Global immunization efforts rebound, but inequalities persist, says WHO and UNICEF

SWITZERLAND — Efforts to vaccinate children worldwide against diseases like measles and diphtheria have shown signs of recovery in 2022 after being severely impacted by the COVID-19 pandemic, according to recent data released by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).

However, the recovery remains uneven, with certain larger lower-middle-income countries, such as India and Indonesia, making significant progress while smaller and poorer countries continue to face challenges.

In 2022, global immunization services were able to reach four million more children compared to the previous year as countries intensified their efforts to combat the setbacks caused by the pandemic.

Nevertheless, the data published by the UN agencies highlights that 20.5 million children did not receive one or more diphtheria, tetanus, and pertussis (DTP) vaccines in 2022, although this is an improvement from the 24.4 million children in 2021.

DTP vaccinations serve as a key indicator of global immunization coverage. However, the number of children missing out on vaccines is still higher than the 18.4 million reported in 2019 before the pandemic disrupted routine immunization services.

“While these data are encouraging and commend the efforts to restore life-saving immunization services after two years of decline, we must not overlook the significant inequities that persist globally and regionally.

When certain countries and regions lag behind, it is the children who suffer the consequences,” stated Tedros Adhanom Ghebreyesus, WHO Director-General.

The recovery in immunization rates has been uneven, with well-resourced countries like India and Indonesia demonstrating progress while middle and low-income countries struggle with slower recovery rates or even continued declines.

Out of the 73 countries that experienced substantial declines in coverage, 15 have managed to recover to pre-pandemic levels, 24 are on the path to recovery, and 34 have either stagnated or continued to decline.

Measles shots trailing

Measles vaccination has not shown the same level of recovery as other vaccines. In 2022, an alarming 21.9 million children, 2.7 million more than in 2019, missed the routine measles vaccination during their first year of life.

Additionally, 13.3 million children did not receive the second dose, leaving under-vaccinated communities vulnerable to outbreaks.

Data reveals that countries with sustained immunization coverage prior to the pandemic have been more successful in stabilizing their services.

South Asia, which experienced gradual increases in coverage before the pandemic, has demonstrated a more rapid and robust recovery compared to regions like Latin America and the Caribbean that faced declines.

The African region, currently lagging behind in its recovery, faces the added challenge of population growth, requiring a scale-up of immunization services to maintain sufficient coverage levels.

With support from Gavi, the Vaccine Alliance, DTP3 vaccine coverage in 57 lower-income countries increased from 78 percent in 2021 to 81 percent in 2022, resulting in a two million reduction in the number of zero-dose children during the same period.

However, this increase primarily occurred in lower-middle-income countries, while many low-income countries have yet to improve coverage.

Dr. Seth Berkley, CEO of Gavi, expressed reassurance at the recovery seen in routine immunization in Gavi-supported countries, particularly in reducing the number of zero-dose children.

However, he emphasized the need to ensure that every country can protect its population to avoid the emergence of two divergent tracks, where larger lower-middle-income countries outpace others.

In a positive development, HPV vaccination coverage has surpassed pre-pandemic levels for the first time since the COVID-19 pandemic began.

HPV vaccination programs initiated before the pandemic reached the same number of girls in 2022 as in 2019.

However, vaccination rates for HPV, which prevents cervical cancer, remain below the target of 90%. In high-income countries, the rate stands at 67%, while in low and middle-income countries where the vaccine has been introduced, it is 55%.

Efforts to recover and strengthen global immunization must continue with a focus on addressing inequalities, ensuring access to vaccines for all children, and maintaining routine immunization services even during challenging times.

Global push to improve routine immunization services

In an international effort to enhance routine immunization services and address the impact of the COVID-19 pandemic on childhood vaccinations, various stakeholders are collaborating to ensure that children worldwide are protected against preventable diseases.

Among these stakeholders are the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), Gavi, the Bill and Melinda Gates Foundation, and other partners.

Earlier this year, the WHO and UNICEF, in conjunction with their partners, launched “The Big Catch-Up,” a global communications and advocacy initiative.

The campaign aims to mobilize governments to reach children who missed out on vaccinations due to the COVID-19 pandemic.

It emphasizes the need to secure financing for immunizations, develop supportive policies for children born during or just prior to the pandemic, strengthen routine services with a focus on marginalized children, and foster vaccine confidence and acceptance.

Despite positive trends indicating a recovery in immunization rates, UNICEF Executive Director Catherine Russell highlights a grave warning.

Until countries address the gaps in routine immunization coverage, children worldwide will remain vulnerable to contracting and dying from preventable diseases.

Diseases such as measles do not recognize borders, underscoring the urgent need to strengthen efforts to catch up on missed vaccinations and restore immunization services to pre-pandemic levels.

The global push to improve routine immunization services is essential to safeguarding children’s health and well-being.

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