Global health leaders issued a “red alert” on child health as they unveiled data showing the biggest sustained drop in childhood vaccinations in around 30 years.
The World Health Organization and Unicef, the children’s charity, said on Friday that the percentage of children who received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3) fell 5 percentage points between 2019 and 2021 to 81 percent and was now back to its lowest level since 2008.
The shortfall reflected the growing number of children living in conflict zones and other regions where immunization was often harder to deliver, the bodies reported. They also pointed to increased misinformation about vaccines and the disruption and diversion of resources caused by Covid-19.
Vaccine coverage dropped in every region, with the East Asia and Pacific region recording the steepest reversal in DTP3 coverage; it fell 9 percentage points in just two years, they said.
The data also underlined the growing threat from measles, with the number receiving a first dose of vaccine against the disease dropping to 81 percent in 2021, also the lowest level since 2008. Meanwhile, compared to 2019, 6.7mn more children missed a third dose of the polio vaccine and 3.5mn did not get the first dose of the HPV vaccine, which protects girls against cervical cancer later in life. Globally, more than a quarter of the coverage of HPV vaccines achieved in 2019 had been lost, they said.
Unicef executive director Catherine Russell said: “This is a red alert for child health.” The world was witnessing “the largest sustained drop in childhood immunization in a generation”, she said, and “the consequences will be measured in lives”.
The two bodies suggested that hopes that 2021 would be a year of recovery had been dashed. Russell said that, while it had been expected that Covid-19 would cause a “pandemic hangover” last year, due to lockdowns and other disruptions caused by the disease, a continued decline was now evident.
She added: “Covid-19 is not an excuse. We need immunization catch-ups for the missing millions or we will inevitably witness more outbreaks, more sick children and greater pressure on already strained health systems.”
The data showed that the majority of children who missed out on protection lived in poorer countries. Eighteen million of the 25 million children who did not receive a single dose of DTP during the year were from low- and middle-income countries, with India, Nigeria, Indonesia, Ethiopia and the Philippines recording the highest numbers.
WHO director-general Tedros Adhanom Ghebreyesus said tackling Covid-19 needed to go hand in hand with vaccinating for “killer diseases like measles, pneumonia and diarrhoea.” It’s not a question of either/or, it’s possible to do both,” he added.
The health leaders warned that the danger of missed vaccinations was being amplified by rapidly rising rates of severe malnutrition, which weakened immunity. “The convergence of a hunger crisis with a growing immunization gap threatens to create the conditions for a child survival crisis,” their report said.
They warned that “monumental efforts” would be required to reach universal levels of coverage and to prevent outbreaks. The cost of falling vaccination levels had already been seen in avoidable outbreaks of measles and polio in the past year, they said.