23 million children missed out on basic childhood vaccines through routine health services in 2020, the highest number since 2009 and 3.7 million more than in 2019
In all regions, rising numbers of children miss vital first vaccine doses in 2020; millions more miss later vaccines
Disruptions in immunization services were widespread in 2020, with the WHO Southeast Asian and Eastern Mediterranean Regions most affected. As access to health services and immunization outreach were curtailed, the number of children not receiving even their very first vaccinations increased in all regions. As compared with 2019, 3.5 million more children missed their first dose of diphtheria, tetanus and pertussis vaccine (DTP-1) while 3 million more children missed their first measles dose.
“This evidence should be a clear warning – the COVID-19 pandemic and related disruptions cost us valuable ground we cannot afford to lose – and the consequences will be paid in the lives and wellbeing of the most vulnerable,” said Henrietta Fore, UNICEF Executive Director. “Even before the pandemic, there were worrying signs that we were beginning to lose ground in the fight to immunize children against preventable child illness, including with the widespread measles outbreaks two years ago. The pandemic has made a bad situation worse. With the equitable distribution of COVID-19 vaccines at the forefront of everyone’s minds, we must remember that vaccine distribution has always been inequitable, but it does not have to be.”
Table 1: Countries with the greatest increase in children not receiving a first dose of diphtheria-tetanus-pertussis combined vaccine (DTP-1)
|United Republic of Tanzania||183’000||249’000|
|Venezuela (Bolivarian Republic of)||75’000||134’000|
The data shows that middle-income countries now account for an increasing share of unprotected children – that is, children missing out on at least some vaccine doses. India is experiencing a particularly large drop, with DTP-3 coverage falling from 91% to 85%.
Fuelled by funding shortfalls, vaccine misinformation, instability and other factors, a troubling picture is also emerging in WHO’s Region of the Americas, where vaccination coverage continues to fall. Just 82% of children are fully vaccinated with DTP, down from 91% in 2016.
Countries risk resurgence of measles, other vaccine-preventable diseases
Even prior to the COVID-19 pandemic, global childhood vaccination rates against diphtheria, tetanus, pertussis, measles and polio had stalled for several years at around 86%. This rate is well below the 95% recommended by WHO to protect against measles –often the first disease to resurge when children are not reached with vaccines – and insufficient to stop other vaccine-preventable diseases.
With many resources and personnel diverted to support the COVID-19 response, there have been significant disruptions to immunization service provision in many parts of the world. In some countries, clinics have been closed or hours reduced, while people may have been reluctant to seek healthcare because of fear of transmission or have experienced challenges reaching services due to lockdown measures and transportation disruptions.
“These are alarming numbers, suggesting the pandemic is unravelling years of progress in routine immunization and exposing millions of children to deadly, preventable diseases”, said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “This is a wake-up call – we cannot allow a legacy of COVID-19 to be the resurgence of measles, polio and other killers. We all need to work together to help countries both defeat COVID-19, by ensuring global, equitable access to vaccines, and get routine immunization programmes back on track. The future health and wellbeing of millions of children and their communities across the globe depends on it.”
Concerns are not just for outbreak-prone diseases. Already at low rates, vaccinations against human papillomavirus (HPV) – which protect girls against cervical cancer later in life – have been highly affected by school closures. As a result, across countries that have introduced HPV vaccine to date, approximately 1.6 million more girls missed out in 2020. Globally only 13% girls were vaccinated against HPV, falling from 15% in 2019.
Globally, the vaccination rate for three doses of diphtheria-tetanus and pertussis (DTP-3) vaccine fell from around 86% in 2019 to 83% in 2020, meaning 22.7 million children missed out, and for measles first dose, from 86 to 84%, meaning 22.3 million children missed out. Vaccination rates for measles second dose were at 71% (from 70% in 2019). To control measles, 95% uptake of two vaccine doses is required; countries that cannot reach that level rely on periodic nationwide vaccination campaigns to fill the gap.
In addition to routine immunization disruptions, there are currently 57 postponed mass vaccination campaigns in 66 countries, for measles, polio, yellow fever and other diseases, affecting millions more people.
Source: WHO;COVID-19 pandemic leads to major backsliding on childhood vaccinations, new WHO, UNICEF data shows , Newsletter 15 July 2021
- Access the full data set here (from 15th July 2021): https://www.who.int/data/immunization
- Multimedia: https://who.canto.global/b/PLVSO https://weshare.unicef.org/Package/2AMZIFH25X95
- Vaccines For All campaign page: https://www.unicef.org/vaccines
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