In Focus: Immunization
Immunization is one of the world’s most cost-effective public health interventions, saving millions of lives each year, and protecting children from illness and disability. Vaccines have helped to halve the number of child deaths worldwide since 1990 and represent a sound financial investment: every $1 spent on childhood immunizations returns an estimated $44 in economic and social benefits. Despite the achievements of immunization programmes in the Europe and Central Asia Region in recent decades, reported immunization rates are uneven across countries — from as high as 98 percent in Albania to as low as 19 percent in Ukraine. The regional average for Eastern Europe and Central Asia stands at 92 percent, still not high enough to protect all children from preventable diseases. What’s more, there was no improvement in coverage between 2014 and 2016. At national levels, disparities can be shocking, with the most vulnerable children often missing out on immunization. Across the Region, more than half a million children have missed out on their routine measles vaccination, and many countries continue to face outbreaks of vaccine-preventable diseases that threaten the lives and well-being of children. Challenges to immunization include weak political commitment and health systems, ‘vaccine hesitancy,’ and concerns about the financial sustainability of national immunization programmes in middle-income countries. UNICEF knows that the whole Region benefits when ALL countries achieve and maintain high vaccine coverage at both national and sub-national levels. Download file (PDF, 981,23 KB) July 2018
What you need to know about COVID-19 vaccines
Vaccines save millions of lives each year and a COVID-19 vaccine could save yours. The COVID-19 vaccines are safe and effective, providing strong protection against serious illness and death. WHO reports that unvaccinated people have at least 10 times higher risk of death from COVID-19 than someone who has been vaccinated. There is also evidence that being vaccinated can help prevent you from spreading the virus, so it protects people around you. It is important to be vaccinated as soon as it’s your turn, even if you already had COVID-19. Vaccines offer more reliable protection than natural immunity. Getting vaccinated is a safer way for you to develop immunity from COVID-19 than getting infected. The COVID-19 vaccines are highly effective, but no vaccine provides 100 per cent protection. Some people will still get ill from COVID-19 after vaccination or pass the virus onto someone else. Therefore, it is important to continue practicing safety precautions to protect yourself and others, including avoiding crowded spaces, physical distancing, hand washing and wearing a mask.
Vaccinations with a smile in Uzbekistan
Baby Imona is visiting the clinic, but there is no fear or tension, because Nurse Aziza Abduazimova knows how to put her and her parents at ease. Aziza’s open face and sweet, cheerful manner make all of the children she meets comfortable. “I always meet babies with a smile. Then I answer all of the parents’ questions about vaccinations so that they feel they can trust me with their child’s health. I make the child comfortable, and chat and play with them. I use toys to create a relationship before vaccinating them.” Aziza has been immunising children at Polyclinic #47 in Tashkent, Uzbekistan for six years now. She says that she loves her job. “I’m a mother myself. I have three sons aged 15, 12 and 10 years old who are all vaccinated and growing up healthy. I didn’t have a moment’s hesitation in getting my children vaccinated, and I am happy to help other mothers raise strong and healthy kids.” Aziza believes that it’s much better to vaccinate a child and prevent a disease than treat the sometimes-serious consequences of an illness. “Polio can cause permanent paralysis. Mumps, a common childhood disease, can make boys infertile, and measles can be fatal. It’s not just the consequences for the individual, either. A child who hasn’t been vaccinated is putting everyone else at risk, including babies and unvaccinated adults.” Nurse Aziza Abduazimova administers the polio vaccine to baby Imona. Nurse Aziza Abduazimova administers the polio vaccine to baby Imona. However, despite all the evidence about the safety of vaccines to prevent serious disease, some parents are still hesitant. “It’s a natural urge for a mother to protect her baby, and some mothers are scared to cause their baby the pain of an injection,” Aziza says. “Believe me, when I first started this job, I used to cry along with the babies, but then I realised that by causing this brief moment of pain, I’m preventing a lot of future suffering.” Some parents read things on the internet that scare them. Aziza says, “I follow a lot of discussions on the web and I often post evidence to prove that they needn’t worry. All the vaccines used in Uzbekistan meet international standards.” Aziza recalls a young mother who didn’t vaccinate her first son. “He got every