Further deterioration in routine immunizations for children in lower-income countries last year went beyond the impacts that distributing massive quantities of COVID-19 vaccines had on health systems, according to Dr. Seth Berkley, head of Gavi, the Vaccines Alliance. Domestic disruptions, such as health worker strikes, also significantly curbed vaccination rates.
The organization released a new analysis on Friday of vaccination rates in the 57 countries it supports with vaccines. This comes on the heels of a report released this month from the World Health Organization and the United Nations International Children's Emergency Fund that found “the largest sustained decline in childhood vaccinations in approximately 30 years.”
“We’re very concerned with the results we're seeing,” Berkley said during a press briefing on Thursday. “Early in 2021, we started to see the beginnings of a recovery across the 57 countries. That recovery has not been maintained everywhere and instead of reaching pre- pandemic levels in 2021, what we've seen is a further, slight deterioration.”
Basic vaccine coverage dropped by one percentage point to 77% in the 57 countries which followed a four percentage point fall during the first year of the pandemic. And the number of zero dose children — those who have not received a single dose of any vaccine in their lives — rose by 570,000 to reach 12.5 million. This is the second year in a row this number has risen.
“This is a very sobering assessment,” said Thabani Maphosa, managing director of country programs at Gavi during the briefing.
Gavi examined whether COVID-19 vaccination efforts in countries was the driving factor that led to the drop in routine immunization coverage but found that “while health systems have certainly been placed under great stress, we see no clear evidence that this is the case,” Berkley said.
But he said the drops in vaccination rates were primarily driven by declines in big countries. The Democratic Republic of Congo, which had seen strong growth, had a large health workers strike that curbed vaccinations, with rates falling from 73% in 2019 to 65% last year, and India saw a drop from 91% to 85%. Other countries that saw large drops include North Korea, Myanmar, and Mozambique.
Berkley said he is also “greatly concerned about a major decline” in HPV vaccinations driven by school closures and supply issues. Only 12% of girls are now getting this vaccine, which is down by 15% since 2019.
Conversely, 19 counties saw vaccine coverage increase last year. Some of the countries that stood out were Chad, which reduced the number of zero-dose children by 16%, and Niger, which reduced the number of zero-dose children by 20%.
And fragile and conflict-affected countries saw a lower decline in vaccine coverage than other countries. In these countries there has been “tremendous effort in recent years to put in place systematic improvements,” Berkley said. Rotavirus coverage, second dose of measles vaccine, and pneumococcal conjugate vaccine in lower-income countries have also seen increases since 2019.
The battles ahead on keeping vaccination rates at high levels are daunting as populations continue to grow rapidly across the African continent meaning vaccination campaigns have “to reach more children each year just to maintain coverage levels,” Maphosa said.
About the author
Sara Jervingsarajerving
Sara Jerving is a Senior Reporter at Devex, where she covers global health. Her work has appeared in The New York Times, the Los Angeles Times, The Wall Street Journal, VICE News, and Bloomberg News among others. Sara holds a master's degree from Columbia University Graduate School of Journalism where she was a Lorana Sullivan fellow. She was a finalist for One World Media's Digital Media Award in 2021; a finalist for the Livingston Award for Young Journalists in 2018; and she was part of a VICE News Tonight on HBO team that received an Emmy nomination in 2018. She received the Philip Greer Memorial Award from Columbia University Graduate School of Journalism in 2014.
