Focus on unvaccinated children, strengthen routine immunization capacities: WHO

New Delhi | June 12, 2023: The World Health Organization today called for focused efforts to provide lifesaving childhood vaccines to the nearly 4.6 million children reported as unvaccinated or zero dose in 2021, as countries intensify efforts to equal or surpass pre-COVID-19 pandemic vaccination coverage levels.

“The number of unvaccinated children more than doubled from 2 million in 2019 to 4.6 million in the Region by 2021 despite efforts by countries to maintain or restore routine childhood immunization. We need to urgently address gaps and challenges aggravated by the COVID-19 pandemic,” said Dr Poonam Khetrapal Singh, Regional Director WHO South-East Asia.

The Regional Director was addressing representatives of ministries of health, national immunization advisory groups and partner agencies participating in a four-day regional workshop to strengthen routine immunization capacities post COVID-19 pandemic.

“We need to accurately identify high-risk areas with high numbers of zero-dose children, and rapidly improve access and uptake of routine immunization,” Dr Khetrapal Singh said.

The catch-up immunization activities and special campaigns being rolled out by countries must be reviewed and measures like increasing age limit of target populations adopted, where needed, for filling the immunity gaps.

The behavioral and social drivers of immunization should be identified to guide focused interventions and strategies to engage communities to accelerate demand for vaccination, she said.

The Regional Director emphasized on periodic mapping of at-risk populations and for developing actionable plans to address gaps in immunization.

Noting that routine immunization coverage in the Region has been highly variable, the Regional Director said while several countries have maintained high childhood vaccination coverage even during the COVID-19 pandemic and are now accelerating progress, some others where coverage declined in 2020 but stabilized in 2021 and 2022 can now reach pre-pandemic levels. However, there are also countries where coverage continues to be sub-optimal.

The Regional Director commended Timor-Leste for introducing pneumococcal vaccine in catch-up campaigns, and Nepal for becoming the fourth country globally in 2022 to introduce typhoid conjugate vaccine.

Dr Khetrapal Singh complimented Bangladesh for restoring immunization services to pre-COVID-19 levels by June 2020; India for launching the intensified vaccination drive – Mission Indradhanush; and Indonesia for completing the readiness requirements for use of the novel oral polio vaccine type 2 within a record time of two weeks from the notification of type 2 circulating vaccine-derived polio outbreak in November 2022.

Bhutan, DPR Korea, Maldives, Sri Lanka and Timor-Leste maintained their measles elimination status throughout the COVID-19 response while Sri Lanka and Maldives were certified for eliminating rubella in 2020.

The WHO South-East Asia Region continues to be free of wild poliovirus and sustains its maternal and neonatal tetanus elimination status.

With persistent effort over the years, routine immunization coverage in the Region had crossed 90% in 2019. The number of zero dose children declined from over 5 million in 2010 to 2 million in 2019. However, during the COVID-19 pandemic the coverage of DPT3 (third dose of vaccine to protect against diphtheria, pertussis and tetanus), which is the standard indicator to measure vaccination coverage, declined from 91% in 2019 to 85% in 2020 and fell further to 82% in 2021, sharply increasing the number of unvaccinated and under vaccinated children in a Region which has the biggest birth cohort.

In addition to identifying challenges and bottlenecks, the workshop aims at identifying gaps in capacities to enable countries design training plans for health workers to further intensify routine immunization, to advocate sustainable support and coordinate across health and other relevant sectors for service delivery within the primary health care.

New Delhi | June 12, 2023