Four years after the onset of COVID-19, children's vaccination rates are stalling and declining. Armed conflicts and weakening of public health systems are to blame
More than four years after the onset of the COVID-19 pandemic, global vaccination rates are stalling, warn the World Health Organization (WHO) and UNICEF.
In the later phases of the pandemic, the lack of progress in child vaccination was partly due to challenges in maintaining public health programs amid health emergencies. However, recent UN data shows an additional 2.7 million children missed vaccinations compared to pre-COVID-19 levels, indicating factors beyond the pandemic are at play.
Last year, 14.5 million children missed all doses of the diphtheria, tetanus, and pertussis (DTP) vaccine, an increase of 600,000 from the previous year. Additionally, 6.5 million were only partially vaccinated, lacking full protection. Of these 21 million children, some 60% live in just 10 countries, concentrated in the Global South.
More than half of these unvaccinated children are in conflict-affected regions, including Afghanistan, the Democratic Republic of the Congo, Sudan, and Yemen, where fighting undermines public health infrastructure and programs. Without vaccines, children face even higher risks from a lack of clean water and food.
This situation highlights the urgent warnings about the dire consequences of interrupted immunization drives in the Gaza Strip due to Israeli attacks. Previously, Palestinian families were generally able to keep up with children's vaccinations, but since October 7, thousands have been unable to start or continue their regimens, increasing health risks to children.
Read more: Afghanistan faces multiple crises rooted in failure to build a robust health system
The DPT vaccination rate is a key indicator of global immunization success and stability of health systems, making the current shortfall particularly alarming. Similarly, the global benchmark for measles vaccination is 95%, yet only 83% of children received their first dose in 2023. This shortfall has led to measles outbreaks in over 100 countries, home to three-quarters of the world's infants. On the other hand, countries with high vaccine coverage did not face these outbreaks.
"Measles outbreaks are the canary in the coal mine, exposing and exploiting gaps in immunization and hitting the most vulnerable first," said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.
Read more: Measles outbreaks across Europe highlight concerning lag in vaccinations
Despite overall worrying trends, the data records some positive examples. Human papillomavirus (HPV) vaccinations expanded during the report period, and countries like Cote d'Ivoire introduced new vaccines to combat a broader range of diseases, including malaria.
While these examples might suggest mild progress, without sufficient resources for public health campaigns, vaccination rates are unlikely to return to pre-pandemic levels or meet targets for global protection and disease eradication.
People's Health Dispatch is a fortnightly bulletin published by the People's Health Movement and Peoples Dispatch. For more articles and to subscribe to People's Health Dispatch, click here.