20 million children left out of life saving vaccines: UNICEF

NEW YORK/GENEVA, 15 July 2019 – 20 million children worldwide – more than 1 in 10 – missed out on lifesaving vaccines such as measles, diphtheria and tetanus in 2018, according to new data from WHO and UNICEF.

Globally, since 2010, vaccination coverage with three doses of diphtheria, tetanus and pertussis (DTP3) and one dose of the measles vaccine has stalled at around 86 percent. While high, this is not sufficient. 95 percent coverage is needed – globally, across countries, and communities – to protect against outbreaks of vaccine-preventable diseases.

“Vaccines are one of our most important tools for preventing outbreaks and keeping the world safe,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “While most children today are being vaccinated, far too many are left behind. Unacceptably, it’s often those who are most at risk– the poorest, the most marginalized, those touched by conflict or forced from their homes – who are persistently missed.”

Most unvaccinated children live in the poorest countries, and are disproportionately in fragile or conflict-affected states. Almost half 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 do get 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.

Stark disparities in vaccine access persist across and within countries of all income levels. This has resulted in devastating measles outbreaks in many parts of the world – including countries that have high overall vaccination rates.

In 2018, almost 350,000 measles cases 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. “Because measles is so contagious, an outbreak points to communities that are missing out on vaccines due to access, costs or, in some places, complacency. We have to exhaust every effort to immunize every child.”

Ukraine leads a varied list of countries with the highest reported incidence rate of measles in 2018. While the country has now managed to vaccinate over 90 percent of its infants, coverage had been low for several years, leaving a large number of older children and adults at risk.

Several 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, there is also data on the coverage of human papillomavirus (HPV) vaccine, which protects girls against cervical cancer later in life. As of 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, WHO and UNICEF are supporting countries to strengthen their immunization systems and outbreak response, including by vaccinating all children with routine immunization, conducting emergency campaigns, and training and equipping health workers as an essential part of quality primary healthcare.

Immunization is a key priority area for Government of India and extensive efforts are being made to reach and vaccinate every child even in the remotest part of the country. India launched Mission Indradhanush (MI), a key strategy to reach the unreached and conducted multiple rounds of immunization sessions to cover children and pregnant mothers missing their scheduled vaccination dose.

In addition, the immunization programme is focusing on preventing more diseases by introducing new vaccines under the programme. Rotavirus vaccine and Pneumococcal vaccines were introduced under Universal Immunization Programme as part of efforts to reduce Pneumonia and Diarrhea, the two major killers of children, under- five years.

Measles Rubella campaign in India

Measles is a highly contagious virus and spreads rapidly in unvaccinated children causing symptoms from rash to blindness, pneumonia to deaths. Rubella virus is the primary cause of congenital rubella syndrome leading to abortions and children born with birth defects of heart, eye and brain. Both Measles and Rubella can be effectively protected by a highly effective Measles-Rubella (MR) vaccine.

India is conducting one of the world’s largest MR campaign to eliminate Measles and control Rubella in the country. As of 1^st July 2019, more than 30 crore children and adolescent between 9 months to 15 years of age have been vaccinated with one dose of MR vaccine in 32 states. The MR vaccine is a safe and effective vaccine and has been Pre-Qualified by WHO for its quality and safety and is licensed by the Central Drugs Standard Control Organization, Government of India. The MR vaccine being used in the campaign is made in India and is exported for use world over.

UNICEF is a technical partner of immunization programme and stands committed to support the Government in ensuring that no child suffers from diseases that can be prevented through vaccination.

 Since 2000, WHO and UNICEF jointly produce national immunization coverage estimates for Member States on an annual basis. In addition to producing the immunization coverage estimates for 2018, the WHO and UNICEF estimation process revises the entire historical series of immunization 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 one year of age. The estimated number of vaccinated children are calculated using population data provided by the 2019 World Population Prospects (WPP) from the UN.

Aditi Bhaduri

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