Publicperception of the importance of vaccines for children declined during the COVID-19 pandemic in 52 out of 55 countries, United Nations Children’s Fund (UNICEF) has said in a report on immunization.
The report warns that a total of 67 million children missed out on vaccinations between 2019 and 2021, with vaccination coverage levels decreasing in 112 countries.
“It was noted that children born just before or during the pandemic are now moving past the age when they would normally be vaccinated hence prompting the need for urgent action to catch up on those who were missed,” the report reads in part.
In 2022 for instance, the number of measles cases was more than double the total in the previous year. The number of children paralyzed by polio was up 16 per cent year-on-year in 2022.
According to the report titled ‘The State of the World’s Children 2023: For Every Child, Vaccination’ the perception of the importance of vaccines for children declined by more than a third in the Republic of Korea, Papua New Guinea, Ghana, Senegal and Japan after the start of the pandemic.
In the new data, collected by The Vaccine Confidence Project and published in April 2023 by UNICEF, China, India and Mexico were the only countries studied where data indicates the perception of the importance of vaccines held firm or even improved.
But what could have occasioned the decline in the vaccine uptake?
According to Catherine Russell, UNICEF Executive Director, as the pandemic hits the peak, the milestones that had been achieved before faced a shaken trust.
“At the height of the pandemic, scientists rapidly developed vaccines that saved countless lives. But despite this historic achievement, fear and disinformation about all types of vaccines circulated as widely as the virus itself,” she argues
Along with the vaccine accessibility, availability and affordability, trust is a critical factor that influences whether parents and caregivers would immunize their children.
They must understand the benefits of the vaccines so that they feel that immunization is an essential part of child caring.
“This data is a worrying warning signal. We cannot allow confidence in routine immunizations to become another victim of the pandemic. Otherwise, the next wave of deaths could be of more children with measles, diphtheria or other preventable diseases,” she added.
The pandemic also worsened existing inequities. For far too many children, especially in the most marginalized communities, vaccination is still not available, accessible or affordable.
The Covid-19 mitigation measures such as distance keeping and work from home could not help sustain the efforts made in child vaccination.
Even before the pandemic, progress on vaccination had stalled for almost a decade as the world struggled to reach the most marginalized children.
According to the report, out of the 67 million children who missed out on routine vaccination between 2019 and 2021, 48 million didn’t receive a single routine vaccine, also known as “zero-dose”.
As of the end of 2021, India and Nigeria (both countries with very high birth-rate) had the largest numbers of zero-dose children but increases in the numbers of zero-dose children were especially notable in Myanmar and the Philippines.
The children who are missing out live in the poorest, most remote and marginalized communities, at times impacted by conflict.
New data produced for the report by the International Center for Equity in Health found that in the poorest households, 1 in 5 children are zero-dose while in the wealthiest, it is just 1 in 20.
It found unvaccinated children often live in hard-to-reach communities such as rural areas or urban slums. They often have mothers who have not been able to go to school and who are given little say in family decisions.
These challenges are greatest in low- and middle-income countries, where about 1 in 10 children in urban areas are zero dose and 1 in 6 in rural areas. In upper-middle-income countries, there is almost no gap between urban and rural children.
Which way now for governments?
To vaccinate every child, it is vital to strengthen primary health care and provide its mostly female front-line workers with the resources and support they need. The UNICEF report finds women are at the front line of delivering vaccinations, but they face low pay, informal employment, lack of formal training and career opportunities and threats to their security.
To address this child survival crisis, UNICEF is calling on governments to upscale on their commitment to increase financing for immunization and to work with stakeholders to unlock available resources, including COVID-19 funds, to urgently implement and accelerate catch-up vaccination efforts to protect children and prevent disease outbreaks.