childhood disease, one after the other, including Hepatitis A. With my encouragement she decided to vaccinate her younger son. He has grown up very healthy. Now when people see them together, they assume the younger one is older because he wasn’t sick as often, he’s so much taller and stronger than his brother. His mother tells everyone her story. She says, ‘If I’d had my older son vaccinated, I wouldn’t have gone through all these troubles.’” Aziza helps parents who have concerns about vaccinations to meet mothers and fathers with children who have been fully immunised. “Peer to peer conversations are really helpful because parents trust fellow parents and they can see the results.” She believes being a good vaccinator isn’t just about following procedures but having the right attitude: “There was one lady who came from outside our clinic’s catchment area. She was surprised to find me so cheerful and friendly. In her previous experiences staff had been professional, but she told me my friendliness has made such a difference to her children; now they feel at ease during and after vaccinations. It makes such a difference how you treat people." "Children pick up a lot from how you deal with them—they connect with a smile.” - adds Aziza. Nurse Aziza puts baby Imona at ease with a toy after administering a vaccine. With toys and smiles, baby Imona is at ease after receiving a vaccine. “My main message to parents would be to follow the vaccination calendar. Don’t wait or delay; it has been developed to protect against the most common diseases in this country and vaccinating on time gives your child the best protection.” Aziza gives baby Imona a last cuddle. She smiles, “Parents share the hope that their child will grow up healthy. In my work as a vaccinator, I can help make that happen.” UNICEF in Uzbekistan trains health professionals across the country to vaccinate children and works closely with the Government to ensure the vaccine system is safe and can reach all children with life-saving immunizations.
Protecting young children from vaccine-preventable diseases
Vaccination is one of the world’s safest and most cost-effective public health interventions. Yet growing distrust in science, coupled with misinformation, means that vaccination coverage rates are declining in some countries and communities, resulting in an upsurge of vaccine-preventable diseases. Research shows that those caring for children…
Vaccination drive ongoing to protect children from deadly measles outbreak in Ukraine
Uliana Dziuba, 36, is holding the hands of her two young children as they wait to receive their vaccination against measles, mumps and rubella (MMR). Unlike her brother Volodia, nine-year-old Maryana is anxious, but Uliana knows how important today is. “I used to refuse to vaccinate the children against measles,” she says. “Once, I refused because they were sick at the time. Another time, there was a very powerful anti-vaccination campaign on social media. But Maryana got measles at age three and now I’m very worried that my son will get sick. I am vaccinating both of them for the first time today.” The pair are among thousands of children now being vaccinated in Lviv region, Ukraine, after the Ministry of Health with support from UNICEF launched an immunization drive. It is using a combined approach: teams of mobile doctors are working to reach school-age children while local clinics are increasing their ability to vaccinate more children. The drive is happening as UNICEF warns that global cases of measles have surged to alarmingly high levels – including in countries that had previously been declared measles free – eroding progress against this highly preventable, but potentially deadly disease. Maryana Dzuba, 9, receives her first dose of MMR vaccine on 21 February 2019 in the medical centre of the Lapaivka village school, Lviv region, Ukraine, as part of a three-week long catch-up vaccination campaign to increase MMR coverage among school aged children in the region. Maryana Dzuba, 9, receives her first dose of MMR vaccine on 21 February 2019 in the medical centre of the Lapaivka village school, Lviv region, Ukraine, as part of a three-week long catch-up vaccination campaign to increase MMR coverage among school aged children in the region. In Ukraine alone, according to Government data, there were more than 53,000 cases of measles in 2018. Another 24,000 people were infected just in the first two months of this year. The situation in Lviv region is particularly dangerous, with approximately 11,000 measles cases in 2018, and up to 50,000 unvaccinated children in the region. Of the 634 children attending Volodia and Maryana’s school in Lviv, only 13 remain unvaccinated due to the ongoing immunization drive. During the first two days, a total of 2,030 children were vaccinated. For many it was the first time. The vaccination drive also helps combat negative attitudes towards vaccination, as well as shortages in vaccine supply through 2009-2015. “Teachers and medical professionals have been