The World Health Organisation and UNICEF warned today, July 15, of an alarming decline in the number of children receiving life-saving vaccines around the world.
This is due to disruptions in the delivery and uptake of immunisation services caused by the Covid-19 pandemic. According to new data by WHO and UNICEF, these disruptions threaten to reverse hard-won progress to reach more children and adolescents with a wider range of vaccines, which has already been hampered by a decade of stalling coverage.
The latest data on vaccine coverage estimates from WHO and UNICEF for 2019 shows that improvements such as the expansion of the HPV vaccine to 106 countries and greater protection for children against more diseases are in danger of lapsing.
Preliminary data for the first four months of 2020 points to a substantial drop in the number of children completing three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3).
This is the first time in 28 years that the world could see a reduction in DTP3 coverage, the marker for immunisation coverage within and across countries.
Alarming decline in the number of children receiving lifesaving vaccines around the world during #COVID19: WHO and @UNICEF
More: https://t.co/fexIvlFgqD pic.twitter.com/zOautor9VK
— World Health Organization (WHO) (@WHO) July 15, 2020
“Vaccines are one of the most powerful tools in the history of public health, and more children are now being immunized than ever before,” said Dr Tedros Adhanom Ghebreyesus, WHO director-general.
“But the pandemic has put those gains at risk. The avoidable suffering and death caused by children missing out on routine immunisations could be far greater than Covid-19 itself. It doesn’t have to be that way. Vaccines can be delivered safely even during the pandemic, and we are calling on countries to ensure these essential life-saving programmes continue.”
Covid-19 disruptions
Due to the Covid-19 pandemic, at least 30 measles vaccination campaigns were or are at risk of being cancelled, which could result in further outbreaks in 2020 and beyond.
Also read: World Health Organisation calls for equitable access to future Covid-19 vaccines in Africa (Video)
According to a new UNICEF, WHO and Gavi pulse survey, conducted in collaboration with the US Centres for Disease Control, the Sabin Vaccine Institute and Johns Hopkins Bloomberg School of Public Health, three quarters of the 82 countries that responded reported Covid-19 related disruptions in their immunisation programmes as of May 2020.
The reasons for disrupted services vary.
Even when services are offered, people are either unable to access them because of reluctance to leave home, transport interruptions, economic hardships, restrictions on movement, or fear of being exposed to people with Covid-19.
Many health workers are also unavailable because of restrictions on travel or redeployment to Covid response duties as well as a lack of protective equipment.
“Covid-19 has made previously routine vaccination a daunting challenge,” said UNICEF executive director Henrietta Fore.
As midwives face COVID-19, they are helping bring new life into the world too.
UNICEF is supporting mothers and newborns with lifesaving care and vaccines.
Join us and help save lives. Every $ will be matched by @Pandora_Corp, up to $1M.
— UNICEF (@UNICEF) July 12, 2020
“We must prevent a further deterioration in vaccine coverage and urgently resume vaccination programs before children’s lives are threatened by other diseases. We cannot trade one health crisis for another.”
Stagnating global coverage rate
Progress on immunisation coverage was stalling before Covid-19 hit, at 85 per cent for DTP3 and measles vaccines.
The likelihood that a child born today will be fully vaccinated with all the globally recommended vaccines by the time she reaches the age of five is less than 20 per cent.
Also read: Watch: World Health Organisation concerned about impact of Covid-19 on health services
In 2019, nearly 14-million children missed out on life-saving vaccines such as measles and DTP3.
Most of these children live in Africa and are likely to lack access to other health services.
Two-thirds of them are concentrated in 10 middle- and low-income countries: Angola, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Mexico, Nigeria, Pakistan, and Philippines.
Children in middle-income countries account for an increasing share of the burden.
Progress and challenges, by country and region
There has been some progress.
Regional coverage for the third dose of DTP in South Asia has increased by 12 percentage points over the last 10 years, notably across India, Nepal and Pakistan.
However, that hard-won progress could be undone by Covid-19 related disruptions.
Countries that had recorded significant progress, such as Ethiopia and Pakistan, are now also at risk of backsliding if immunisation services are not restored as soon as feasible.
The situation is especially concerning for Latin America and the Caribbean, where historically high coverage has slipped over the last decade.
In Brazil, Bolivia, Haiti and Venezuela, immunisation coverage plummeted by at least 14 percentage points since 2010.
These countries are now also confronting moderate to severe Covid-related disruptions.
As the global health community attempts to recover lost ground due to Covid-19 related disruptions, UNICEF and WHO are supporting countries in their efforts to reimagine immunization and build back better by:
- Restoring services so countries can safely deliver routine immunisation services during the Covid-19 pandemic, by adhering to hygiene and physical distancing recommendations and providing protective equipment to health workers;
- Helping health workers communicate actively with caregivers to explain how services have been reconfigured to ensure safety;
- Rectifying coverage and immunity gaps;
- Expanding routine services to reach missed communities, where some of the most vulnerable children live.
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