Maintaining routine immunization services vital during the COVID-19 pandemic – WHO and UNICEF
The COVID-19 pandemic is a stark reminder that infectious diseases know no borders. All countries are vulnerable, regardless of income levels or the strength of their health care systems. Across the European Region, where tens of millions of people have been living in lockdown for weeks, and over 100,000 people have died, the speed and devastation of the novel coronavirus has completely upended lives. The urgent need for a COVID-19 vaccine underscores the pivotal role immunizations play in protecting lives and economies. As scientists around the world work to develop a vaccine against the novel coronavirus and health care capacities are stretched in responding to COVID-19, national routine immunization programmes are more critical than ever before. Governments across the Region must use every opportunity possible to protect people from the many diseases for which vaccines are already available. When routine vaccinations are missed, the risk of disease outbreaks increases. In 2018, approximately 527 000 children missed their first-dose of measles-containing vaccine in the WHO European Region. One year later in 2019, the measles virus exposed immunity gaps in Europe, infecting over 100 000 people, across all age-groups. Protecting children, adolescents and adults from vaccine-preventable diseases through vaccination is a must for the sustainability of health care systems. “We know that vulnerability to infectious diseases anywhere is a threat to public health everywhere,” said Ms. Afshan Khan, UNICEF Regional Director for Europe and Central Asia. “It is critical that routine immunization programmes continue during this crisis, while adequately protecting health workers and individuals receiving vaccinations. Reaching the most vulnerable children who have missed routine immunizations in the past should be prioritized.” If, during these unprecedented times, local COVID-19 response measures cause temporary interruptions of routine immunization services, countries should plan to resume immunization services as quickly as possible after the situation stabilizes. Countries should be prepared to vaccinate those at higher risk and ensure everyone, including the most marginalized, will have equal access to a COVID-19 vaccine when it becomes available. “ We can prevent further impact of COVID-19 on our healthcare systems by assuring that individuals of all ages remain vaccinated according to national schedules. I urge countries to maintain immunization service delivery and drive demand for vaccination, through the life-course even at this difficult time. Prioritizing immunization is one of my four flagship areas and central to WHO’s vision for health in the new European Programme of Work” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. WHO and UNICEF will continue to support governments’ efforts to strengthen their immunization programmes, including through strategic planning for equitable provision of immunization, strengthening vaccine-preventable disease surveillance and community engagement and education. As we step into a new future, vaccines will continue to serve as a foundation for health and wellbeing for all. It is through solidarity, joint action and tireless commitment to leaving no one behind that we can create a healthier future together. #Vaccineswork Georgia immunization UNICEF/UN0326765/Georgia
UNICEF reaches almost half of the world’s children with life-saving vaccines
– UNICEF procured 2.5 billion doses of vaccines to children in nearly 100 countries in 2016, reaching almost half of the world’s children under the age of five. The figures, released during World Immunization Week, make UNICEF the largest buyer of vaccines for children in the world. Nigeria, Pakistan and Afghanistan, the three remaining polio-endemic countries, each received more doses of vaccines than any other country, with almost 450 million doses of vaccines procured to children in Nigeria, 395 million in Pakistan and over 150 million in Afghanistan. UNICEF is the lead procurement agency for the Global Polio Eradication Initiative. Access to immunization has led to a dramatic decrease in deaths of children under five from vaccine-preventable diseases, and has brought the world closer to eradicating polio. Between 2000 and 2015, under five deaths due to measles declined by 85 per cent and those due to neonatal tetanus by 83 per cent. A proportion of the 47 per cent reduction in pneumonia deaths and 57 per cent reduction in diarrhea deaths in this time is also attributed to vaccines. Yet an estimated 19.4 million children around the world still miss out on full vaccinations every year. Around two thirds of all unvaccinated children live in conflict-affected countries. Weak health systems, poverty and social inequities also mean that 1 in 5 children under five is still not reached with life-saving vaccines. “All children, no matter where they live or what their circumstances are, have the right to survive and thrive, safe from deadly diseases,” said Dr. Robin Nandy, Chief of Immunization at UNICEF. “Since 1990, immunization has been a major reason for the substantial drop in child mortality, but despite this progress, 1.5 million children still die from vaccine preventable diseases every year.” Inequalities persist between rich and poor children. In countries where 80 per cent of the world’s under-five child deaths occur, over half of the poorest children are not fully vaccinated. Globally, the poorest children are nearly twice as likely to die before the age of five as the richest. “In addition to children living in rural communities where access to services is limited, more and more children living in overcrowded cities and slum dwellings are also missing out on vital vaccinations,” said Nandy. “Overcrowding, poverty, poor hygiene and sanitation as well as inadequate nutrition and health care increase the risk of diseases such as pneumonia, diarrhea and measles in these communities; diseases that are easily preventable with vaccines.” By 2030, an estimated 1 in 4 people will live in urban poor communities, mainly in Africa and Asia, meaning the focus and investment of immunization services must be tailored to the specific needs of these communities and children, UNICEF said.