campaigning for vaccinations,” says school headteacher Tetiana Malieryk. “We held all-school meetings and parent-teacher conferences, where the danger of measles was explained. Now fewer parents are refusing vaccinations and those children who did not receive vaccinations because of their parents’ beliefs are being vaccinated.” Next in line for vaccinations at the school in Lviv are six-year-old twins Vitalina and Yuliana. The girls and their mother Olesia Kechur, 37, are dressed in traditional embroidered clothing. This will be their second vaccination against measles. Twins Vitalina and Yuliana Kechur, 6, are given a check-up by the doctor before receiving MMR vaccination on 21 February 2019 in the medical centre of the Lapaivka village school, Lviv region, western Ukraine. Twins Vitalina and Yuliana Kechur, 6, are given a check-up by the doctor before receiving MMR vaccination on 21 February 2019 in the medical centre of the Lapaivka village school, Lviv region, western Ukraine. “The mother is very responsible about vaccinations,” reports Halyna Narolska, their doctor. “They get all of them and don’t miss anything.” Narolska has been a doctor for over 30 years. During this time, she says, she has not seen a single complication from an MMR vaccine. “Temperature may increase and there may be rash on day four, but neither has happened to a single child that we have vaccinated,” she says. “The only way to stop the outbreak is to vaccinate all children.” “There is a measles outbreak all over the world,” remarked Ukraine’s Deputy Minister for Healthcare Olha Stefanyshyna, during a recent visit to Lviv. “However, Ukraine is sadly a leader among the European countries. This is why we need to take extraordinary measures. I would like to say that this campaign is aimed primarily at children who missed their vaccination against measles, mumps, and rubella in the past. Today, we have better coverage of children who are born now.” UNICEF and its partners are supporting governments to reach millions of children in countries around the globe with life-saving immunization. However, stronger commitment and actions to vaccinate more children and protect them from preventable diseases is critical – including in Ukraine.
#VaccinesWork to protect children in Ukraine, amid measles outbreak
As a mother of two young children, Natalia was once told by her doctor that vaccinations were unnecessary. Now – with a measles outbreak gripping Ukraine –Natalia is glad she chose to ignore the doctor’s advice and instead vaccinate her children. This recent national outbreak has affected 16,500 people and killed 13, including nine children. According to a UNICEF poll taken in 2016, 16 percent of parents in Ukraine have refused vaccinations for their children. Natalia with her two children in a park in Kyiv. Natalia, with her two young children in a park in Kyiv. “Many parents I know still refuse to vaccinate their children,” says Natalia, whose children received the MMR vaccine against measles, mumps and rubella. “They say the vaccines are bad, that they have adverse effects. My children are fine and I think their health is more important.” Ukraine’s Ministry of Health has been leading the outbreak response since 2017 with support from UNICEF and other partners. While less than half of all children in the country were vaccinated against measles as part of routine immunization in 2016 (via the MMR vaccine), the number more than doubled in 2017 to over 90 percent, according to the Ministry. Valentyna Ginzburg, a doctor who heads Kyiv’s state healthcare department, says she and her team have been working to combat the measles outbreak since first being alerted to a rise in infections following the New Year and Orthodox Christmas celebrations in 2018. “We received information on the incidence rates of measles in Kyiv,” Dr. Ginzburg says. “We knew we needed to take rapid action to prevent a situation similar to other regions, such as Odesa, where there had already been fatalities amongst both adults and children from the illness.” Measles is one of the most contagious diseases around and we understood that if we were not proactive and did not control it, it would have not been long before we had the same situation as in other regions. Dr. Ginzburg Dr. Ginzburg explains how she and her colleagues had to act quickly to stop the spread of the disease in Kyiv. UNICEF/2018/Krepkih Dr. Ginzburg explains how she and her colleagues had to act quickly to stop the spread of the disease in Kyiv. In the four days that followed, 11,000 children were vaccinated in Kyiv. Around 48,000 children were immunized from January to March, a tally that would normally take 12 months to reach. Following national recommendations on outbreak response, authorities in Kyiv launched a ‘situation room’ to collect the latest information and coordinate response actions. Being vaccinated was also made a pre-condition for children attending schools and preschools to help stop the spread. The city administration also encouraged medical specialists