Pandemic-related decline in childhood vaccinations could trigger resurgence of diseases

Nearly three out of four infants live in countries where low vaccination coverage is already leading to measles outbreaks.

16.07.2024

Global childhood immunization coverage will plateau in 2023, meaning Another 2.7 million boys and girls are unvaccinated or have not received all their vaccinations compared to pre-pandemic levels.

According to assessments* recently published by UNICEF and the World Health Organization (WHO), continued efforts are needed to update, restore and strengthen vaccination systems.

“Recent trends show that in many countries there are too many unvaccinated children,” says our Executive Director, Catherine Russell.

Unstable conditions favor the absence of immunization

More than half of unvaccinated boys and girls live in 31 fragile settings affected by conflict and violence, where boys and girls are particularly vulnerable to preventable diseases due to lack of security, access to health services, nutrition and health.

Hana gets vaccinated for the first time

This is a case Hana, 20 monthswhom we see in the photo with his father, after receiving the measles vaccineShe and her family are in a refugee camp in Sudan, although they are originally from South Sudan, a country that has experienced years of conflict and where health needs are evident.

This child was vaccinated for the first time, her father says happily, because immunization services are offered free to families. He was able to vaccinate all his children that day.

UNICEF is conducting vaccination campaigns across Sudan where millions of displaced people, especially children, live in overcrowded conditions and need protection from disease and an end to outbreaks.

These campaigns are also needed to reach children with zero doses so they can receive vaccines that can save their lives.

Far from pre-pandemic levels

Global immunization coverage has remained virtually unchanged since 2022 and, more worryingly, has still not returned to 2019 levels.

These trends reflect ongoing challenges related to disruptions in health services, logistical issues, vaccine hesitancy and inequalities in access to services.

Measles vaccine

Declining vaccination coverage is leading to outbreaks of the deadly disease measles. Data also show that vaccination rates have stagnated, leaving nearly 35 million boys and girls unprotected or only partially protected.

In 2023, only 83% of children worldwide received the first dose of measles vaccine through health services, while the number of children receiving the second dose increased only slightly from the previous year, reaching 74%.

These figures fall short of the 95% coverage needed to prevent outbreaks, prevent unnecessary deaths from the disease and achieve measles elimination goals.

Over the past five years, measles outbreaks have affected 103 countries, home to about three-quarters of the world’s infants. Low vaccination coverage (80% or less) has been a significant factor.

In contrast, 91 countries with high measles vaccination coverage had no outbreaks.

Dr Tedros Adhanom Ghebreyesus, WHO Director-General, says “there is a solution to this problem. The measles vaccine is cheap and can be administered even in the most difficult to reach places.”

Diphtheria, tetanus and pertussis vaccine (DPT)

A key indicator of global immunization coverage is the number of children vaccinated against diphtheria, tetanus and pertussis. In 2023, this rate remained stable at 84%, with 108 million boys and girls vaccinated with all three doses.

However, The number of boys and girls who have not received a single dose of vaccine increased from 13.9 million in 2022 to 14.5 million in 2023.

An additional 6.5 million boys and girls did not receive the third dose of DTP vaccine needed to achieve protection against the disease during breastfeeding and early life.

HPV vaccine

Global HPV vaccination coverage among girls has increased significantly.

The proportion of adolescent girls worldwide who have received at least one dose of the HPV vaccine, which provides protection against cervical cancer, has increased from 20% in 2022 to 27% in 2023, largely due to strong vaccine rollout in countries supported by Gavi, the vaccine alliance, such as Bangladesh, Indonesia and Nigeria. The use of a single-dose HPV vaccination regimen has also helped increase vaccination coverage.

However, HPV vaccination coverage falls far short of 90% target to eliminate cervical cancer as a public health problem, since it affects only 56% of adolescent girls in high-income countries and 23% in low- and middle-income countries.

Goal: to speed up vaccination.

While some regions, such as Africa and low-income countries, have made modest progress, recent assessments highlight the need to accelerate efforts to achieve the Immunization Agenda 2030 (IA2030) goals.

The goal is to achieve 90% coverage and reduce the number of children with zero doses globally to less than 6.5 million by 2030.

This requires greater investment in innovation and greater collaboration. Bold local action is needed to reach everyone, everywhere.

“Closing the immunization gap requires a global effort by governments, partners and local leaders to invest in primary health care and community workers to ensure all children are vaccinated and health care is strengthened overall,” Russell concludes.

At UNICEF, we are the world’s largest purchaser of vaccines, distributing nearly 2.8 billion doses to 105 countries in 2023 alone. We vaccinated 133 million children against measles, many in emergencies, and more than 400 million were vaccinated against polio..

*The latest WHO and UNICEF National Immunization Coverage Estimates (WUENIC) provide the world’s largest and most comprehensive data set on immunization trends against 14 diseases.