Global childhood vaccination coverage stalled in 2023, leaving 2.7 million more children unvaccinated and under-vaccinated compared to pre-pandemic levels in 2019, according to data released today by the World Health Organization (WHO) and UNICEF.
The latest WHO and UNICEF Estimates of National Immunization Coverage (WUENIC) – which provide the world’s largest and most comprehensive dataset on vaccination trends for vaccinations against 14 diseases – highlight the need for continued coverage, recovery and strengthening efforts of the system.
“The latest trends show that too many children are still missing in many countries,” said UNICEF Executive Director Catherine Russell. “Closing the vaccination gap requires a global effort, with governments, partners and local leaders investing in primary health care and community workers to ensure that every child is vaccinated and that overall health care is strengthened.”
According to the findings, the number of children who received three doses of the diphtheria, tetanus and pertussis (DTP) vaccine in 2023 – a key indicator of global vaccination coverage – stopped at 84% (108 million). However, the number of children who did not receive a single dose of the vaccine increased from 13.9 million in 2022 to 14.5 million in 2023.
More than half of unvaccinated children live in the 31 countries with fragile, conflict-affected and vulnerable environments, where children are particularly vulnerable to preventable diseases due to disruptions and lack of access to security, nutrition and health services.
In addition, 6.5 million children did not complete their third dose of the DTP vaccine, which is necessary to achieve protection against disease in infancy and early childhood.
These trends, which show that global vaccination coverage has remained largely unchanged since 2022 and – most worryingly – has not yet returned to 2019 levels, reflect ongoing challenges with disruptions in healthcare services, logistical challenges, reluctance vaccines and inequalities in access to services.
Low vaccine coverage is already leading to measles outbreaks
The data further show that vaccination rates against the deadly measles disease have stalled, leaving nearly 35 million children with no or only partial protection.
In 2023, only 83% of children worldwide received their first dose of measles vaccine through routine health services, while the number of children who received the second dose increased modestly from the previous year to 74% of children. These figures fall short of the 95% coverage required to prevent outbreaks, avoid unnecessary illness and death, and meet measles elimination goals.
In the past five years, measles outbreaks have affected 103 countries – home to around three-quarters of the world’s infants. Low vaccination coverage (80% or less) was an important factor. In contrast, 91 countries with strong measles vaccine coverage had no cases.
“Measles outbreaks are the canary in the coal mine, exposing and exploiting gaps in vaccination and hitting the most vulnerable first,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This is a solvable problem. Measles vaccine is cheap and can be administered even in the most difficult places. WHO is committed to working with all our partners to support countries to close these gaps and protect children who most at risk as soon as possible.”
Global HPV vaccine coverage among girls increased significantly
The new data also highlight some bright spots in vaccination coverage. The steady introduction of new and underutilized vaccines, including for human papillomavirus (HPV), meningitis, pneumococcal, poliomyelitis and rotavirus disease, continues to expand coverage, particularly in the 57 countries supported by Gavi, the Vaccine Alliance.
For example, the proportion of adolescent girls worldwide who received at least 1 dose of the HPV vaccine, which provides protection against cervical cancer, increased from 20% in 2022 to 27% in 2023. This is largely due to strong imports in Gavi supported countries such as Bangladesh, Indonesia and Nigeria. The use of the single-dose HPV vaccine schedule has also helped boost vaccine coverage.
The HPV vaccine is one of the most effective vaccines in the Gavi portfolio and it is incredibly encouraging that it is now reaching more girls than ever before. With vaccines now available to over 50% of eligible girls in African countries, we have a lot of work to do, but today we can see that we have a clear path to eliminating this terrible disease.”
Dr Sania Nishtar, CEO of Gavi, the Vaccine Alliance
However, HPV vaccine coverage is well below the 90% target to eliminate cervical cancer as a public health problem, reaching only 56% of adolescent girls in high-income countries and 23% in low- and low-income countries. middle income.
A recent poll of more than 400,000 users of UNICEF’s digital platform for youth, U-Report, revealed that over 75% do not know or are unsure what HPV is, highlighting the need for better vaccine access and awareness of the public. When informed about the virus, its link to cancer and the existence of a vaccine, 52% of respondents said they wanted to get the HPV vaccine but were prevented by financial constraints (41%) and lack of availability (34%).
Strong local action is needed to reach everyone, everywhere with vaccines
While modest progress has been made in some regions, including the African region and low-income countries, the latest estimates highlight the need to accelerate efforts to achieve the Immunization Agenda 2030 (IA2030) targets of 90% coverage and no more than 6.5 million”. zero-dose children worldwide by 2030.
The IA2030 Partnership Council calls for increased investment in innovation and continued collaboration. The council also recommends that partners intensify their support for country leadership to improve routine immunization as part of their comprehensive primary health care programs, supported by strong political support, community leadership and sustainable funding.
