Childhood immunization bounces back to pre-COVID-19 levels in five South Asian countries

NEW DELHI/ KATHMANDU, 18 July 2023 – Immunization services in South Asia reached 1.96 million more children in 2022 compared to the previous year, as countries stepped up efforts to address the historic backsliding in immunization caused by the COVID-19 pandemic and save children’s lives.

According to data published today by UNICEF and the World Health Organization (WHO), in 2022, the coverage of the third dose of the Diphtheria, Pertussis and Tetanus vaccine (DTP3) increased by 6 percentage points, from 85 per cent in 2021 to 91 per cent in South Asia. The DTP vaccine is used as the global marker for immunization coverage.

“South Asia’s progress to catch up with life-saving vaccinations is tremendous news for the children in the region who now have a better chance of being protected against deadly diseases such as measles, tetanus and more,” said UNICEF Deputy Regional Director for South Asia, Noala Skinner. “We owe this progress to the leadership of countries, the investment of donors and partners, tenacity of millions of vaccinators and the commitment of parents to get their children vaccinated despite several challenges during and after the COVID-19 pandemic waves.” 

Among the eight South Asian countries, Bangladesh, Bhutan, Pakistan, India and the Maldives have fully recovered to their pre COVID-19 coverage levels. Sri Lanka and Nepal have made significant strides towards achieving complete recovery but are yet to fully catch-up.

Though progress has been made in Afghanistan, more efforts are needed to reach over 400,000 missing children with vaccination services. All countries, except Afghanistan and Pakistan, achieved vaccine coverage of above 90 per cent for DTP3, which is considered very high.

According to the data, in 2022, India, Sri Lanka, and Nepal had the highest percentage reductions in the number of children who weren’t vaccinated at all, with a decrease of 58 per cent, 50 per cent and 38 per cent respectively. In India, the number of children without any vaccines decreased from 2.7 million in 2021 to 1.13 million in 2022.

The percentage of children vaccinated with the new pneumococcal conjugate vaccines, which protect children against pneumonia, jumped 28 percentage points from 44 in 2021 to 72 per cent in 2022.

Vaccination for the first vaccine dose against measles - one of the most contagious vaccine preventable diseases - increased from 87 per cent in 2021 to 92 per cent in 2022. This was higher than the 2-percentage point increase globally.  As a result, an additional 1.94 million children were vaccinated against the deadly disease in South Asia in 2022.  However, the regional coverage for the first dose of measles vaccine is still lower than the target of 95 per cent needed to prevent measles outbreaks. According to WHO surveillance data, in 2022 alone, there were 54,959 measles cases in South Asia, nearly triple the reported cases in 2021. 

UNICEF worked with countries in the region to boost immunization coverage:

• India used catch-up campaigns and vaccinations to reach children with a primary health care package of health and nutrition interventions.
• In Bangladesh, there were several digital health interventions, including eTracker, GIS-based eMicroplanning and child biometry for immunization, to improve access and make it easier for parents to get their children vaccinated.
• In Pakistan, several initiatives were implemented, including an urban immunization strategy in 5 mega cities, round-the-clock vaccination services in labour rooms and immunization, health, nutrition and water and sanitation services in hard-to-reach areas to address vaccine refusals.
• In Afghanistan, mobile health clinics helped to take vaccinations to unvaccinated children in remote villages.

Despite the progress, an estimated 3 million children out of 34 million surviving infants in South Asia did not receive the three recommended doses of DTP vaccine and are not fully vaccinated. Even within countries, disparities exist which require targeted interventions to vaccinate children.

As part of ‘The Big Catch-Up’ advocacy campaign launched in April this year, UNICEF is calling on South Asian governments to catch up the children who missed vaccinations by doubling down on their commitment to increase financing for immunization and new strategies for immunization programmes to reach every child who was born before or during the pandemic.

#####

Notes to editors: 

* A substantial decline is considered a decline of 5 percentage points or more in 2020 and/or 2021 compared to 2019. Smaller fluctuations in coverage were not unusual before the pandemic.

The data indicates how many children in the target age group for routine immunization services were reached in 2022. It is not structured to capture catch-up of those who were missed during the pandemic, as many of these children will have ‘aged out’ of local immunisation services. However, some catch-up may have been recorded as “routine” services and reflected in the data.

About the data

Based on country-reported data, the WHO and UNICEF estimates of national immunization coverage (WUENIC) provide the world’s largest and most comprehensive dataset on immunization trends for vaccinations against 13 diseases given through regular health systems - normally at clinics, community centres, outreach services, or health worker visits. For 2022, data were provided from 183 countries.