A total of 67 million children around the world, including nearly 250,000 in Vietnam, missed out on vaccinations between 2019 and 2021, with vaccination coverage levels decreasing in 112 countries, UNICEF warned on April 20 in a new report on immunisation.
“The State of the World’s Children 2023: For Every Child, Vaccination” revealed that 48 million children globally didn’t receive a single routine vaccine, also known as “zero-dose”.
Vietnam was listed as the 18th country in the world with the largest number of zero-dose children, as 187,315 children under one year old did not receive any vaccinations in 2021, the year of the severe fourth wave of COVID-19 infections with stringent lockdown measures in place.
Worldwide, the children who are missing out live in the poorest, most remote and marginalised communities, at times impacted by conflict. New data produced for the report by the International Centre for Equity in Health found that in the poorest households, one in five children are zero-dose. Among the wealthiest, this number is just one in 20. It found unvaccinated children often live in hard-to-reach communities such as rural areas or urban slums.
They often have mothers who cannot go to school and are given little say in family decisions.
These challenges are greatest in low- and middle-income countries, where about one in ten children in urban areas are zero doses and one in six in rural areas. In Vietnam, data showed that the prevalence of zero-dose children in urban areas was almost 1.5 times higher than those living in rural areas (6.3%-4.2%), while the prevalence in the poorest households was almost double those in the wealthiest (13.5%-6.6%)
“The pandemic interrupted childhood vaccination almost everywhere, including in Vietnam, especially due to intense demands on health systems, the diversion of immunisation resources to COVID-19 vaccination, health worker shortages and stay-at-home measures," said Lesley Miller, UNICEF Deputy Representative in Vietnam. "Added to this is a current delay in the procurement of vaccines.
We are deeply concerned about the possibility of outbreaks of vaccine-preventable diseases – measles in particular. “Children born just before or during the pandemic are now moving past the age when they would normally be vaccinated, underscoring the need for urgent action to catch up on those who were missed and prevent deadly disease outbreaks.”
The report also showed that the public perception of the importance of vaccines for children declined during the COVID-19 pandemic in 52 out of 55 countries studied.
Vaccine confidence is volatile and time specific. However, the report warns the confluence of several factors suggests the threat of vaccine hesitancy may be growing.
These factors include uncertainty about the response to the pandemic, growing access to misleading information, declining trust in expertise, and political polarisation. To vaccinate every child, it is vital to strengthen primary health care and provide its mostly female front-line workers with the resources and support they need.
The report finds women are at the front line of delivering vaccinations, but they face low pay, informal employment, lack of formal training and career opportunities and threats to their security.
To address this child survival crisis, UNICEF is calling on governments to double down on their commitment to increase financing for immunisation and to work with stakeholders to unlock available resources, to urgently implement and accelerate catch-up vaccination efforts to protect children and prevent disease outbreaks.
The report is urging governments to; urgently identify and reach all children, especially those who missed vaccinations during the COVID-19 pandemic; strengthen demand for vaccines, including by building confidence; prioritise funding to immunisation services and primary health care; and build resilient health systems through investment in female health workers, innovation and local manufacturing.
“Vietnam’s successful experience in its mass immunisation campaign against COVID-19 laid a good foundation for the country to immediately address the current delays in procurement of vaccines and fast-track catch-up for children who have missed out on routine immunisations”, said UNICEF Deputy Representative Miller “Routine immunisation and strong health systems are our best shot at preventing future pandemics, unnecessary deaths and suffering.”/.