Record number of infants vaccinated in 2017
: A record 123 million infants were immunized globally in 2017, according to data released today by the World Health Organization and UNICEF. The data shows that: 9 out of every 10 infants received at least one dose of diphtheria-tetanus-pertussis (DTP) vaccine in 2017, gaining protection against these deadly diseases. An additional 4.6 million infants were vaccinated globally with three doses of the diphtheria-tetanus-pertussis vaccine in 2017 compared to 2010, due to global population growth. 167 countries included a second dose of measles vaccine as part of their routine vaccination schedule and 162 countries now use rubella vaccines. As a result, global coverage against rubella increased from 35 per cent in 2010 to 52 per cent. The human papillomavirus (HPV) vaccine was introduced in 80 countries to help protect women against cervical cancer. Newly available vaccines are being added as part of the life-saving vaccination package – such as those to protect against meningitis, malaria and even Ebola. Despite these successes, almost 20 million children did not receive the benefits of full immunization in 2017. Of these, almost 8 million (40 per cent) live in fragile or humanitarian settings, including countries affected by conflict. In addition, a growing share are from middle-income countries, where inequity and marginalization, particularly among the urban poor, prevent many from getting immunized. As populations grow, more countries need to increase their investments in immunization programmes. To reach all children with much-needed vaccines, the world will need to vaccinate an estimated 20 million additional children every year with three doses of the diphtheria-tetanus-pertussis vaccine (DTP3); 45 million with a second dose of measles vaccine; and 76 million children with 3 doses of pneumococcal conjugate vaccine. In support of these efforts, WHO and UNICEF are working to expand access to immunization by: Strengthening the quality, availability and use of vaccine coverage data. Better targeting resources. Planning actions at sub-national levels and Ensuring that vulnerable people can access vaccination services.
More than 117 million children at risk of missing out on measles vaccines, as COVID-19 surges
“As COVID-19 continues to spread globally, over 117 million children in 37 countries may miss out on receiving life-saving measles vaccine. Measles immunization campaigns in 24 countries have already been delayed; more will be postponed. “During this challenging period, the Measles & Rubella Initiative (M&RI) expresses solidarity with families, communities, governments and emergency responders and joins our global immunization and health partners, including those within Gavi, the Vaccine Alliance and the Global Polio Eradication Initiative (GPEI) in our collective focus and fight against the threat of COVID-19. The pandemic sweeping the globe requires a coordinated effort and commitment of resources to ensure frontline health workers around the world are protected, as they face and respond to this new threat. At the same time, we must also champion efforts to protect essential immunization services, now and for the future. “The World Health Organization (WHO) has issued new guidelines endorsed by the Strategic Advisory Group of Experts on Immunization -- to help countries to sustain immunization activities during the COVID-19 pandemic. The guidelines recommend that governments temporarily pause preventive immunization campaigns where there is no active outbreak of a vaccine-preventable disease. M&RI partners, which include the American Red Cross, the U.S. Centers for Disease Control and Prevention, UNICEF, the United Nations Foundation and WHO, strongly agree with these recommendations. We also urge countries to continue routine immunization services, while ensuring the safety of communities and health workers. The recommendations also ask governments to undertake a careful risk-benefit analysis when deciding whether to delay vaccination campaigns in response to outbreaks, with the possibility of postponement where risks of COVID-19 transmission are deemed unacceptably high. “If the difficult choice to pause vaccination is made due