Childhood Vaccination Rates Show Promise of Recovery, But Inequities Remain, Says UNICEF and WHO

Millions of children worldwide have missed routine childhood vaccinations during the Covid-19 pandemic, but new data suggests that this decline may be reversing. According to estimates released by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), there were 4 million more children who received routine childhood immunizations last year compared to the previous year. Dr. Ephrem Lemango, associate director of immunization at UNICEF, noted that this is a positive change from the continued decline in coverage observed in previous years.

In 2021, 18.1 million children missed all of their routine immunizations, while last year, that number decreased to 14.3 million. However, it is still higher than the 2019 figure of 12.9 million children. Similarly, the number of children who missed one or more routine vaccinations also decreased from 24.4 million in 2021 to 20.5 million last year. Nonetheless, this remains higher than the 2019 number of 18.4 million children. UNICEF Executive Director Catherine Russell pointed out that while there is a positive trend, there is also a grave warning. The gaps in routine immunization coverage need to be addressed to prevent children from contracting and dying from preventable diseases, as these viruses do not recognize borders.

Researchers at UNICEF and WHO analyzed immunization trends from 183 countries and noted that 73 of these countries reported substantial declines in childhood immunization coverage during the pandemic. The data revealed that 15 of these countries have returned to pre-pandemic vaccination levels, 24 are on the path to recovery, and 34 have either stagnated or continued to experience declines. WHO Director-General Tedros Adhanom Ghebreyesus acknowledged the progress made but emphasized the need to address global and regional inequities. When countries and regions lag in immunization coverage, children bear the consequences.

The recovery of childhood immunizations seems to be concentrated in certain countries, with South Asia experiencing a more rapid and robust recovery. Eight countries, including India, Indonesia, and Brazil, accounted for 3.8 million of the 4 million children who were reached last year. However, low-income countries, especially in Africa, continue to struggle with immunization coverage, along with other health service challenges. Efforts to catch up children who missed their vaccinations should be strengthened, particularly in low-income countries that require concerted support.

The data also revealed disparities in the recovery rates for different vaccines. While the measles vaccine showed a modest recovery, the diphtheria, tetanus, and pertussis vaccine (DTP) had a better recovery rate. The percentage of children completing their first dose of the measles vaccine increased from 81% in 2021 to 83% last year, but it is still lower than the 86% achieved in 2019. On the other hand, for the DTP vaccine, the percentage of children completing their first dose increased to 89% in 2022, surpassing both the 2021 and 2019 rates.

Additionally, the new data revealed that HPV vaccination coverage has surpassed pre-pandemic levels for the first time. However, the coverage is still far from the goal of 90% among 15-year-old girls, which is crucial in eliminating cervical cancer by 2030.

In response to the decline in childhood immunizations during the pandemic, several organizations launched a global campaign called The Big Catch-Up. This initiative aims to ensure that children who missed vaccinations receive them promptly. Seth Berkley, CEO of Gavi, the Vaccine Alliance, emphasized the need for every country to protect their people and prevent the emergence of a two-track system where larger, lower middle-income countries outpace the rest.

The upward trend in childhood immunizations is an encouraging sign. However, it is essential to continue efforts to improve coverage and address the gaps that still exist. Upholding routine immunization services and catching up children who missed their vaccinations are crucial steps in safeguarding children’s health and preventing the resurgence of disease outbreaks.