Childhood vaccination starts to recover globally, but still not at pre-pandemic levels

Today, UN data show an upturn; however, by 2022, an estimated 20.5 million children will not receive one or more routine vaccines, particularly in low-income countries, putting children at risk of preventable disease outbreaks.

In 2022, basic vaccines reached four million more children than the previous year, as countries redoubled their efforts to reverse the reversal in vaccine coverage resulting from the COVID-19 pandemic, which disrupted routine immunisation services.

The World Health Organization (WHO) and the UN Children's Fund (UNICEF) reported that despite this improvement, 20.5 million children did not receive one or more routine inoculations, a number even higher than the 18.4 million children who did not have their full immunisation schedule in 2019, before the pandemic interruptions.

The UN agencies stressed that unvaccinated children live mostly in low-income countries, putting them at serious risk of outbreaks of preventable diseases.

Inequalities persist

WHO Director-General Tedros Adhanom Ghebreyesus praised the hard work of authorities and workers in restoring immunisation services after two years of delay.  

However, he stressed that global and regional averages "do not tell the whole story and mask serious and persistent inequities. When countries and regions fall behind, children pay the price," Tedros said.

In this regard, the agencies explained that the recovery in global immunisation has been uneven and that improvement has been concentrated in a few countries. They said progress in resource-rich countries with large child populations, such as India and Indonesia, masks slower recovery or even continued declines in most low-income countries, especially for measles vaccination.

Of the 73 countries that recorded substantial declines in coverage during the pandemic, 15 have recovered to pre-emergency levels, 24 are on the road to recovery, and 34 have stagnated or continue to decline. 

Pillar of primary health care

In this regard, the UN recalled that routine immunisation is a fundamental pillar of primary health care and enables progress in other related health sectors. 

WHO and UNICEF specified that vaccination against measles, one of the most infectious pathogens, has not caught up as well as other vaccines, putting 35.2 million more children at risk of measles infection. Last year, 21.9 million children did not receive the routine measles vaccine in their first year of life, while another 13.3 million missed their second dose, putting children in under-vaccinated communities at risk of outbreaks.

UNICEF's Executive Director said that behind the positive numbers lies a serious warning.
 

Viruses know no borders

"Until more countries close the gaps in routine immunization coverage, children everywhere will continue to be at risk of contracting and dying from preventable diseases. Viruses like measles know no borders. Efforts must be urgently redoubled to recover unvaccinated children, while restoring and further improving immunisation services from pre-pandemic levels," warned Catherine Russell.

The agencies noted that countries with consistent and sustained vaccination coverage in the years before the pandemic have been better able to stabilise immunisation services since then, the data show. For example, South Asia, which reported gradual and steady increases in coverage in the decade before the pandemic, has shown a faster and stronger recovery than regions that suffered prolonged declines, such as Latin America and the Caribbean. The African region is lagging behind in its recovery.

Boosting efforts

All of this underscores the need to boost recovery efforts and strengthen the global immunisation system, the agencies said in a joint statement.

To accelerate immunisation recovery, WHO and UNICEF, as well as Gavi, the Vaccine Alliance, and other partners called for:

• Redouble commitment to increase funding for immunisation and work with stakeholders to unlock available resources to urgently restore disrupted and overstretched services.
• Develop new policies to enable immunisations to reach children who were born just before or during the pandemic and who are beyond the age at which they would be inoculated by routine immunisation services.
• Strengthen immunisation and primary health care services, including community health systems, and address systemic immunisation challenges to correct long-term stagnation in immunisation and reach the most marginalised children.
• Develop and maintain trust and acceptance of vaccines through engagement with communities and health providers.