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A quick look: the state of routine immunization in Europe and Central Asia

A new UNICEF report shows that the public perception of the importance of childhood vaccines has declined in the region.

UNICEF
Boy in Poland receives a vaccine.
UNICEF/U.S. CDC/UN0705561/Kasia Strek

About

Immunization allows children everywhere to live lives free of many forms of disability and illness. UNICEF's The State of the World’s Children 2023 highlights the current situation of immunization for children globally. UNICEF's regional brief for Europe and Central Asia demonstrate that public demand, scientific innovations and – perhaps above all – political will can drive rapid change. 

Now is a time for determination.

Now is a time for political will.

Now is the time to protect the health of every child.

Girl receiving a HPV vaccine.

67 million children

Between 2019 and 2021, 67 million children across the world missed out on routine vaccinations.

2-month-old gets vaccinated by Nurse as part of his routine childhood immunization session.

327,400 children

327,400 are “zero-dose” and “under-vaccinated” children. That means they have not received any vaccinations or the third required dose of the diphtheria-pertussis-tetanus (DPT3) vaccine.

Nurse in office

29 countries

29 countries in the region found a decrease in the perception of the importance of vaccines for children.

3-month-old gets vaccinated in Tajikistan

One million

Nearly one million of children who missed one or several routine vaccinations live in Europe and Central Asia.

Immunization coverage in Europe and Central Asia

Europe and Central Asia has the highest immunization coverage rates in the world. However, the pandemic set back immunization coverage.
Girl receiving a HPV vaccine.
UNICEF/UN0687610/Babajanyan VII Photo
  • Nearly one million children in Europe and Central Asia missed all or some routine vaccinations between 2019 and 2021. Many of these children missed out on these vaccines due to the disruption to health services caused by the COVID-19 pandemic.
  • Overall, vaccination coverage across Europe and Central Asia is relatively high compared to other regions. However, recent data show that the public perception of the importance of childhood vaccines has declined across countries in Europe and Central Asia since the onset of the pandemic.
  • Immunization is central to protecting children’s health and well-being, allowing them to live free of many forms of disability and illness.

Understanding zero-dose

‘Zero-dose’ and ‘under-vaccinated’ have become key concepts in explaining immunization coverage.
  • Among children who missed one or several routine vaccinations in the region, 327,400 are “zero-dose” and “under-vaccinated” children, meaning they have either not received any vaccines or the third required dose of the diphtheria-pertussis-tetanus (DPT) vaccine – critical markers in immunization coverage.
  • Bosnia and Herzegovina, Kyrgyzstan, Moldova, North Macedonia and Ukraine have among the highest rates of zero-dose children in the region. Bosnia and Herzegovina, Georgia, Montenegro, Romania and Ukraine have among the highest rates of under-vaccinated children.
2-month-old gets vaccinated by Nurse as part of his routine childhood immunization session.
UNICEF/UN0635898/Babajanyan VII Photo

Disruptions to vaccination

The impact of the COVID-19 pandemic is still being felt
3-month-old gets vaccinated in Tajikistan
UNICEF/UN0635918/Babajanyan VII Photo
  • The pandemic caused immense disruption to health services globally, including immunization. Across Europe and Central Asia, as in other parts of the world, several clinics were closed, the distribution of syringes and other medical supplies were disrupted, and health staff were prioritized for the COVID-19 response. Meanwhile, families were placed under lockdown and fearful of visiting health facilities.
  • In countries where children missed out on routine immunizations, we have seen an uptick in vaccine-preventable illnesses such as diphtheria, measles and polio.

Vaccine confidence

Using behavioural insights to understand and identify barriers to immunization and address vaccine hesitancy.
  • In 29 countries in Europe and Central Asia Region, there was a decrease in the perception of the importance of vaccines for children.
  • Among the 29 countries, Croatia experienced the greatest decline in confidence in childhood vaccines, with a 29% decrease, followed by Latvia with a decrease of 27% and Slovakia with a decrease of 25%.
  • Immunization saves lives. It is central in protecting children’s health and well-being, as it allows children everywhere to live lives free of many forms of disability and illness. Yet, since the onset of the pandemic, we have seen a decline in confidence in the perception of the importance of childhood vaccines.
Nurse in office
UNICEF/UN0759494/Babajanyan VII Photo

Immunization trends

Despite undeniable progress over many decades, we continue to face critical challenges in immunization.
Nurse shows vaccination calendar
UNICEF/UN0760644/Babajanyan VII Photo

Other key data on immunization in Europe and Central Asia featured in the report include:

  • The highest prevalence of zero-dose children is among mothers with primary education.
  • Vulnerable and marginalized children in the region, including Roma children, are less likely to receive routine immunization, especially in Balkan countries, where vast gaps still exist.
  • Despite achieving high human papillomavirus (HPV) vaccine coverage rates in Turkmenistan and Uzbekistan, a decline in coverage was present in most other countries. The HPV vaccine helps protect against several cancers, notably cervical cancer, estimated to be the fourth largest cause of cancer deaths among women worldwide.

Taking action

Here is a set of concrete and actionable recommendations to reach every child with vaccines and to ensure that immunization and primary health-care systems are ready to meet future challenges.

UNICEF is calling on governments to double-down on their commitment to increase financing for immunization and to work with stakeholders to unlock available resources, including leftover COVID-19 funds, to urgently implement and accelerate catch-up vaccination efforts to protect children and prevent disease outbreaks.

Among the recommendations for governments are the following:

  • Urgently identify and reach all children, especially those who missed vaccinations during the COVID-19 pandemic.
  • Strengthen confidence in and demand for vaccines, including by working closely with communities to address their vaccination needs and concerns.
  • Prioritise funding to immunization services and primary health care.
  • Build resilient health systems through investment in female health workers, innovation and local manufacturing.
Mother holds her child in Kyrgyzstan
UNICEF/UN0759519/Babajanyan VII Photo