The world is before biggest decline in childhood vaccinations by about 30 years old. The alert is from the World Health Organization (WHO) and the United Nations Children’s Fund (Unicef).
Data released this Thursday (14) show that the percentage of children who received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3) – a marker of vaccine coverage within and between countries – fell by 5 percentage points between 2019 and 2021, to 81%.
As a result, 25 million children missed one or more doses of the immunizer through routine vaccination services in 2021 alone. The rate is 2 million more compared to 2020 and 6 million more than in 2019.
The entities point out that the drop in vaccination coverage puts an increasing number of children at risk of preventable diseases.
According to WHO and UNICEF, the drop in vaccination is associated with different factors.
According to the survey, an increasing number of children live in conflict environments, where access to immunization is often challenging. The analysis also indicates an increase in misinformation and issues related to Covid-19, such as service and supply chain disruptions, diversion of resources for pandemic response efforts and restriction of movement, measures that have limited access and availability of services. of immunization.
“This is a red alert for child health. We are witnessing the biggest sustained drop in childhood immunization in a generation. The consequences will be measured in lives,” said Catherine Russell, executive director of UNICEF.
“While a pandemic ‘hangover’ was expected last year as a result of Covid-19 disruptions and lockdowns, what we are now seeing is an ongoing decline. Covid-19 is no excuse. We need to get immunization back for the missing millions or we will inevitably witness more outbreaks, more sick children and greater pressure on already overstretched health systems.”
WHO and UNICEF estimates indicate that 18 million children, among 25 million eligible for vaccination, did not receive a single dose of immunization against diphtheria, tetanus and whooping cough during the year. Most live in low- and middle-income countries, with India, Nigeria, Indonesia, Ethiopia and the Philippines recording the highest numbers in the vaccine deficit.
Among the countries with the largest relative increases in the number of children not receiving a single vaccine between 2019 and 2021 are Myanmar and Mozambique.
With the advance in the pace of vaccination against Covid-19 and changes in the epidemiological scenario of the pandemic, 2021 was expected to be a year of recovery for immunization programs. However, vaccination coverage against diphtheria, tetanus and whooping cough has returned to its lowest level since 2008.
The WHO warns that, in addition to this, the decline in coverage of other basic vaccines has taken the world off the path to achieving global goals, including the immunization indicator for the Sustainable Development Goals.
The survey indicates that the historic setback in immunization rates taking place against a backdrop of increasing rates of severe acute malnutrition, a situation that can make common childhood diseases lethal for malnourished children who already have weakened immunity.
Vaccination coverage fell in all regions of the world, with the East Asia and Pacific region standing out, registering the biggest reversal in coverage of diphtheria, tetanus and pertussis, falling nine percentage points in just two years.
Worldwide, more than a quarter of the human papillomavirus (HPV) vaccine coverage that was achieved in 2019 was lost. Experts warn of serious health consequences for women and girls, as global coverage of the first dose of the HPV vaccine is only 15%, even though the first vaccines were licensed more than 15 years ago.
“Planning for and fighting Covid-19 must also go hand in hand with vaccination against deadly diseases such as measles, pneumonia and diarrhea,” said Tedros Adhanom, director-general of the WHO. “It’s not a matter of one or the other, it’s possible to do both”, he adds.
positive indices
The survey points out that some countries were able to significantly stem the declines in vaccination.
Uganda maintained high levels of coverage in routine immunization programs while implementing a targeted Covid-19 vaccination program to protect priority populations, including healthcare workers.
Similarly, Pakistan has returned to pre-pandemic coverage levels from significant immunization efforts.
risk of outbreaks
WHO and UNICEF warn that achieving universal levels of coverage and preventing outbreaks will require monumental efforts. Inadequate coverage levels have resulted in preventable measles and polio outbreaks in the last 12 months.
Coverage of the first measles dose dropped to 81% in 2021, also the lowest level since 2008. The index means that 24.7 million children missed their first measles dose in 2021, 5.3 million more than in 2019. Another 14.7 million did not receive the required second dose.
Likewise, compared to 2019, 6.7 million more children missed the third dose of the polio vaccine and 3.5 million missed the first dose of the HPV vaccine – which protects girls against cervical cancer. uterus.
Experts argue that the two-year sharp decline follows nearly a decade of stagnant progress. To circumvent the problem, it will be necessary to go beyond the interruptions related to the pandemic, but face the systemic challenges of immunization in the countries.
Brazilian scenario
Polio, also called polio or infantile paralysis, is a contagious disease caused by a virus that can infect children and adults through direct contact with feces or secretions passed through the mouth of people with the infection.
Vaccination is the only way to prevent the disease that can lead to complications such as muscle paralysis, which mainly affect the legs.
The Ministry of Health says that vaccination coverage against the disease has been showing results below the target of 95% since 2016. All children under 5 years of age must be vaccinated according to a routine schedule and in the annual national campaign. The vaccination schedule is three doses of the injectable vaccine (at 2, 4 and 6 months) and two more booster doses with the bivalent oral vaccine (droplet).
Vaccination is also the only preventive measure against measles, a disease caused by a virus that can be fatal. Transmission occurs through contact with contaminated people, through coughing, speaking, sneezing or breathing.
The triple viral vaccine, which prevents measles, mumps and rubella, is available in the Unified Health System (SUS) even outside the period of the national campaign. In the National Vaccination Calendar, the immunizer is available for people from 12 months to 59 years of age.
Data from the Ministry of Health’s LocalizaSUS platform indicate that, in 2022, more than 8 million doses were administered against measles in the country, 6 million of which were only in children. Child vaccination coverage is at 46.90%, according to LocalizaSUS.
Complications of measles include pneumonia, ear infections and inflammation in the brain.
According to the Ministry of Health, in 2019, 2020 and 2021, 1,545, 239 and 128 cases of pertussis were confirmed in the country, respectively.
Respiratory infection is communicable and caused by bacteria. The main symptoms are bouts of dry cough. The disease can also affect the trachea and bronchi. Children younger than 6 months can have complications that, if not treated correctly, can lead to death.
Vaccines against whooping cough are also available at health posts by the SUS.
Global immunization agenda
WHO and Unicef are working with Gavi, the Vaccine Alliance, and other partners to deliver the 2030 Global Immunization Agenda. The strategy envisions that all countries and global partners can achieve established goals in preventing disease through immunization and universal delivery of vaccines.
Necessary actions
Global Immunization Agenda partners call on governments and relevant organizations to:
- Intensify efforts for catch-up vaccination to address the backlash in routine immunization and expand services in underserved areas to reach unvaccinated children and implement campaigns to prevent outbreaks;
- Implement evidence-based, people-centred and tailored strategies to build trust in vaccines and immunization, combat misinformation and increase vaccine uptake, particularly among vulnerable communities;
- Ensure ongoing pandemic preparedness and response and efforts to strengthen the global health architecture, with investment in primary health care services;
- Ensure political commitment from governments and increase the allocation of domestic resources to strengthen and sustain immunization in primary care;
- Prioritize strengthening health information systems and disease surveillance to provide the data and monitoring needed for programs to have maximum impact;
- Leverage and increase investment in research to develop and improve vaccines and immunization services.
Source: CNN Brasil
