Reports confirm pandemic-related drop in basic childhood vaccination

As pandemic disruptions kept families in their homes and shuttered clinics, and as health workers focused their attention on battling COVID-19, officials worried that the world would lose ground on immunizing kids against regular childhood disease.

Two new reports confirmed the gaps, with one group estimating 23 million children missed their basic vaccines in 2020 and another finding a 7% drop in diphtheria, tetanus, and pertussis (DTP) and measles-containing (MCV) immunization.

In other developments, the World Health Organization (WHO) COVID-19 emergency committee weighed in on the latest developments, some global leaders pushed for China to allow more research into the source of SARS-CoV-2, and hot spot countries continue to report record daily highs.

Reports document childhood vaccination disruptions

The first report, based on WHO and UNICEF data from 160 countries, revealed that the level of missed vaccines was the highest since 2009 with 3.7 million more children missing vaccines in 2020 compared to 2019—the year before the pandemic.

Most of the kids, as many as 17 million, probably didn't receive any vaccine doses in 2020, widening longstanding vaccine inequities with kids in conflict and poverty-affected areas hit hardest. Some of the countries that experienced the biggest gaps included India, Pakistan, Indonesia, parts of Africa, and parts of the Americas.

In a WHO statement today, the group's Director-General Tedros Adhanom Ghebreyesus, PhD, said multiple disease outbreaks resulting from the gaps would be catastrophic for communities that are already battling COVID, increasing the urgency to invest in childhood vaccination.

Henrietta Fore, UNICEF's executive director, said even before the pandemic, health officials worried that the world was losing ground on childhood immunization, evidenced by the widespread measles outbreak 2 years ago. "The pandemic has made a bad situation worse," she said. "With the equitable distribution of COVID-19 vaccines at the forefront of everyone’s minds, we must remember that vaccine distribution has always been inequitable, but it does not have to be."

The second report on pandemic-related declines in childhood immunization came from a team based at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. Their modeling study, published today in The Lancet, looked at DPT and MCV1 vaccination based on country-reported data, electronic medical records, and human movement data. It includes data from 94 countries.

They estimated that globally, third-dose DTP and first-dose MCV dropped more than 7% compared to expected coverage without COVID-19, translating into more than 8.5 million kids missing their third DTP vaccine dose and 8.9 million more missing their first measles vaccine dose when compared to prepandemic levels. Disruptions were highest in April but recovered to near-expected levels by December.

Gradual and steady progress seems to be underway, the team wrote. However, they said several factors threaten getting immunization back on track, including ongoing transmission, the circulating of new variants, and a focus on COVID-19 vaccine rollout.

In a related commentary, two immunization experts, one from the London School of Hygiene and Tropical Medicine and the other from the International Vaccine Institute in Seoul, wrote that the indirect effects from the pandemic on health services have been colossal.

They wrote that the groups' findings are timely, given that the risk of childhood preventable diseases will rise as countries ease physical distancing measures.

"We recommend national immunisation programmes to act upon this valuable evidence for planning and implementation of catch-up vaccination services to close the immunity gaps, to avoid reversing the substantial gains from childhood immunisation in reducing mortality and morbidity globally," the authors wrote.

WHO experts weigh latest COVID threats

The WHO's COVID-19 emergency committee met yesterday for the eighth time to assess the latest pandemic developments, and as expected, unanimously agreed that the situation still warrants a public health emergency of international concern (PHEIC) under the International Health Regulations. The group meets every 3 months or more often as needed to review the latest findings.

In a statement today, the group noted that the pandemic is nowhere near finished with new variants continuing to evolve along with the threat of newer and possibly more dangerous ones. They also raised concerns about inadequate funding for the WHO's Strategic Preparedness and Response Plan, which they said needs more flexible and predictable funding.

The group also tweaked some of its earlier recommendations and, for example, urged countries not to require proof of COVID-19 vaccination for international travel, given the limited access to and inequitable distribution of the vaccine.

Pressure grows for deeper source probe

In other WHO developments, at a briefing today, the group fielded questions about the probe into the source of SARS-CoV-2. WHO officials said they will share plans for a phase 2 study with member states tomorrow, according to Reuters.

At the briefing, Germany's health minister Jens Spahn called on China to ease the investigation into the source of the virus. Spahn was at the briefing today to unveil Germany's $307 million donation to the WHO's ACT Accelerator, designed to speed the development and equitable distribution of vaccines, treatments, and diagnostics.

In a related development, the WHO said it would correct several "unintended errors" in a joint report with China into the origins of the virus, following questions from the Washington Post about the location of the first family cluster in Wuhan, which was not linked to the seafood market though to be the center of the outbreak.

The WHO said the mistakes were due to editing errors and do not affect the report's conclusions.

More global headlines

  • In Africa, hospital admissions are increasing in 10 countries, with at least five, including South Africa, Namibia, and Zambia, reporting intensive care unit bed shortages, WHO African regional office officials said today at a briefing. Matshidiso Moeti, MBBS, the group's director, said the top priority is boosting oxygen supplies.

  • Hot-spot countries reported more record daily highs for cases, including Indonesia, Malaysia, and Kazakhstan. Also, Tokyo—host to the Olympic Games that begin next week—reported a 6-month high of 1,308 daily cases.

  • In Australia, a cluster of 18 cases in Victoria state triggered by workers who traveled from Sydney prompted the announcement of a 5-day lockdown.

  • The global today passed 188 million cases and is now at 188,362,972 cases, with at least 4,057,469 deaths, according to the New York Times COVID-19 tracker.

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