Routine Childhood Immunisations in Low-Income Countries Declined Again in 2021; Signs of Recovery in 2022
Childhood immunisation checks in low-income countries
Doctors in Pakistan check an infant for a scar showing signs of Bacillus Calmette-Guerin (BCG) vaccination – used to protect against TB in high-burden countries. 

Routine childhood immunisation across 57 low income countries declined slightly for the second consecutive year in 2021, following massive pandemic-related interruptions in vaccine coverage in 2020, according to Gavi, the Vaccine Alliance.

Vaccine coverage stood at 77%, one percent less than in 2020. 

Preliminary data between January and May 2022, however, shows signs of improvement in childhood immunisation coverage, according to preliminary WHO data contained in Gavi’s 2021 Annual Progress Report. 

In 2021, 65 million children were immunised in the 57 Gavi-supported countries, generating economic benefits equivalent of more than $18.9 million. Gavi-supported countries also contributed $161 million in co-financing to advance national commitments to childhood immunisation, and ensure programme sustainability. 

Gavi countries also administered more than two billion Covid-19 vaccines in 2021. 

“Since 2019, we have seen the biggest sustained drop in routine immunisation in a generation, and millions of children are still missing out,” Catherine Russell, UNICEF’s executive director said. “Immunisation is one of the world’s most effective and cost-effective public health interventions.” 

This is not the first time that global health organisations have flagged this issue. In July, WHO and UNICEF sounded the alarm on the largest sustained decline in childhood vaccinations across the globe in 30 years. As per their estimate, around 25 million infants missed out on routine lifesaving vaccines due to many factors like increased conflicts that blocked immunisation access and Covid-19.

Signs of improvement in 2022

Though childhood immunisation numbers declined in 2020 and 2021 due to the Covid-19 pandemic, preliminary data from the World Health Organization (WHO) shows early signs of improvement in 2022. Data collected from January to May 2022 from 16 countries suggests a 2% increase in the basic vaccine coverage among children. 

In December 2021, Gavi also approved funding to support the world’s first malaria vaccine roll-out in sub-Saharan Africa in 2022-2025. 

Expressing disappointment over the continued decline in 2021 in childhood immunisation rates, Gavi’s CEO Dr Seth Berkley said that the early indications on the 2022 data still provides grounds for optimism. 

“There is no higher priority for the Alliance in 2022 than keeping routine immunisation progress on track,” he said. 

Focus on zero-dose children

The number of children who received no vaccine doses in the 57 low income countries increased by 570,000 in 2021, Gavi reported, pegging the total at 12.5 million children. Cumulatively, this is a 34% increase when compared with the 2019-figures – reflecting the much more massive drop in coverage that occurred in 2020, the first year of the pandemic. 

‘Zero-dose’ children are infants who have not received their first dose of the DTP1 vaccine, which protects them from diptheria, tetanus and pertussis. It is one of the first vaccines administered to infants.

In July’s report, 18 million infants out of the 25 million who missed out on lifesaving vaccines did not receive even a single dose of the DTP1 vaccine, thus increasing their risk of dangerous diseases like diptheria, tetanus and pertussis.

Prof José Manuel Barroso, chair of the Gavi Board, said that leveling out of the decline shows signs of recovery by countries’ “heroic” immunization programmes. “As we move forward, we must maintain our focus on supporting routine immunisation and reaching zero-dose children with life-saving vaccines,” he added.  

Added Russell:  “…we need to…make sure lost ground does not become lost lives.”

Image Credits: CDC Global, Public domain, via Wikimedia Commons.

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