Pediatric Vaccination Stall Around the Worldwith coverage remaining below pre-Covid levels. “Global childhood immunization levels stalled in 2023, leaving many children without life-saving protection.” This is the alarm raised by two United Nations agenciesthe World Health Organization (WHO) and UNICEF, which for last year, compared to 2019, estimate “2.7 million more children were unvaccinated or undervaccinated”.
The Wuenic report (WHO/UNICEF Estimates of National Immunization Coverage), which provides the world’s largest and most comprehensive data set on immunization trends against 14 diseases, explain WHO and UNICEF, highlights “the need for continued efforts” to recover and strengthen coverage levels. “The latest trends – says Catherine Russell, UNICEF Executive Director – demonstrate that In many countries, too many children continue to miss out on vaccinations. “Closing the vaccination gap requires a global effort,” warns Russel, urging governments and local authorities to invest in primary health care and human resources, to “ensure that every child is vaccinated and that overall health care is strengthened.”
The number of children who received 3 doses of diphtheria, tetanus and pertussis (DTP) vaccine in 2023, which is a key indicator for global vaccination coverage – the 2 UN agencies underline – stopped at 84% (108 million). However, Children who have not received even one dose of DTP vaccine increased from 13.9 million in 2022 to 14.5 million in 2023. More than half of the unvaccinated live in 31 countries with fragile or conflict-affected contexts, where children are particularly vulnerable to preventable diseases due to poor security, poor food and lack of care. In addition, 6.5 million children have not completed the third dose of the DTP vaccine, which is required to obtain protection from the disease. “These trends show that global vaccination coverage has remained essentially unchanged since 2022 and, even more alarmingly, has not returned to 2019 levels”, note WHO and UNICEF, citing “disruptions in health services, logistical challenges, vaccine hesitancy and inequalities in access to services”.
Anti-measles flop, 3 out of 4 children live in countries with epidemics
“Low vaccination coverage is already causing measles epidemics”, which “have affected 103 countries in the last 5 years, home to about three-quarters of all children in the world”, is one of the data highlighted by the World Health Organization (WHO) and UNICEF. The data show that “vaccination rates against measles”, a potentially “deadly” infection, warn the 2 UN agencies”, in 2023 “are at a standstill, leaving almost 35 million children without protection or with only partial protection”.
Last year – WHO and UNICEF report – only 83% of children worldwide received the first dose of measles vaccine, while the number of children who had the second dose increased modestly compared to the previous year, to 74%. Figures that “do not reach the 95% coverage needed to prevent epidemics, avoid illnesses and deaths, and achieve the goals of measles eradication”. In the more than 100 countries that have experienced measles epidemics in the last five years, the 2 agencies point out, “low vaccination coverage (80% or less) has been a major factor”. And in fact, “on the contrary, 91 countries with solid measles vaccination coverage have not had epidemics”.
“Measles outbreaks are the canary in the coal mine,” says WHO Director-General Tedros Adhanom Ghebreyesus. “They expose immunization gaps and hit the most vulnerable first,” he warns. But measles, the DG reminds us, “is a solvable problem. The measles vaccine is affordable and can be delivered even in the most difficult settings. WHO is committed to working with all our partners to help countries close this gap and protect the most at-risk children as quickly as possible.”
Anti-HPV coverage among girls is growing but far from 90%
Instead, vaccination coverage against the Human Papillomavirus (HPV) is increasing, at least among girls, but it remains far from the levels recommended by international health authorities. “The percentage of adolescents globally who have received at least one dose of the HPV vaccine, which protects against cervical cancer, has increased from 20% in 2022 to 27% in 2023,” they report. However, the two UN agencies specify, “vaccination coverage against HPV is well below the 90% target” that could “eliminate cervical cancer as a public health problem. In fact, it reaches” “only 56% of girls in high-income countries and 23% in low- and middle-income countries”.
For WHO and UNICEF, the increased HPV vaccination coverage among adolescents is due “in large part to the strong rollout of the vaccine in countries supported by Gavi”, the Vaccine Alliance, “such as Bangladesh, Indonesia and Nigeria. The single-dose vaccination programme has also contributed to increasing vaccination coverage”. Commented Sania Nishtar, CEO of Gavi: “The HPV vaccine is one of the most impactful vaccines in our portfolio and it is incredibly heartening that it is reaching more girls than ever before. With vaccines available for more than 50% of eligible adolescents in African countries, we have a lot of work to do, but today we see a clear path towards eradicating this terrible disease”.
A recent survey conducted on more than 400,000 users of the UNICEF digital platform for young people, U-Report, highlights that over 75% are not aware of what Papillomavirus is or are unsure. It is necessary to fill this information gap, because once the nature of the virus, its link with cancer and the existence of a vaccine are understood – WHO and UNICEF point out – 52% of those interviewed said they wanted to receive the anti-HPV vaccine, citing financial constraints (41%) and lack of availability (34%) as obstacles.
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