to the spread of COVID-19, we urge leaders to intensify efforts to track unvaccinated children, so that the most vulnerable populations can be provided with measles vaccines as soon as it becomes possible to do so. While we know there will be many demands on health systems and frontline workers during and beyond the threat of COVID-19, delivering all immunization services, including measles vaccines, is essential to saving lives that would otherwise be lost to vaccine-preventable diseases. “The M&RI supports the need to protect communities and health workers from COVID-19 through a pause of mass campaigns, where risks of the disease are high. However, this should not mean that children permanently miss out. Urgent efforts must be taken now at local, national, regional and global levels to prepare to close the immunity gaps that the measles virus will exploit, by ensuring that vaccines are available and that they reach children and vulnerable populations, as quickly as possible, to keep them safe. “Despite having a safe and effective vaccine for over 50 years, measles cases surged over recent years and claimed more than 140,000 lives in 2018, mostly of children and babies – all of which were preventable. Against this already dangerous backdrop, preventive and responsive measles vaccination campaigns have now been paused or postponed in 24 countries to help avert further spread of COVID-19. Campaigns expected to take place later in 2020 in an additional 13 countries may not be implemented. Together, more than 117 million children in 37 countries, many of whom live in regions with ongoing measles outbreaks, could be impacted by the suspension of scheduled immunization activities. This staggering number does not include the number of infants that may not be vaccinated because of the effect of COVID-19 on routine immunization services. Children younger than 12 months of age are more likely to die from measles complications, and if the circulation of measles virus is not stopped, their risk of exposure to measles will increase daily. “The M&RI salutes the heroism of health and emergency workers across the globe, and we recognize the vital role they play in delivering clear, trusted information, as well as preventive and supportive care within their communities. We must invest in health workers and ensure they are protected from infection and empowered as part of sustainable and functioning primary health systems. They are the first line of defense against global epidemics. We also recognize the role of parents and caregivers in ensuring their children are vaccinated by following physical distancing recommendations in line with national guidance. Finally, we call on countries and local leaders to implement effective communication strategies to engage communities, ensure supply and demand for vaccination remains strong, and help assure a healthy life for every child especially in this challenging time.” #####
UNICEF procures healthcare supplies worth over KGS 12 million to help the Kyrgyz Republic respond to COVID-19
delivered personal protective equipment worth over KGS 12,000,000 to the Ministry of Health and Social Development. UNICEF provided 8,000 medical masks, 12,500 pairs of nitrile gloves for vaccinators, 20,000 pairs of gynaecological gloves, and 11,350 units of antiseptics for healthcare institutions and medical workers. UNICEF procured Personal Protective Equipment (PPE) on behalf of the Ministry through its Supply Division based in Copenhagen, hosting the world's largest humanitarian warehouse. The Ministry of Health and Social Development will use these essential supplies to support its ongoing vaccination efforts to respond to the pandemic and protect frontline healthcare workers. Gynaecological gloves are also being delivered to maternity facilities in Bishkek, Osh and Batken to improve the safety of mothers, newborns and medical staff. In addition, UNICEF procured 890,000 medical masks to ensure safe vaccination against COVID-19. " UNICEF is working around the clock to deliver essential supplies globally to respond to COVID-19. It includes the provision of vaccines, syringes, immunization equipment, medicines and personal protective equipment. In close collaboration with the Government of Kyrgyzstan, we are providing these protective supplies to maternities and hospitals so that everyone can be protected ", said Yulia Oleinik, UNICEF Deputy Representative in Kyrgyzstan. UNICEF will continue to support the Government in the COVID-19 response by delivering COVID-19 vaccines through the COVAX facility, procuring cold chain equipment for vaccine storage, providing essential supplies for frontline workers and supporting the socioeconomic measures to ensure that every child can survive and thrive. The handover of the supplies to the maternity house in Bishkek, Kyrgyzstan UNICEF Kyrgyzstan
