Childhood Immunization Rebounds – But Still Below Pre-Pandemic Levels
Oral polio vaccination – despite a post-COVID rebound, 20.5 million children still missed out on routine vaccinations in 2022.

Routine childhood immuniaztions rebounded in 2022 from the set-backs of the COVID pandemic.  But coverage still fell short of pre-COVID numbers in 2019, with 20.5 million children missing out on one or more routine vaccines last year as compared to 18.4 million in 2019.

The new data is contained in a report published jointly Tuesday morning by the World Health Organization and UNICEF.  The data tracks a wide range of vaccines, but uses immunization against diptheria, tetanus and pertussis (DTP) as a marker for immunization coverage globally.

In 2022, 20.5 million children missed out on one or more DTP vaccines, as compared to 24.4 million children in 2021, according to the new global data set.

Of the 20.5 million children who missed out on one or more doses of their DTP vaccines in 2022, 14.3 million did not receive a single dose, so-called ‘zero-dose’ children. The 2022 figure represents an improvement over the 18.1 million zero-dose children in 2021 but remains higher than the 12.9 million children that missed all DTP doses in 2019.

“These data are encouraging, and a tribute to those who have worked so hard to restore life-saving immunization services after two years of sustained decline in immunization coverage,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “But global and regional averages don’t tell the whole story and mask severe and persistent inequities. When countries and regions lag, children pay the price.”

Indeed, progress was greater in large, and better-resourced countries like India and Indonesia, the WHO/UNICEF report notes. It was much less so in many other low-income countries.

Of the 73 countries that recorded substantial declines in coverage during the pandemic, 15 recovered to pre-pandemic levels and 24 are on route to recovery, the report finds. However, another 34 have seen vaccination rates stagnate at pandemic levels, or even continue to decline.

“These concerning trends echo patterns seen in other health metrics,” said WHO.

Additionally, while DTP is used as a marker, vaccinations against various childhood diseases still vary widely.  For instance, vaccination against measles – one of the most infectious pathogens – has not recovered as well as other vaccines, putting an additional 35.2 million children at risk of measles infection, WHO said in a press release.

First dose measles coverage increased to 83 per cent in 2022 from 81 per cent in 2021 but remained lower than the 86 per cent achieved in 2019. As a result, last year, 21.9 million children missed the routine measles vaccination in their first year of life – 2.7 million more than in 2019 – while an additional 13.3 million did not receive their second dose, placing children in under-vaccinated communities at risk of outbreaks.

Overall, coverage with three DTP doses in 57 low-income countries supported by Gavi, The Vaccine Alliance, increased to 81% in 2022, as compared to only 78% in 2021, however, this remains below the pre-pandemic rates of  86% recorded in 2019, UNICEF said.

“Beneath the positive trend lies a grave warning,” said UNICEF Executive Director Catherine Russell. “Until more countries mend the gaps in routine immunization coverage, children everywhere will remain at risk of contracting and dying from diseases we can prevent. Viruses like measles do not recognize borders.”

Image Credits: UNICEF South Africa/2013/Hearfield, Sanofi Pastuer/Flickr.

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