UNICEF flagship report highlights urgent need to resume child immunizations

Contemporary PEDS JournalJune 2023
Volume 40
Issue 5

The COVID-19 pandemic took a massive toll on routine vaccinations for children across the globe. Now, the United Nations Children’s Fund is calling for quick and swift action to get back on track. 

Child receiving vaccine | Image Credit: © angellodeco - © angellodeco - stock.adobe.com.

Child receiving vaccine | Image Credit: © angellodeco - © angellodeco - stock.adobe.com.

“For Every Child, Vaccination” is the United Nations Children’s Fund’s (UNICEF) flagship “State of the World’s Children 2023,” report. It calls for urgent resumption of child immunizations and routine vaccinations after heavy disruptions took place during the COVID-19 pandemic.

Routine immunization and vaccination coverage dropped significantly during the COVID-19 pandemic, putting millions of children in danger of childhood’s most serious diseases. Recovery, according to the report, will be an up-hill battle, but immunization lessons learned from the pandemic itself can be encouraging.

On a global scale from 2019 to 2021, the number of zero-dose children rose from 13 million to 18 million. The number of under-vaccinated children rose from 6 million to 25 million. A key measure of vaccine coverage in children is being fully vaccinated against diptheria, tetanus, and pertussis (DTP). Percentage of fully vaccinated children in this category fell from 86% to 81%, and a similar fall was observed in vaccination coverage for measles. According to the report, the global population lost more than a decade’s progress regarding adequately immunized children.

UNICEF reports that measles cases doubled in 2022 compared to the previous year. After 2 years of declining immunizations during the pandemic, a 5% fall in the number of children that received their first measles shot was observed. About 95% of a community needs to be immunized to reach heard immunity regarding measles, thus any decline in coverage is “worrying and raises the risk of significant outbreaks of the disease,” according to the report.

Efforts to vaccinate children against human papillomavirus (HPV) were severely impacted by the COVID-19 pandemic. Currently, about 12% of eligible girls are fully vaccinated against HPV, which helps protect against cancers, notably cervical cancer. Authors noted that the world lost more than a quarter of global HPV vaccination coverage, partly due to school closures, where many children receive vaccinations. A recent multi-country survey revealed half of meningococcal vaccination appointments were delayed or canceled amid the COVID-19 pandemic as well. In all, UNICEF estimates that 67 million children partially or entirely missed out on routine immunization between 2019 and 2021.

In countries across the globe, signs that confidence in vaccines has declined. Data in the report indicated that confidence in the importance of children vaccination declined in 52 of 55 countries that had available data. China and India are 2 countries with very large populations that saw the perception of importance for child vaccines increase. Perception of the importance of vaccines for children varied by gender and age differences, as declines were noticed more among people younger than 35 years and among women. UNICEF states more data collection is needed to better monitor vaccine confidence on a broader level.

Quick action is called for to resume routine child vaccinations, and according to the report, lessons can be learned from the COVID-19 pandemic, as “vast resources can be mobilized, and new vaccines can be developed rapidly and introduced around the world,” authors wrote.

UNICEF stated the worldwide COVID-19 Vaccines Global Access (COVAX) initiative has shipped about 1.9 billion vaccine doses globally. According to the article, a similar effort is needed now. 

“The establishment of the COVID-19 Vaccine Delivery Partnership (CoVDP) to coordinate, harmonize and streamline support for vaccine delivery is another testimony to the political will and institutional agility needed in times of crisis. With millions of children’s lives at stake, we need the same urgency around routine child immunization,” the article states.


United Nations Children’s Fund. The state of the world’s children 2023: for every child, vaccination. Accessed April 20, 2023. https://www.unicef.org/reports/state-worlds-children-2023

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