‘RM Child-Health’: safeguarding the health of refugee and migrant children in Europe
More than 1.3 million children have made their way to Europe since 2014, fleeing conflict, persecution and poverty in their own countries. They include at least 225,000 children travelling alone – most of them teenage boys – as well as 500,000 children under the age of five. In 2019 alone, almost 32,000 children (8,000 of them unaccompanied or separated) reached Europe via the Mediterranean after perilous journeys from Syria, Afghanistan, Iraq and many parts of Africa – journeys that have threatened their lives and their health. Many have come from countries with broken health systems, travelling for months (even years) with no access to health care and facing the constant risks of violence and exploitation along the way. Many girls and boys arriving in Europe have missed out on life-saving immunization and have experienced serious distress or even mental health problems. They may be carrying the physical and emotional scars of violence, including sexual abuse. The health of infants and mothers who are pregnant or breastfeeding has been put at risk by a lack of pre- and post-natal health services and of support for child nutrition. Two girls wash a pot in the common washing area of the Reception and Identification Centre in Moria, on the island of Lesvos, in Greece. Two girls wash a pot in the common washing area of the Reception and Identification Centre in Moria, on the island of Lesvos, in Greece. Child refugees and migrants also face an increased health risk as a result of crowded and unhygienic living conditions during their journeys and at their destinations. Even upon their arrival in Europe, refugee and migrant children and families often face continued barriers to their health care, such as cultural issues, bureaucracy, and a lack of information in their own language. Southern and South East European countries are at the heart of this challenge, struggling to meet the immediate needs of vulnerable refugee and migrant children. And now, an already serious problem is being exacerbated by the COVID-19 pandemic. Refugee checks on his son
Our goals for children
Half of all deaths among children under the age of five in the Region occur in the first month of life. 400,000 children under the age of one have not received the recommended three doses of DTP vaccine, and immunization rates are falling because of system failures and vaccine hesitancy. Less than 30 per cent of Roma children are fully immunized in parts of the Balkan countries. Only 32 per cent of babies in the Region are exclusively breastfed during their first six months of life – one of the lowest rates worldwide.
Work with UNICEF
A day at the office can mean many things to a UNICEF staff member It could mean talking with a 14-year-old former child soldier about their experiences, or finding funding for vital supplies for children during an emergency, or dedicating each day to efforts to eradicate a killer disease. It's not all drama, of course. Much of the organization's work is all but invisible: securing funding for HIV/AIDS or immunization programmes, for example, or chipping away at political inertia, or setting up structures for effective emergency response. And there's the vital task of building alliances with local communities, helping them to ensure the education, protection and well-being of their own children. This selection of UNICEF staff profiles aims to give you an insight into the way the organization works, day by day, to improve the lives of individual children around the world. Interested in a similar job?
