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In the last 10 years, Latin America and the Caribbean has gone from having one of the highest childhood vaccination rates in the world to one of the lowest, it has warned UNICEF during the launch of the report The State of the World’s Children 2023: For every childhood, vaccinationwhich indicates that this deterioration in immunization in the region follows a global trend.
The report shows that, worldwide, 67 million children did not receive one or more vaccinations in three years due to disruption to health services caused by strains on health systems, diversion of scarce resources, conflict and decreased confidence of people in immunization.
In the Latin American region, coverage of the third dose of the diphtheria, tetanus and pertussis vaccine, also known as DTP3, among children under one year of age fell 18 percentage points, from 93% in 2012 to 75% in 2021.
“This is the lowest routine vaccination rate in the region in almost 30 years, which places Latin America and the Caribbean below the world average (81%) and just ahead of Eastern and Southern Africa (74%)”, highlights the UN agency.
According to the latest estimates of the World Health Organization and the United Nations Children’s Fund, the decline in immunization in Latin America and the Caribbean has left 2.4 million children, one in four under one year of age, unprotected against vaccine-preventable diseases.
Poverty and inequality are increasing in many parts of the world.
Poverty and vaccination
More than 1.7 million of those children are medically classified as “zero dose”, which means that have never received any vaccination. Children from the poorest households are nearly three times more likely to have never been immunized in their lifetime than those from the richest households, a new analysis of the report reveals.
“For many years, Latin America and the Caribbean had one of the highest childhood vaccination rates in the world. Now it presents one of the lowest. This is one of the most serious childhood vaccination crises the region has seen in almost 30 years”, said Garry Conille, UNICEF regional director for Latin America and the Caribbean.
Conille assured that “diseases such as diphtheria, measles and poliopreviously thought to have been eradicated in many countries, are reappearing throughout the region, endangering the lives of the most marginalized children and the well-being of all.
Multiple factors…
The decline in childhood vaccination in Latin America is due to multiple factors.
On the one hand, natural disasters, violence, urbanization, instability and migration have contributed to the rising inequality.
In addition, the disparity in public spending on health in the region and the reduction of investment in some countries have left communities marginalized with limited access to primary health care services quality.
The COVID-19 pandemic exacerbated these challenges, halting childhood vaccinations due to intense demands on healthcare systems and stay-at-home measures.
In recent years, there are also signs of decreased confidence in vaccination in some countries of the region.
A girl receives medical assistance at a migrant shelter in El Paraíso, Honduras.
There is no excuse
The report highlights that vaccination not only saves lives, but is also a proven strategy for reduce future health care costs and support economic growth. Vaccination generates a strong return on investment of up to $26 for every $1 invested.
“With one of the best childhood immunization records, Latin America and the Caribbean have no excuses. Ten years ago, this region demonstrated that it could protect children from life-threatening diseases. There is no reason why we can’t do it again now, with more knowledge, capacity and resources,” says Conille.
“Vaccination is one of the simplest and most cost-effective public health interventions. To catch up on lost ground and ensure that all children are vaccinated, governments and partners must invest in immunization and primary health care. We can prevent childhood diseases now or bear the costs later.”
To recover from the setback and reduce the number of zero dose children in Latin America, UNICEF calls on governments and partners to:
- Urgently identify and vaccinate all childrenespecially those from the poorest households and indigenous and Afro-descendant boys and girls who have not been vaccinated
- give priority to financing vaccination services and primary health care
- build more resilient health systems by investing in health personnel, innovation and the production of vaccine supplies in the region
- Boost demand for vaccinesbuilding confidence, among other strategies
Lack of trust
The State of the World’s Children 2023 highlights that worldwide there has been a decline in confidence in vaccination. For example, the perception of the importance of vaccines for children decreased by more than a third in the Republic of Korea, Papua New Guinea, Ghana, Senegal and Japan after the start of the pandemic.
Just China, India and Mexico were the only ones of the 55 countries studied where the data indicate that perception the importance of vaccines held steady or even improved.
