushed the world off-track to meet global goals, including the immunization indicator for the Sustainable Development Goals, the UN Organisations added. They warn that these backsliding in rates of immunization was happening against a backdrop of rapidly rising rates of severe acute malnutrition. The WHO and UNICEF stated that monumental efforts will be required to reach universal levels of coverage and to prevent outbreaks. “Inadequate coverage levels have already resulted in avoidable outbreaks of measles and polio in the past 12 months, underscoring the vital role of immunization in keeping children, adolescents, adults, and societies healthy,” they said. Meanwhile, WHO Director-General Dr Tedros Adhanom Ghebreyesus stressed the importance of planning and tackling COVID-19 to go hand-in-hand with vaccinating for killer diseases like measles, pneumonia and diarrhea,” said. “It’s not a question of either/or, it’s possible to do both,” he said.Gavi, the Vaccine Alliance, CEO Seth Berkley noted that it was heart-breaking to see more children losing out on protection from preventable diseases for a second year in a row. The priority of the Alliance must be to help countries to maintain, restore and strengthen routine immunization alongside executing ambitious COVID-19 vaccination plans, not just through vaccines but also tailored structural support for the health systems that will administer them, the CEO expressed.
The IA2030 partners call on governments and relevant actors to:
- Intensify efforts for catch-up vaccination to address backsliding on routine immunization, and expand outreach services in underserved areas to reach missed children and implement campaigns to prevent outbreaks;
- Implement evidence-based, people-centred, and tailored strategies to build trust in vaccines and immunization, counter misinformation and increase vaccine uptake particularly among vulnerable communities;
- Ensure current pandemic preparedness and response and the global health architecture strengthening efforts lead to investment in primary health care (PHC) services, with explicit support to strengthen and sustain essential immunization;
- Ensure political commitment from national governments and increase domestic resource allocation to strengthen and sustain immunization within PHC;
- Prioritize health information and disease surveillance systems strengthening to provide the data and monitoring needed for programmes to have maximum impact; and
- Leverage and increase investment in research to develop and improve new and existing vaccines and immunization services that can achieve community needs and deliver on IA2030 goals