to visit schools and raise awareness of vaccination among both teachers and parents. Maryna Stefanenko, a pediatrician at a clinic on the left bank of Kyiv, gives more details. “We had a lot of people coming in, even those who normally go to private clinics,” she says. Dr Stefanenko’s clinic usually administers around 80 vaccines per day, but during the outbreak they were immunizing around 1,200 people each day. On the other side of the city, in Obolon district, another clinic rushed to meet demand. A pediatrician there, Dr Natalia Yatsenko, explained that as part of her job, she must sign the paperwork for parents who refuse to vaccinate their children. She says she spends a lot of time explaining the benefits of vaccination, as well as the risks for children who do not receive their shot. Before the measles outbreak, she managed to talk some 10 per cent of objectors into changing their mind. However, during the outbreak, she did not even have to persuade them – many parents who were once against vaccinations were very keen to bring their children to the clinic. A young boy receives several vaccines at a time at Dr Natalia Yatsenko clinic in Kyiv. A young boy receives several vaccines at a time at Dr Natalia Yatsenko clinic in Kyiv. Another factor in the response? The effects of armed conflict in eastern Ukraine. “We had some internally displaced people from the eastern regions who came to our clinic,” says Yatsenko. “They told us that their children’s vaccination records had been falsified, and now they wanted to vaccinate them for real. So we vaccinated them.” “We also vaccinated some parents,” adds Stefanenko. “The parents bought the vaccines for themselves from the pharmacy then brought them to us and we administered the shots.” Dr. Ginzburg also advocated with the Kyiv authorities to address one of the biggest issues the country is struggling with - access to vaccines for adults and health workers. “All health workers had to be checked and those who required vaccination had to be immunized,” she says. “Then we were sure that, no matter what, the doctors wouldn’t be incapacitated.” The city administration also made sure the municipal pharmacy chain had measles vaccines available for adults. Artem, six, receives his second dose of the MMR (mumps, measles, rubella) vaccine in Kyiv. Artem, six, receives his second dose of the MMR (mumps, measles, rubella) vaccine in Kyiv. Although vaccines for children were available in 2017, increased demand had depleted stocks in some regions. To help replenish stocks, a new expedited supply of MMR vaccines was delivered by UNICEF at the request of the Ministry of Health at the end of February 2018, and another 800,000 doses are due this month, to ensure sufficient vaccines for both routine immunization of children and those who may have missed their immunizations in previous years. Significant progress has been made in reaching more children with vaccines, yet still an estimated 1.5 million children die globally from vaccine preventable diseases every year and an estimated half a million children in the region are still not immunized. Millions of lives can be saved by extending basic health services like routine immunization to the most vulnerable and disadvantaged, and UNICEF is on the ground immunizing millions of children each year . Vaccines protect children against disease and death, saving up to three million lives every year. In short, #VaccinesWork.
Tracking anti-vaccination sentiment in Eastern European social media networks
This UNICEF working paper aims to track and analyse online anti-vaccination sentiment in social media networks by examining conversations across social media in English, Russian, Romanian and Polish. The findings support the assumption that parents actively use social networks and blogs to inform their decisions on vaccinating their children. The…
The undeniable power of vaccines
]: Olena Kudryashova and her daughter, Maya, 17 months, walk outside their home in Kyiv. Both caught measles in 2018. Olena was infected first, before spreading the illness to her daughter. Today, Olena supports vaccination as early as possible. “Vaccination, like politics or religion, leaves no one indifferent,” she says. “But… there is no room for discussion in vaccination. It is absurd to deny its effectiveness.” Инна Онищенко, блогер Facebook, популярный среди молодых матерей в Украине. “It is easy to be an anti-vaccinator when you have no children,” admits Inna Onyshchenko, a Facebook blogger popular among mothers of young children in Ukraine. Before she was a mother, Inna spoke out against vaccination. When she became pregnant, she reconsidered. Today, her three-year-old daughter Zoryana has all of her vaccinations and Inna shares her experiences on her blog, dispelling common myths about immunization. Светлана Овдий играет возле своего дома в пригороде Киева со своим трёхлетним сыном Кириллом. Svitlana Ovdiy plays with her son Kyrylo, 3, a tetanus survivor, near their house outside Kyiv. The infection put Kyrylo in a