By Asmau Ahmad
The United Nations Children’s Fund (UNICEF) and the World Health Organisation (WHO), have recognised Nigeria’s efforts in boosting routine immunisation in spite of COVID-19.
This is according to a joint statement issued by both organisations on childhood immunisation’s global recovery after the COVID-19 backslide on Tuesday.
According to the statement, in spite of the devastating effect of the Covid-19 pandemic in 2020-2022, the Nigeria immunisation programme undertook some exemplary efforts to boost childhood immunisation coverage along with protecting Nigerians from Covid-19.
“The 2022 WHO and UNICEF Estimates of National Immunisation Coverage, WUENIC and admin data shows clear improvement of Penta3 coverage which is 62 per cent and 85 per cent respectively.
“Further recovery of the Nigerian childhood immunisation coverage is currently underway through the big catch up in line with global immunization catch up strategy, which is targeting its 2.2 million zero dose children.”
On the global scene, they said that immunisation services reached four million more children in 2022 compared to 2021, as countries stepped up efforts to address the historic backsliding in immunisation caused by the pandemic.
According to the statement, data published by both organisations in 2022 indicated that 20.5 million children missed out on one or more vaccines delivered through routine immunisation services, compared to 24.4 million children in 2021.
It added that in spite of the improvement, the number remains higher than the 18.4 million children who missed out in 2019 before pandemic-related disruptions, underscoring the need for ongoing catch-up, recovery and system strengthening efforts.
“The vaccine against Diphtheria, Tetanus and Pertussis (DTP) is used as the global marker for immunisation coverage.
“Of the 20.5 million children who missed out on one or more doses of their DTP vaccines in 2022, 14.3 million did not receive a single dose, so-called zero-dose children.
“The figure represents an improvement from the 18.1 million zero-dose children in 2021 but remains higher than the 12.9 million children in 2019,” the statement said.
Both organisations also said that the early stages of recovery in global immunisation have not occurred equally, with the improvement concentrated in a few countries.
They added that progress in well-resourced countries with large infant populations, such as India and Indonesia, masks slower recovery or even continued declines in most low-income countries, especially for measles vaccination.
Also, that of the 73 countries that recorded substantial declines in coverage during the pandemic, 15 recovered to pre-pandemic levels, 24 are on route to recovery while 34 have stagnated or continued declining.
These concerning trends, the statement said, echo patterns seen in other health metrics.
It, however, said that countries must ensure they are accelerating catch-up, recovery and strengthening efforts to reach every child with the vaccines they need and take the opportunity to make progress in other related health sectors.
For vaccination against measles, the statement said it has not recovered as well as other vaccines, putting an additional 35.2 million children at risk of measles infection.
“First dose measles coverage increased to 83 per cent in 2022 from 81 per cent in 2021 but remained lower than the 86 per cent achieved in 2019.
“As a result, last year, 21.9 million children missed the routine measles vaccination in their first year of life, 2.7 million more than in 2019, while an additional 13.3 million did not receive their second dose, placing children in under-vaccinated communities at risk of outbreaks.”
The data also indicates that countries with steady, sustained coverage in the years before the pandemic have been better able to stabilise immunisation services since.
Citing an example of South Asia which reported gradual, ongoing increases in coverage in the decade prior to the pandemic, it said it has demonstrated a more rapid and robust recovery than regions that suffered longstanding declines, such as Latin America and the Caribbean.
It added that the African region, which is lagging behind in its recovery, faces an extra challenge.
“With an increasing child population, countries must scale up routine immunisation services every year in order to maintain coverage levels.”
The statement said that DTP3 vaccine coverage in the 57 lower-income countries supported by Gavi, the Vaccine Alliance increased to 81 per cent in 2022, a considerable increase from 78 per cent in 2021.
Also, that the number of zero-dose children who receive no basic vaccines also dropped by two million in these countries.
For HPV vaccination coverage, it said that for the first time, it surpassed pre-pandemic levels.
According to the statement, HPV vaccination programmes that began pre-pandemic reached the same number of girls in 2022 than 2019.
However, coverage in 2019 was well below the 90 per cent target, a situation which has remained true in 2022, with mean coverages in HPV programmes reaching 67 per cent in high income countries and 55 per cent in low- and middle-income countries.
Also, that the newly inaugurated HPV revitalisation, led by the Gavi Alliance, aims to strengthen existing programme delivery and facilitate more introductions.
Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, commented on the progresses made.
He said it was incredibly reassuring, after the massive disruption wrought by the pandemic to see routine immunisation making such a strong recovery in Gavi-supported countries, especially in terms of reducing the number of zero-dose children.
“However, it is also clear from this important study that we need to find ways of helping every country protect their people, otherwise we run the risk of two tracks emerging, with larger, lower middle-income countries outpacing the rest.”
The UNICEF Executive Director, Catherine Russell, said that beneath the positive trend lies a grave warning
“Until more countries mend the gaps in routine immunisation coverage, children everywhere will remain at risk of contracting and dying from diseases we can prevent.
“Viruses like measles do not recognise borders. Efforts must urgently be strengthened to catch up children who missed their vaccination, while restoring and further improving immunisation services from pre-pandemic levels.”
For the WHO Director-General, Dr Tedros Ghebreyesus, the new data is encouraging and a tribute to those who have worked so hard to restore life-saving immunisation services after two years of sustained decline in immunisation coverage.
He, however, said that global and regional averages do not tell the whole story and mask severe and persistent inequities.
He added that “when countries and regions lag, children pay the price.”
The statement said that many stakeholders are working to expedite recovery in all regions and across all vaccine platforms.
Through the inauguration of ‘The Big Catch-Up’, a global communications and advocacy push, the stakeholders called on governments to catch up the children who missed vaccinations during the pandemic, restore immunisation services to pre-pandemic levels, and strengthen them.