Two leading UN agencies, the World Health Organisation (WHO) and UNICEF children’s fund, attribute the dangerous stagnation of global vaccination rates to conflict, inequality and complacency.
According to reports by the UN agencies released on July 15th, 20 million children worldwide – more than one in 10 – were not vaccinated against the deadly diseases of measles, diphtheria and tetanus in 2018.
It was reported by reliefweb that since 2010, the three doses of diphtheria, tetanus and pertussis (DTP3) and the single dose of the measles vaccine has stopped at around 86%. Although the previous percentage is considered high, it is still not sufficient. At least 95% coverage is required globally to protect nations against outbreaks of vaccine-preventable diseases.
Director-General of the WHO Tedros Adhanom Ghebreyesus, pointed out, “Vaccines are one of our most important tools for preventing outbreaks and keeping the world safe. While most children today are being vaccinated, still many others are unvaccinated. Unacceptably, it’s often those who are most at risk– the poorest, the most marginalised, those touched by conflict or forced from their homes - who are regularly missed.”
Most unvaccinated children live in the poorest countries and a high proportion live in fragile conflict zones. Almost half of the 20 million children are in just 16 countries - Afghanistan, the Central African Republic, Chad, Democratic Republic of the Congo (DRC), Ethiopia, Haiti, Iraq, Mali, Niger, Nigeria, Pakistan, Somalia, South Sudan, Sudan, Syria and Yemen.
If these children become sick, they are at risk of the severest health consequences, and least likely to access lifesaving treatment and care.
Measles outbreaks reveal entrenched gaps in coverage, often over many years
Immense discrepancies in vaccine access prevail across and within countries of various income levels. This has resulted in devastating measles outbreaks in many countries all over the world, including countries that have high overall vaccination rates.
In 2018, almost 350,000 cases of measles were reported globally, more than doubling from 2017.
“Measles is a real-time indicator of where we have more work to do to fight preventable diseases,” said Henrietta Fore, UNICEF’s Executive Director. “Measles is a highly contagious disease, an outbreak anywhere means that communities cannot reach the vaccines either due to access, costs or, in some places, complacency. We have to exert every effort to immunise every child.”
Ukraine is among the highest countries with reported incidence of measles in 2018. While the country has now managed to vaccinate over 90% of its infants, coverage had been low for several years, leaving a large number of older children and adults at risk.
Many other countries with high incidence and high coverage have significant groups of people who have missed the measles vaccine in the past. This shows how low coverage over time or discrete communities of unvaccinated people can spark deadly outbreaks.
Human papillomavirus (HPV) vaccine coverage data available for the first time
For the first time, according to the UN agencies, there is also data on the coverage of human papillomavirus (HPV) vaccine, which protects girls against cervical cancer. In 2018, 90 countries ,home to 1 in 3 girls worldwide, had introduced the HPV vaccine into their national programmes. Just 13 of these are lower-income countries. This leaves those most at risk of the devastating impacts of cervical cancer still least likely to have access to the vaccine.
Together with partners like Gavi, the Vaccine Alliance and the Measles & Rubella Initiative, WHO and UNICEF are supporting countries to strengthen their immunisation systems and outbreak response, by vaccinating all children with routine immunisation, conducting emergency campaigns, and training and equipping health workers as an essential part of quality primary healthcare.
About the data
Since 2000, WHO and UNICEF jointly produce annual national immunisation coverage estimates for member states. In addition to producing the immunisation coverage estimates for 2018, the WHO and UNICEF estimation process revises the entire historical series of immunisation data with the latest available information. The 2018 revision covers 39 years of coverage estimates, from 1980 to 2018. DTP3 coverage is used as an indicator to assess the proportion of children vaccinated and is calculated for children under the age of one. The estimated number of vaccinated children is calculated using population data provided by the 2019 World Population Prospects from the UN.