medically-induced coma, and he spent 50 days in the hospital. “When he heard my voice... he started crying, calling for help, but there was nothing more I could do,” Svitlana recalls. “Now vaccination is a top priority issue in our family.” Ханна Прокопышин находится со своим девятилетним внуком Дмитрием в больнице, где он проходит лечение от бронхиальной астмы. Hanna Prokopyshyn sits with her grandson Dmytro, 9, in the hospital where he receives treatment for bronchial asthma. Dmytro’s parents initially were afraid to vaccinate their son due to his condition – a concern doctors dispelled, especially amid Ukraine’s measles outbreak. Dmytro has already successfully received the first dose of the MMR vaccine and his parents plan to follow the National Immunization Schedule. Сергей Олийнык, врач-педиатр, изображён на фото со своей годовалой дочерью Катей. Serhiy Oliynyk, a paediatrician, holds his daughter Katya, age 1, before setting off to work at Kosiv hospital in Western Ukraine. Serhiy promotes vaccines among his patients and recently had Katya inoculated against measles. Children should generally receive their first dose of the MMR vaccine at age 1; babies at high risk of contracting measles, especially during an outbreak, can receive the MMR shot as early as 6 months. Анна Кравчук, студентка медицинского университета, является одной из шести детей в своей семье. Anna Kravchuk, a university student and one of six children, did not get vaccinated until the measles outbreak in Ukraine reached her school. Many of Anna’s fellow students were infected – one died. After Anna got vaccinated, she convinced her mother to vaccinate her younger sisters. “I am sometimes being asked for medical advice,” she says. “And, of course, in the first year of study I am not a reliable adviser. But for immunization I know for sure – it just must be done. It is obligatory.” Марьяна Возница, главный врач Украинской специализированной детской больницы во Львове, изображена на фото в своём кабинете. “The problems with vaccination... result from the poor communication between doctors and and patients,” says Maryana Voznytsya, Head Doctor at the Ukrainian Specialized Children’s Hospital in Lviv. She adds that her hospital deals with the consequences of other doctors’ vaccination failures. In recent years, the hospital has received six tetanus cases, with many doctors facing the disease for the first time. “Everyone should know that doctors and patients are on the same side in the fight against diseases.” Олесь Похраничный, директор частной школы во Львове, изображён на фото с одной из трёх своих дочерей. Oles Pohranychnyi, a private school director in Lviv, once believed the misconceptions surrounding vaccines – he and his wife decided not to vaccinate their three daughters. Increased risk of measles and other illnesses in Ukraine, such as tetanus and diphtheria, made them change their minds. “The National Education System should... give people confidence in vaccination and health services in general,” Oles says, holding his daughter. He now organizes UNICEF-supported vaccination training for parents and arranges inoculations for staff. Медсестра Иванна Кныш на фото после вакцинации троих детей в Западной Украине. “The more openly we talk about vaccination, the more we'll be trusted by parents, because they realize that there's nothing to be afraid of,” says Ivanna Knysh, pictured after vaccinating three children in Western Ukraine. Until recently, Ivanna, a nurse, worked at a healthcare facility in Novoselytsya, a town in which 100 per cent of children were vaccinated thanks to her efforts. Now a UNICEF-certified vaccination trainer, Ivanna actively encourages doctors to help dispel parents’ fears by better explaining the procedure. Игорь Сухомлин, ресторатор, изображён на фото вместе с женой и тремя детьми у своего ресторана в Киеве. After his middle son contracted chickenpox, Igor Sukhomlyn, a restaurateur and thought leader in Kyiv, was not willing to take any chances. He and his wife immediately vaccinated other members of the family from chickenpox, and no one else got sick. “Vaccination is a valuable scientific achievement,” says Igor, pictured with his wife and children in front of his restaurant. This World Immunization Week, UNICEF and the Bill & Melinda Gates Foundation are launching a new global campaign to emphasize the power and safety of vaccines. From 24–31 April, the foundation will contribute US$1 to UNICEF for every like or share of a social media post using the hashtag #VaccinesWork, up to US$1 million. In the meantime, UNICEF will continue to assist Ukraine’s Ministry of Health in monitoring the outbreak, helping the Government procure free vaccines and spreading the message that together, communities can protect everyone through vaccines. Learn more World Immunization Week UNICEF's work on immunization in the region Vaccine FAQs Parents' most frequently asked questions about vaccines Vaccines and the diseases they prevent Vaccines and the diseases they prevent