Mitigating the impact of COVID-19 on children and families in the Western Balkans and Turkey
There is abundant evidence that children bear a heavy burden resulting from disrupted essential services, increased social isolation, and loss of family income. In pandemic times, parents and caregivers are more likely to feel overwhelmed with providing stimulation and care for their young children and delay seeking prompt medical attention for children. Childhood immunization and other basic services were often suspended. School closures can mean a year of lost learning and children become more susceptible to dropping out. Uncertainties have created family distress, which contributes to serious mental health issues, especially among children who are vulnerable to violence and abuse. The pandemic has deepened pre-existing vulnerabilities of children with disabilities and children living in poverty. In 2021, UNICEF and the European Commission Directorate-General for Neighbourhood and Enlargement Negotiations launched a two-year initiative to
30 years of child rights: Historic gains and undeniable achievements, but little progress for the world’s poorest children - UNICEF
Although more children are immunized than ever before, a slowdown in immunisation coverage rates over the past decade is threatening to reverse hard-won gain in children’s health:
UNICEF commemorates 70 years of tireless work for the world’s most vulnerable children
– On the 70th anniversary of its founding, UNICEF celebrates the immense progress made for the world’s children – and renews the urgent call to reach millions of children whose lives and futures are endangered by conflict, crisis, poverty, inequality and discrimination. “UNICEF was founded after World War II to bring help and hope to all children at risk or in need – no matter which country they lived in or what role that country played in the war. Our mission is no less urgent and universal today,” said UNICEF Executive Director Anthony Lake. “With so many children around the world in so much need, we are recommitting ourselves to delivering results for every child.” The organization was established by the United Nations General Assembly to help children in post-war Europe, China and the Middle East. Funded entirely through voluntary contributions from governments, civil society, the private sector and concerned citizens, it rapidly expanded its reach and by 1955 was working for children in more than 90 countries. Today, UNICEF is the world’s largest children’s organization, working with partners in 190 countries and territories and through the efforts of 13,000 national and international staff to reach every child. UNICEF’s relentless engagement in the world’s toughest places has helped create remarkable progress for children in recent decades. The number of children dying before their fifth birthdays has been more than halved in the past 25 years. Hundreds of millions of children have been lifted out of poverty. Out-of-school rates among primary-school-aged children have been reduced by more than 40 per cent since 1990. In the 1940s, UNICEF provided emergency nutrition aid, mainly in the form of milk, to children in post-war Europe. In 2015, the organization and its partners treated 2.9 million children for severe acute malnutrition worldwide. In the 1950s, UNICEF led its first immunization campaigns against diseases such as tuberculosis and yaws. In 2015, the organization procured 2.8 billion doses of vaccines, and with its partners helping to protect 45 per cent of children under 5 years old worldwide from a range of deadly diseases. In 1953, UNICEF launched its first water, sanitation and hygiene programmes. Between 1990 and 2015, 2.6 billion people gained access to improved drinking water sources and 2.1 billion gained access to improved sanitation facilities. In 1961, UNICEF expanded its programmatic focus to include children’s education. In 2015, UNICEF and its partners provided 7.5 million children aged 3 to 18 with access to formal or non-formal basic education. In 1989, the United Nations General Assembly adopted the Convention on the Rights of the Child, which specifies that all children should be registered at birth to establish their identity under the law and thus to safeguard their rights. In 2015, UNICEF supported the registration of more than 9.7 million children’s births in 54 countries. In 1998, UNICEF became a founding member of the Roll Back Malaria Partnership to support malaria treatment and research, and expand prevention measures such as long-lasting insecticide-treated bed nets. In 2015, UNICEF procured 22.3 million bed nets to protect children and families in 30 countries. Since its founding, UNICEF has responded to thousands of humanitarian emergencies affecting children. In 2015, UNICEF and partners vaccinated 11.3 million children against measles in countries affected by crisis; provided 4 million children in emergency situations with access to formal or non-formal basic education; and provided psychosocial support for 2 million children caught in conflicts and natural disasters. Despite this impressive progress, millions of children are still being left behind because they live in poverty or in hard-to-reach communities, because of their gender, race, religion, ethnic group, or because they have a disability. Nearly 250 million children are growing up in countries affected by conflict and nearly 50 million children have been uprooted from their homes. “UNICEF’s vision for the next 70 years is a world in which our work is no longer necessary -- a world in which every child is healthy, safe, educated, cared for and protected … and all children can make the most of their potential,” said Lake. “It’s the right thing to do, and the surest path to a better future for us all.”
