WHO, UNICEF Lament Global Decline in Vaccination as 25m Children Miss Routine Immunisation

Segun Awofadeji in Bauchi

The World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) have lamented the global decline in vaccination coverage with 25 million infants missing out on life-saving vaccines in 2021.

According to a statement by UNICEF made available to THISDAY at the weekend by it Communication Officer, Bauchi Field Office, Mr. Opeyemi Olagunju, quoted Catherine Russell, UNICEF Executive Director, to have said: “The largest sustained decline in childhood vaccinations in approximately 30 years has been recorded in official data published today 15th July, 2022 by WHO and UNICEF.”

The report also disclosed that, “The percentage of children who received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3) – a marker for immunisation coverage within and across countries – fell five percentage points between 2019 and 2021 to 81 per cent.

“As a result, 25 million children missed out on one or more doses of DTP through routine immunisation services in 2021 alone. This is two million more than those who missed out in 2020 and six million more than in 2019, highlighting the growing number of children at risk from devastating but preventable diseases.
“The decline was due to many factors including an increased number of children living in conflict and fragile settings where immunisation access is often challenging, increased misinformation and COVID-19 related issues such as service and supply chain disruptions, resource diversion to response efforts, and containment measures that limited immunisation service access and availability.
“This is a red alert for child health. We are witnessing the largest sustained drop in childhood immunisation in a generation. The consequences will be measured in lives.”

It added: “While a pandemic hangover was expected last year as a result of COVID-19 disruptions and lockdowns, what we are seeing now is a continued decline. COVID-19 is not an excuse.
“We need immunisation catch-ups for the missing millions or we will inevitably witness more outbreaks, more sick children and greater pressure on already strained health systems.”

The report added that, “18 million of the 25 million children did not receive a single dose of DTP during the year, the vast majority of whom live in low- and middle-income countries, with India, Nigeria, Indonesia, Ethiopia and the Philippines recording the highest numbers.”
It noted that among countries with the largest relative increases in the number of children who did not receive a single vaccine between 2019 and 2021 were Myanmar and Mozambique.

According to the statement, globally, over a quarter of the coverage of HPV vaccines achieved in 2019 have been lost.
This, it stated, has grave consequences for the health of women and girls, as global coverage of the first dose of human papillomavirus (HPV) vaccine was only 15 per cent, despite the first vaccines being licenced over 15 years ago.
According to the report, “It was hoped that 2021 would be a year of recovery during which strained immunisation programmes would rebuild and the cohort of children missed in 2020 would be caught-up.

“Instead, DTP3 coverage was set back to its lowest level since 2008 which, along with declines in coverage for other basic vaccines, pushed the world off-track to meet global goals, including the immunisation indicator for the Sustainable Development Goals.

“This historic backsliding in rates of immunisation is happening against a backdrop of rapidly rising rates of severe acute malnutrition. A malnourished child already has weakened immunity and missed vaccinations can mean common childhood illnesses quickly become lethal to them.
“The convergence of a hunger crisis with a growing immunization gap threatens to create the conditions for a child survival crisis.”
Vaccine coverage dropped in every region, with the East Asia and Pacific region recording the steepest reversal in DTP3 coverage, falling nine percentage points in just two years.

“Planning and tackling COVID-19 should also go hand-in-hand with vaccinating for killer diseases like measles, pneumonia and diarrhea,” WHO Director-General, Dr. Tedros Adhanom Ghebreyesus was also quoted to have said.
 “It’s not a question of either/or, it’s possible to do both”.

It further stated that, “Some countries notably held off declines. Uganda maintained high levels of coverage in routine immunisation programmes, whilst rolling out a targeted COVID-19 vaccination programme to protect priority populations, including health workers.
“Similarly, Pakistan returned to pre-pandemic levels of coverage thanks to high-level government commitment and significant catch-up immunisation efforts. To achieve this in the midst of a pandemic, when healthcare systems and health workers were under significant strain, should be applauded.

“Monumental efforts will be required to reach universal levels of coverage and to prevent outbreaks. Inadequate coverage levels have already resulted in avoidable outbreaks of measles and polio in the past 12 months, underscoring the vital role of immunisation in keeping children, adolescents, adults, and societies healthy.

“First dose measles coverage dropped to 81 per cent in 2021, also the lowest level since 2008. This meant 24.7 million children missed their first measles dose in 2021, 5.3 million more than in 2019. A further 14.7 million did not receive their needed second dose. Similarly, compared to 2019, 6.7 million more children missed the third dose of polio vaccine and 3.5 million missed the first dose of the HPV vaccine – which protects girls against cervical cancer later in life.”

The report stated further: “WHO and UNICEF are working with Gavi, the Vaccine Alliance and other partners to deliver the global Immunisation Agenda 2030 (IA2030), a strategy for all countries and relevant global partners to achieve set goals on preventing diseases through immunisation and delivering vaccines to everyone, everywhere, at every age.”