Turning every “no” into a “yes” to protect children from the current measles outbreak in Romania
Over 19,000 people in Romania have been diagnosed with measles since 2016. To date, 64 people have died – 58 of them children. The outbreak is the result of a drop-in immunization coverage over the past two decades, with many parents fearful of vaccination, due to the spread of misinformation. For example, the proportion of children who have received a second dose of the measles vaccine – which is needed to adequately protect a child form the deadly disease - dropped from 97 per cent in 2000 to 76 per cent in 2016. It was only after UNICEF started re-engaging in the national measles programme that this drop was stopped, and the coverage is currently up 5 percent from 2016 for the second dose. UNICEF focused on improving immunization awareness of the general public via TV, radio and social media, as well as on redesigning the national electronic vaccination registry, on conducting catchup immunization campaigns in areas with extremely low coverage, and on improving behavior and communication skills of local health workers on immunization. Besides these actions, UNICEF supported teams of health and social workers in 45 communities in Bacău county, in eastern Romania. Their interventions focus on providing a minimum package of community-based health services, including access to vaccination, to save and improve children’s lives. Adina and Didina are two mothers who have been reached by these community-based teams, and whose children are now fully immunized against the disease. The initiative relies on the work of health professionals such as Gabi Stan and social workers like Magda Grigoriu to build trust with families. Delia and Mario are the first children to come home from school, followed by Alberto at 2 pm and Petrina at 3 pm. All four children do their homework at this small table with their mother Adina. Delia and Mario are the first children to come home from school, followed by Alberto at 2 pm and Petrina at 3 pm. All four children do their homework at this small table with their mother Adina.
What we know about the Omicron variant
WHO reports that early evidence suggests that previous infection could offer less protection against Omicron in comparison to other variants of concern, such as Delta. Information is still limited though and we will share updates as it becomes available. You should get vaccinated even if you’ve previously had COVID-19. While people who recover from COVID-19 may develop some natural immunity to the virus, we do not yet know how long it lasts or how well you are protected. Vaccines offer more reliable protection.
Ukraine’s elderly reunited with loved ones after vaccine
The COVID-19 pandemic has also impacted people who live with disabilities. Anatolii Nesterenko is just 52, but lives in a nursing home after doctors were forced to amputate both his legs as a result of severe frostbite. Anatolii Nesterenko is just 52, but lives in a nursing home. Anatolii did not hesitate to get vaccinated. He believes it is a responsibility. “I do not want this infection to continue to poison everybody’s life,” he says. Anatolii’s neighbour, 47-year-old Bohdan Volynchuk, also uses a wheelchair after suffering a stroke in 2018. He dreams of learning how to walk again and knows the vaccine will protect him. “For this, I have to be vaccinated, among other things,” he says. “Lockdown has been very restrictive. Having immunity, I will be able to see people without fear. And, if I can restore the mobility of the body, I hope to move back to my home. Everything is fine here, but I want to have a life.”
Support for frontline workers: Implementation of health policies for refugee and migrant children
“I find the tool for identification of unaccompanied and separated girls [UASGs] very useful since the indicators included are clear and help us recognise UASGs more quickly.” A frontline worker in Serbia welcomes a new tool to identify refugee and migrant girls Two girls are talking to each other. The ‘RM Child-Health’ initiative has supported work across five European countries over the past year to equip those who work directly with refugee and migrant children and adolescents with all the skills and resources they need to turn health policies into concrete action. In its first full year, this 27-month, co-funded €4.3 million initiative, which was launched in January 2020 by the European Union Directorate-General for Health and Food Safety, has enhanced the knowledge and skills of frontline workers to maximize the impact of their work with young refugees and migrants. The initiative promotes and supports multi-disciplinary approaches and teams to address the complex causes of health problems among refugee and migrant children, from trauma, anxiety and over-crowded conditions, to lack of hygiene facilities and immunization. As a result, support from the ‘RM Child-Health’ initiative builds trust between refugee and migrant families and a wide range of frontline workers, including health service providers.