COVID-19 could reverse decades of progress toward eliminating preventable child deaths, agencies warn
– The number of global under-five deaths dropped to its lowest point on record in 2019 – down to 5.2 million from 12.5 million in 1990, according to new mortality estimates released by UNICEF, the World Health Organization (WHO), the Population Division of the United Nations Department of Economic and Social Affairs and the World Bank Group. Since then, however, surveys by UNICEF and WHO reveal that the COVID-19 pandemic has resulted in major disruptions to health services that threaten to undo decades of hard-won progress. “The global community has come too far towards eliminating preventable child deaths to allow the COVID-19 pandemic to stop us in our tracks,” said Henrietta Fore, UNICEF Executive Director. “When children are denied access to health services because the system is overrun, and when women are afraid to give birth at the hospital for fear of infection, they, too, may become casualties of COVID-19. Without urgent investments to re-start disrupted health systems and services, millions of children under five, especially newborns, could die.” Over the past 30 years, health services to prevent or treat causes of child death such as preterm, low birthweight, complications during birth, neonatal sepsis, pneumonia, diarrhea and malaria, as well as vaccination, have played a large role in saving millions of lives. Now countries worldwide are experiencing disruptions in child and maternal health services, such as health checkups, vaccinations and prenatal and post-natal care, due to resource constraints and a general uneasiness with using health services due to a fear of getting COVID-19. A UNICEF survey conducted over the summer across 77 countries found that almost 68 per cent of countries reported at least some disruption in health checks for children and immunization services. In addition, 63 per cent of countries reported disruptions in antenatal checkups and 59 per cent in post-natal care. A recent WHO survey based on responses from 105 countries revealed that 52 per cent of countries reported disruptions in health services for sick children and 51 per cent in services for management of malnutrition. Health interventions such as these are critical for stopping preventable newborn and child deaths. For example, women who receive care by professional midwives trained according to internationals standards are 16 per cent less likely to lose their baby and 24 per cent less likely to experience pre-term birth, according to WHO . "The fact that today more children live to see their first birthday than any time in history is a true mark of what can be achieved when the world puts health and well-being at the centre of our response,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Now, we must not let the COVID-19 pandemic turn back remarkable progress for our children and future generations. Rather, it’s time to use what we know works to save lives, and keep investing in stronger, resilient health systems.” Based on the responses from countries that participated in the UNICEF and WHO surveys, the most commonly cited reasons for health service disruptions included parents avoiding health centers for fear of infection; transport restrictions; suspension or closure of services and facilities; fewer healthcare workers due to diversions or fear of infection due to shortages in personal protective equipment such as masks and gloves; and greater financial difficulties. Afghanistan, Bolivia, Cameroon, the Central African Republic, Libya, Madagascar, Pakistan, Sudan and Yemen are among the hardest hit countries. Seven of the nine countries had high child mortality rates of more than 50 deaths per 1000 live births among children under five in 2019. In Afghanistan, where 1 in 17 children died before reaching age 5 in 2019, the Ministry of Health reported a significant reduction in visits to health facilities. Out of fear of contracting the COVID-19 virus, families are de-prioritizing pre- and post-natal care, adding to the risk faced by pregnant women and newborn babies. Even before COVID-19, newborns were at highest risk of death. In 2019, a newborn baby died every 13 seconds. Moreover, 47 per cent of all under-five deaths occurred in the neonatal period, up from 40 per cent in 1990. With severe disruptions in essential health services, newborn babies could be at much higher risk of dying. For example, in Cameroon, where 1 out of every 38 newborns died in 2019, the UNICEF survey reported an estimated 75 per cent disruptions in services for essential newborn care, antenatal check-ups, obstetric care and post-natal care. In May, initial modelling by Johns Hopkins University showed that almost 6,000 additional children could die per day due to disruptions due to COVID-19. These reports and surveys highlight the need for urgent action to restore and improve childbirth services and antenatal and postnatal care for mothers and babies, including having skilled health workers to care for them at birth. Working with parents to assuage their fears and reassure them is also important. “The COVID-19 pandemic has put years of global progress to end preventable child deaths in serious jeopardy,” said Muhammad Ali Pate, Global Director for Health, Nutrition and Population at the World Bank. “It is essential to protect life-saving services which have been key to reducing child mortality. We will continue to work with governments and partners to reinforce healthcare systems to ensure mothers and children get the services they need.” "The new report demonstrates the ongoing progress worldwide in reducing child mortality,” said John Wilmoth, Director of the Population Division of the United Nations Department of Economic and Social Affairs. “While the report highlights the negative effects of the COVID-19 pandemic on interventions that are critical for children’s health, it also draws attention to the need to redress the vast inequities in a child's prospects for survival and good health.” ###### A child and his mother while waiting to receive medical care UNICEF/UNI347480/Poveda