Child health alert, “the biggest drop in vaccinations in the last 30 years”

Unicef ​​and WHO report: 25 million in 2021 did not receive one or more doses of vaccine against diphtheria, tetanus and pertussis. Coverage for measles, polio and Hpv drops. Among the causes are conflicts, misinformation and the Covid-19 pandemic

© UNICEF / UN0516945 / Panjwani

ROME – Official data released today by WHO and UNICEF records the largest sustained decline in childhood vaccinations in around 30 years. The percentage of children who received three doses of the vaccine diphtheria, tetanus and pertussis (DTP3) – an indicator of vaccination coverage used both in and between countries – decreased by 5 percentage points between 2019 and 2021 and reached 81%. As a result, in 2021, 25 million children alone did not receive one or more doses of DTP from routine vaccination services. This is 2 million more than those who skipped vaccination in 2020 and 6 million more than in 2019, highlighting the growing number of children at risk for terrible but preventable diseases.

The decline is due to many factors, includingincrease in the number of children living in contexts of conflict and fragilitywhere access to vaccinations is often difficult,increase in disinformation and problems related to Covid-19such as disruptions in services and the supply chain resource diversion against pandemic control activities and containment measures that have restricted access to and availability of vaccination services. 18 of the 25 million children did not even receive a dose of DTP during the year, most of whom live in low- and middle-income countries, with India, Nigeria, Indonesia, Ethiopia and the Philippines which registers the highest numbers. Among the countries with the largest relative increase in the number of children who did not receive any vaccines between 2019 and 2021 are Myanmar and Mozambique.

The coverage of the first measles dose fell to 81% in 2021, the lowest level since 2008. This means that 24.7 million children did not receive the first dose of measles vaccine in 2021, 5.3 million more than in 2019. A further 14.7 million did not receive the required second dose. Similarly compared to 2019, 6.7 million more children did not receive the third dose of polio vaccine, and 3.5 million did not receive the first dose of the HPV vaccine. which protects girls against cervical cancer in old age.

This is a red warning for children’s health. We see the largest sustained decline in childhood vaccinations over a generation. The consequences will be measured in human lives, he said Catherine Russell, Director General of Unicef. “While the consequences of the pandemic were expected last year after disruptions and closures caused by Covid-19, what we are seeing now is a sustained decline. COVID-19 is no excuse. We need to restore vaccinations to the millions of missing children, otherwise we will inevitably see new epidemics, more sick children and greater pressure on already struggling health systems. ‘

Globally, over a quarter of human papillomavirus (HPV) vaccine coverage obtained in 2019 has been lost. This has serious consequences for the health of women and girls, as the global coverage of the first dose of HPV vaccine is only 15%, despite the fact that the first vaccines were approved over 15 years ago. It was hoped that 2021 would be a year of recovery in which the strained vaccination programs would be rebuilt and the group of children not reached by 2020 would be made up. Instead, coverage of DTP3 has been pushed back to the lowest level since 2008 and, along with the decline in coverage of other nuclear vaccines, has driven the world away from achieving global goals, including the vaccination indicator for development goals.

This historic retreat in vaccination rates is taking place on the basis of rapid increase in the incidence of severe acute malnutrition. A malnourished child already has oneweakened immunity and lack of vaccinations can cause common childhood diseases to quickly become fatal to him. The convergence of a famine crisis and a growing vaccine shortage threaten to create the conditions for one children’s survival crisis. Vaccination coverage fell across all regions, with East Asia and the Pacific region experiencing the strongest turnaround in DTP3 coverage, falling nine percentage points in just two years.

Planning and management of Covid-19 should go hand in hand with vaccination against life-threatening diseasesI like measles, pneumonia and diarrhea, he said Tedros Adhanom Ghebreyesus, WHO Director – General. ‘It’s not a question of one or the other you can do both.’ Some countries have held back the decline. Uganda has maintained high levels of coverage in routine vaccination programs, at the same time as launching a targeted vaccination program against Covid-19 to protect priority populations, including healthcare professionals. Corresponding Pakistan has returned to pre-pandemic coverage levels thanks to high-level government efforts and significant recovery vaccination efforts. It is to be commended that this has been achieved in the midst of a pandemic in which healthcare systems and healthcare professionals were under considerable pressure. Monumental efforts will be needed to achieve universal coverage levels and prevent epidemics. Inadequate levels of coverage have already caused preventable outbreaks of measles and polio in the last 12 months, underlining the vital role of vaccinations in keeping children, young people, adults and society healthy. The sharp decline in two years follows nearly a decade of halted progress, underscoring the need to address not only pandemic-related disorders but also systemic vaccination-related challenges to ensure that all children and adolescents are met.

WHO and UNICEF work with Gavi, the Vaccine Alliance and other partners to implement 2030 Global Vaccination Agenda (IA2030), a strategy for all affected countries and global partners with a view to achieving the objectives set for disease prevention through vaccination and the provision of vaccines to all, everywhere and at all ages. ‘It is heartbreaking to see more children lose protection against preventable diseases for the second year in a row. The Alliance’s priority must be to help countries maintain, restore and strengthen routine vaccinations along with the implementation of ambitious COVID-19 vaccination plans, not only through vaccines but also with tailored structural support for the health systems that will administer them, says Seth Berkley . , CEO of Gavi, Alliance for Vaccines.

IA2030 partners call on governments and relevant actors to: Intensify recovery vaccination efforts to address delays in routine vaccination and expand dissemination services in underserved areas to reach missing children and carry out campaigns to prevent epidemics; Implement tailor-made, people-centered and data-driven strategies to build trust in vaccines and vaccinations, tackle disinformation and increase vaccine intake, especially among vulnerable communities; Ensure that the current pandemic preparedness and response and efforts to strengthen the global healthcare architecture lead to investment in primary healthcare (PHC) with explicit support to strengthen and support essential vaccinations; Ensure the political commitment of national governments and increase the allocation of national resources to strengthen and support primary health care vaccinations; Prioritize strengthening health information and disease surveillance systems to provide the data and surveillance needed to maximize the impact of programs. Leverage and increase investment in research to develop and improve new and existing vaccines and vaccination services that can meet community needs and achieve IA2030 goals.

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