Focus on unvaccinated children, build routine immunization capacity: WHO

The World Health Organization today called for targeted efforts to provide lifesaving childhood vaccines to the nearly 4.6 million children reported as unvaccinated or at zero dose in 2021, as countries step up efforts to match or exceed pre-COVID-19 pandemic vaccine coverage levels.

“The number of unimmunized children has 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 must urgently address the gaps and challenges aggravated by the COVID-19 pandemic,” said Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia.

The Regional Director was addressing representatives from ministries of health, national immunization advisory groups and partner agencies attending a four-day regional workshop to build routine immunization capacity after the COVID-19 pandemic.

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

Catch-up vaccination activities and special campaigns deployed by countries should be reviewed and measures such as increasing the age limit of target populations adopted, where appropriate, to address immunity gaps.

Behavioral and social drivers of vaccination must be identified to guide targeted interventions and strategies to engage communities to accelerate demand for vaccination, she said.

The regional director emphasized periodic mapping of at-risk populations and developing action plans to address immunization gaps.

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

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

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

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

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

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

In addition to identifying challenges and bottlenecks, the workshop aims to identify capacity gaps to enable countries to design training plans for health workers to further scale up routine immunization, to advocate for sustained support and coordinate across health and other relevant sectors for service delivery within the framework of primary health care. care.