“Trust in vaccination is volatile and specific over time,” says UNICEF, noting that, despite the falls, general support for vaccines remains relatively strong. In nearly half of the 55 countries surveyed, more than 80% of respondents believe that vaccines are important for children.
Brochure on vaccination against COVID-19 and health protocols.
misleading information
However, the report cautions that the confluence of several factors suggests that the threat of vaccine hesitancy may be growing. These factors include uncertainty about the response to the pandemic, increasing access to misleading information, declining trust in experts, and political polarization.
“At the height of the pandemic, scientists rapidly developed vaccines that saved countless lives. But despite this historic achievement, fear and misinformation about all kinds of vaccines circulated as widely as the virus itself,” said Catherine Russell, Director UNICEF Executive.
Russell notes that this data is a worrying red flag. “We cannot allow reliance on routine immunizations to become another victim of the pandemic. Otherwise, the next wave of deaths could be more children with measles, diphtheria or other preventable diseases.”
For the UN agency, it is alarming that the decline in confidence comes amid the largest sustained decline in childhood immunization in 30 years, fueled by the COVID-19 pandemic.
The pandemic has disrupted childhood vaccination in most parts of the world, especially due to the intense demands on health systems, the diversion of immunization resources to vaccination against COVID-19, the shortage of health personnel and the stay-at-home measures. home, says UNICEF.
The report indicates that children born just before or during the pandemic are exceeding the age at which they should normally be vaccinated, underscoring the need for urgent action to catch up with those who were not vaccinated and prevent outbreaks of deadly diseases. .
Polio paralysis on the rise
In 2022, for example, the number of measles cases was more than double the total for the previous year. The number of children paralyzed by polio increased 16% year-on-year in 2022. Comparing the period from 2019 to 2021 with the previous triennium, the number of children paralyzed by polio increased eightfold, highlighting the need to ensure vaccination efforts are sustained.
The pandemic also exacerbated existing inequalities. For too many children, especially in the most marginalized communities, vaccination remains unavailable, accessible or affordable. Even before the pandemic, vaccination progress had stalled for nearly a decade as the world struggled to reach the most marginalized children.
Of the 67 million children who missed out on routine vaccination between 2019 and 2021, 48 million did not receive a single routine vaccination. As of late 2021, India and Nigeria (both countries with very large birth rates) had the highest number of zero-dose children, although increases in the number of zero-dose children were especially notable in Myanmar and the Philippines.
A child receives the oral polio vaccine during a UNICEF-supported immunization campaign in the city of Marib, Yemen.
The burden of inequality
Children without vaccinations live in the poorest, most remote and marginalized communities, sometimes affected by conflict.
New data produced for the report by the International Center for Health Equity reveals that in the poorest homesone in five children does not receive any dosewhile in the richest, only one in twenty.
Unvaccinated children often live in hard-to-reach communities, such as rural areas or urban slums. They often have mothers who have not been able to go to school and are given little say in family decisions. These problems are greatest in low- and middle-income countries, where approximately one in ten children in urban areas is zero-dose and one in six in rural areas. In middle- and high-income countries, the gap between urban and rural children is almost non-existent.
Inequality among health workers
To vaccinate all children, strengthening primary health care is vital and provide its workers, the majority of whom are women, with the resources and support they need. The report notes that women are on the front line of vaccination, but they face low wages, informal employment, lack of formal training and opportunities professionals and threats to their security.
To address this child survival crisis, UNICEF is calling on governments to redouble their commitment to increase immunization funding and to work with stakeholders to unlock available resources, including funds left over from COVID-19, to urgently implement and accelerate recovery vaccination efforts to protect children and prevent disease outbreaks.
“Vaccines have saved millions of lives and protected communities from outbreaks of deadly diseases. We know all too well that diseases do not respect borders. Routine immunization and strong health systems are our best bet to prevent future pandemics and unnecessary death and suffering With resources still available from the COVID-19 vaccination campaign, now is the time to redirect those funds to bolster immunization services and invest in sustainable systems for all children,” Russell said.
