Why has childhood vaccination coverage seen its largest drop in a generation?

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Childhood Vaccination Coverage Declines Due to Pandemic-Related Disruptions

Approximately 25 million children globally missed routine vaccinations in the past year, marking a significant decline in childhood immunisation coverage. This represents an increase of two million children compared to 2020 and six million more than in 2019, pushing coverage rates back to levels not seen since the early 2000s. The situation worsened in 2021, with coverage dropping in every region, primarily due to the ongoing impacts of the COVID-19 pandemic on healthcare systems and immunisation campaigns.
Disruption of Routine Immunisation Services

The global decline in childhood vaccination is directly linked to the disruptions caused by the pandemic. In 2021, the focus on COVID-19 immunisation campaigns, coupled with economic slowdowns and increased strain on healthcare infrastructure, stymied efforts to recover routine vaccination rates. This led to a 5% drop in global DTP3 (diphtheria, tetanus, and pertussis) vaccination coverage, reaching 81% in 2021. The data, which relies on information from national health systems in 177 countries, indicates that this backslide is the most substantial sustained decline in a generation.
Rise in Unvaccinated Children

A concerning consequence of this trend is the significant increase in the number of "zero-dose" children, those who have not received any vaccinations at all. Between 2019 and 2021, the number of such children rose by 37%, from 13 million to 18 million, predominantly in low and middle-income countries. This surge in unvaccinated children poses a heightened risk for outbreaks of preventable diseases, as maintaining over 90% vaccination coverage is generally required to prevent widespread transmission.
Increased Risk of Measles Outbreaks

The impact of reduced vaccination coverage is particularly evident in the rise of measles cases. In 2021 alone, 24.7 million children missed their first dose of the measles vaccine, and an additional 14.7 million missed the crucial second dose. This resulted in measles vaccination coverage falling to 81% in 2021, the lowest point since 2008. Reports of increased measles cases have already emerged, with Africa experiencing a 400% rise in 2022, underscoring the vulnerability created by these vaccination gaps.

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Why has childhood vaccination coverage seen its largest drop in a generation?

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