The proportion of children who received three doses of the diphtheria, tetanus and pertussis (DTP3) vaccine – an indicator of vaccination coverage within and between countries – fell by five percentage points between 2019 and 2021 to 81%, the WHO said, and UNICEF on 15 July. As a result, 25 million children missed one or more doses of DTP through routine immunization services in 2021 alone, they said – two million more than those who missed in 2020 and six million more than in 2019. Catherine Russell, UNICEF’s executive director, called for vaccination coverage, warning that “the consequences will be measured in lives” and said the data showed there was a “red alert for children’s health”. He added: “While a pandemic hangover was expected last year as a result of the Covid-19 disruptions and lockdowns, what we are seeing now is a continued decline. Covid-19 is no excuse. We need vaccination coverage for the millions who are being missed or we will inevitably see more outbreaks, more sick children and more strain on already overburdened health systems.” The organizations said the overall decline was due to several factors – including more children living in “conflict and fragile environments” with “challenging” access to vaccination. “increased misinformation”; and “Issues related to Covid-19”, such as service and delivery disruptions, diversion of resources and containment measures that limit access to vaccination.
“Child Survival Crisis”
Vaccine coverage declined in every region, with the East Asia and Pacific region recording the sharpest reversal in DTP3 coverage, falling nine percentage points in just two years, the data show. Of the 25 million children who did not receive one or more doses of DTP, 18 million did not receive a single dose in 2021, most of whom live in low- and middle-income families, with India, Nigeria, Indonesia, Ethiopia and The Philippines records the highest numbers. Myanmar and Mozambique are among the countries with the largest relative increases in the number of children who did not receive a single vaccine between 2019 and 2021, the data show. WHO and UNICEF also found that, globally, more than a quarter of the human papillomavirus (HPV) vaccine coverage achieved in 2019 has also been missed, which has “serious consequences for the health of women and girls’, as global coverage of the first dose of the HPV vaccine is only 15%, despite the fact that the first vaccines were licensed more than 15 years ago. The organizations warned that the decline in vaccination rates is occurring against a backdrop of “rapidly increasing rates of severe acute malnutrition”, which together threaten to “create the conditions for a child survival crisis”, as “a malnourished child is already immunocompromised and has lose Vaccinations can mean that common childhood diseases quickly become fatal for them.’ The charities also highlighted that “inadequate levels of coverage have already led to preventable outbreaks of measles and polio in the past 12 months”. Coverage of the first dose of measles fell to 81% in 2021 – also the lowest level since 2008. This means that 24.7 million children missed their first dose of measles in 2021, 5.3 million more than in 2019. Another 14 .7 million did not receive the second installment. Compared to 2019, 6.7 million more children missed the third dose of the polio vaccine in 2021 and 3.5 million missed the first dose of the HPV vaccine. “The sharp two-year decline follows nearly a decade of stalled progress,” WHO and UNICEF said, “underscoring the need not only to address the disruptions associated with the pandemic, but also the challenges of systemic immunization to ensure that every child and teenager is accessible’.
Maintaining routine vaccination
WHO and UNICEF are working with Gavi, the Vaccine Alliance and other partners to implement the Global Immunization Agenda 2030 (IA2030) – a strategy to achieve set goals to prevent disease through vaccination and the delivery of vaccines to all. Dr Seth Berkley, CEO of Gavi, Vaccine Alliance, said: “The Alliance’s priority must be to help countries maintain, restore and boost routine vaccination, while executing ambitious vaccination plans for Covid- 19, not only through vaccines but also adapted structural support of the health systems that will manage them”. WHO Director-General Dr Tedros Adhanom Ghebreyesus said that “Covid-19 planning and response should go hand in hand with vaccination for killer diseases such as measles, pneumonia and diarrhoea. It’s not an either/or issue, it’s possible to do both.” IA2030 partners call on governments and relevant agencies to: – Intensification of supplementary vaccination efforts to address backsliding in routine vaccination and expansion of outreach services to underserved areas to reach missing children and implementation of outbreak prevention campaigns – Implement evidence-based, people-centred and tailored strategies to build confidence in vaccines and immunizations, combat misinformation and increase vaccine uptake, especially among vulnerable communities – Ensuring current pandemic preparedness and response and efforts to strengthen the global health architecture lead to investments in primary health care (PHC) services, with explicit support for strengthening and maintaining basic 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 to provide the data and monitoring needed for programs to have maximum impact – Leverage and increase investment in research to develop and improve new and existing vaccines and immunization services that can meet community needs and achieve IA2030 goals. In May, official figures revealed that only 7% of children aged 5-11 had been vaccinated against Covid-19 in England so far. In April, GPs in Somerset were asked to assess the “sustainability” of childhood vaccination provision in the coming years, as tougher targets resulted in a number of GPs losing tens of thousands in income from childhood vaccinations. Complete the relevant Immunizations and Infections CPD sections Nursing in Practice Learning sign up for free or upgrade to a premium membership for full access for just £29.95 a year.
