Official data published by UN agencies on Friday shows the largest sustained decline in childhood vaccination rates in approximately 30 years, with 25 million infants missing out on lifesaving shots in 2021.
The figures released by the World Health Organisation (WHO) and UN Children’s Fund (UNICEF), show the percentage of children who received three doses of the vaccine.
It shows percentage of children who received three doses of the vaccines against diphtheria, tetanus and pertussis (DTP3) – a marker for immunisation coverage within and across countries – fell five points between 2019 and 2021, to 81 per cent.
The 25 million children who missed out on doses of DTP through routine immunisation services last year is two million more than in 2020, and six million more than in 2019.
“This highlights the growing number of children at risk from devastating but preventable diseases,” the UN agencies said in a statement.
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 on social media and COVID-19 related issues such as service and supply chain disruptions, resources being diverted, and containment measures that limited access to jabs, also played a part.
“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,” Catherine Russell, UNICEF Executive Director, said.
“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.”
Some 18 million of the 25 million children missing out, 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, the agencies note.
Myanmar and Mozambique are among the countries with the largest relative increases in children who did not receive a single vaccine between 2019 and 2021.
Globally, over a quarter of the coverage of HPV vaccines that was achieved in 2019 has been lost.
This has grave consequences for the health of women and girls, as global coverage of the first dose of Human PapillomaVirus (HPV) vaccine is only 15 per cent, despite the availability of a vaccine for the past 15 years on the global market.
The agencies said they had hoped 2021 “would be a year of recovery during which strained immunisation programmes would rebuild,” following the first year of the pandemic.
But instead, they stated that 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 (SDGs).
The decline in 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 immunisation gap threatens to create the conditions for a child survival crisis.”
Vaccine coverage dropped in every region, with the East Asia and Pacific recording the steepest decline, down nine per cent in just two years.
“Planning and tackling COVID-19 should also go hand-in-hand with vaccinating for killer diseases like measles, pneumonia and diarrhoea,” Tedros Ghebreyesus, WHO Director-General said, noting that “It’s not a question of either/or, it’s possible to do both”.
Some countries successfully maintained a high rate of coverage in routine immunisations, such as Uganda, which managed to roll out a targeted COVID-19 vaccination programme to protect priority populations, including health workers.
Pakistan returned to pre-pandemic levels of coverage thanks to high-level government commitment and significant catch-up immunisation efforts.
Monumental efforts will be required to reach universal levels of coverage and to prevent outbreaks, the WHO and UNICEF warned.
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.
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.
“It’s heart-breaking to see more children losing out on protection from preventable diseases for a second year in a row.
“The priority of the Alliance must be to help countries to maintain, restore and strengthen routine immunisation alongside executing ambitious COVID-19 vaccination plans, not just through vaccines but also tailored structural support for the health systems that will administer them,” Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, said.
