July 27, 2022
The New York Times reports on analysis from UNICEF and the WHO of a staggering confluence of factors that contributed to the largest backslide in routine immunization in 30 years. Millions of children missed part or all of their early childhood vaccinations due to conflict, climate emergencies, misinformation, pandemic lockdowns, and COVID-19 efforts that diverted resources. The advocacy head of UNICEF described it as an “emergency for children’s health” that could threaten the lives of millions of children.
Vaccination rates for diphtheria, tetanus and pertussis (DTP3), measles, and polio all fell significantly between 2019 and 2021. Such lapses are estimated to mean some 25 million children did not receive protection against lethal illness. The number of zero-dose children increased from 13 million to 18 million, with the largest declines in India, Nigeria, Indonesia, Ethiopia, the Philippines and Brazil.
Many experts expected a rebound in vaccinations last year. Instead, the problem only continued to worsen – spurred by COVID-19 misinformation campaigns and mistrust in public health. Parents are picking and choosing between vaccinations. Current vaccination rates of DPT3 and measles equates to that of 2008 when birth cohorts were lower than today’s. In Brazil, once eradicated measles is once again circulating, and exemplifies what could happen with other, vaccine-treatable diseases.
UNICEF believes an extraordinary amount of resources and commitment will be needed to recover the vaccine decline. Some of the factors, climate emergencies and COVID, are sure to persist. Addressing the shortfall will require heavy investment and novel tactics to combat this crisis. A renewed approach to public health, particularly at the community level, may be among the best available efforts to helping children around the world get caught up and protected.
PIDS member James Conway provided this comment on the story, “Immunizations have proven to be one of the most important public health endeavors ever – in terms of both preventable mortality and morbidity. While the SARS-CoV2 pandemic has had numerous negative direct impacts on society and health systems, almost as consequential are the indirect impacts. Hundreds of millions of doses of routinely recommended childhood immunizations have been missed over the past few years, largely due to the empowerment of vaccine hesitancy proponents and the diversion of public health resources. This decreased immunization coverage translates into dramatic decreases in herd immunity, against countless vaccine preventable diseases, where progress towards control or eradication had been dramatic over the last decade. Only through a concerted and collaborative effort, and dedicated resources, will we be able to regain lost ground – and protect against looming outbreaks and the widespread reintroduction and spread of these devastating diseases across the globe.”