The percentage of children around the world who received 3 doses of the vaccine against diphtheria, tetanus and pertussis (DTP3) – a marker for immunization coverage within and across countries – fell 5 percentage points between 2019 and 2021 to 81%, according to official data published today by WHO and the United Nations Children’s Fund (UNICEF).
The WHO European Region’s average of 94% DTP3 coverage recorded in both 2020 and 2021 represents a 1% decrease compared to 2019. While overall the Region prevented further backsliding in 2021, disparities in immunization performance among countries are evident.
Eleven of the Region’s 53 countries were able to vaccinate a greater proportion of eligible children with DTP3 in 2021, in some cases even exceeding 2019 levels; however, 16 countries saw their level of coverage decline in 2021.
The majority of those reporting a ≥ 5% decline with DTP3 and/or the first dose of measles-containing vaccine in 2021 compared to 2019 levels are middle-income countries (MICs). With 50% of the 20 MICs in the Region reporting coverage below 90% in 2021, compared to less than 10% of high-income countries, the immunization equity gap among countries and their populations in the Region has increased.
“The COVID-19 pandemic has tested the strength and resilience of immunization programmes and health systems in every country. Efforts to provide every infant with routine vaccinations while simultaneously rolling out over 1.5 billion COVID-19 vaccine doses, together with supplemental vaccination campaigns, including against polio, have been extraordinary,” says WHO Regional Director for Europe Dr Hans Henri P. Kluge.
“To prevent future outbreaks, we must stay committed – not just to recover lost ground, but also to progress further in ensuring everyone in our Region is protected from vaccine-preventable diseases.”
Compounded challenges ahead
The regional immunization performance in 2021 reflects intensive efforts in all countries to sustain routine immunization services while also expanding COVID-19 vaccination. Pockets of under-vaccination also reflect continuing barriers to vaccination that predate the pandemic, including systemic programmatic weaknesses and gaps in acceptance of and demand for vaccines.
To prevent outbreaks of diphtheria, measles and other vaccine-preventable diseases in the years to come, national immunization programmes in the Region now face a triple challenge of increasing routine immunization coverage and ensuring unvaccinated children catch up on all their missed doses, while continuing to provide COVID-19 vaccination. The European Immunization Agenda 2030, adopted by all countries in the Region, will guide this process with a focus on increasing equity and developing local solutions to local barriers.