Globally, since 2010, vaccination coverage with three doses of diphtheria, tetanus and pertussis (DTP3) and one dose of the measles vaccine has stalled at around 86%. While high, this is not sufficient, as 95% coverage is needed - globally, across countries, and communities - to protect against outbreaks of vaccine-preventable diseases.
Photo: World Economic Forum
“Vaccines are one of our most important tools for preventing outbreaks and keeping the world safe,” said Dr Tedros Adhanom Ghebreyesus, director-general of the World Health Organisation (WHO). “While most children today are being vaccinated, far too many are left behind. Unacceptably, it’s often those who are most at risk– the poorest, the most marginalised, those touched by conflict or forced from their homes - who are persistently missed.”
Most unvaccinated children live in the poorest countries, and are disproportionately in fragile or conflict-affected states. Almost half are in just 16 countries - Afghanistan, the Central African Republic, Chad, Democratic Republic of the Congo (DRC), Ethiopia, Haiti, Iraq, Mali, Niger, Nigeria, Pakistan, Somalia, South Sudan, Sudan, Syria and Yemen.
If these children do get sick, they are at risk of the severest health consequences, and least likely to access lifesaving treatment and care.
Measles outbreaks reveal entrenched gaps in coverage, often over many years
Stark disparities in vaccine access persist across and within countries of all income levels. This has resulted in devastating measles outbreaks in many parts of the world – including countries that have high overall vaccination rates.
In 2018, almost 350,000 measles cases were reported globally, more than doubling from 2017.
“Measles is a real time indicator of where we have more work to do to fight preventable diseases,” said Henrietta Fore, Unicef’s executive director. “Because measles is so contagious, an outbreak points to communities that are missing out on vaccines due to access, costs or, in some places, complacency. We have to exhaust every effort to immunise every child.”
Ukraine leads a varied list of countries with the highest reported incidence rate of measles in 2018. While the country has now managed to vaccinate over 90% of its infants, coverage had been low for several years, leaving a large number of older children and adults at risk.
Several other countries with high incidence and high coverage have significant groups of people who have missed the measles vaccine in the past. This shows how low coverage over time or discrete communities of unvaccinated people can spark deadly outbreaks.