Working towards maintaining positive child immunisation trend in Bangladesh: Unicef

Despite initial disruptions during the first months of the pandemic, Bangladesh restored routine immunisation services to pre-Covid-19 levels in June 2020 and has steadily maintained this coverage, says Unicef.

In addition, the country successfully held a mass immunisation campaign for measles and rubella from December 2020 to January 2021 that reached 36 million children and overcame the additional challenges posed by Covid-19.

Now with the third and to date largest spike of Covid-19 in Bangladesh, working towards maintaining this positive child immunisation trend will be key, according to Unicef.

While immunisation services have started to recover from disruptions caused by Covid-19, millions of children remain vulnerable to deadly diseases, the World Health Organization (WHO), Unicef and Gavi, the Vaccine Alliance have warned during World immunisation Week, highlighting the urgent need for a renewed global commitment to improving vaccination access and uptake.

"Vaccines will help us end the Covid-19 pandemic but only if we ensure fair access for all countries, and build strong systems to deliver them," said Dr Tedros Adhanom Ghebreyesus, WHO's Director-General.

"And if we're to avoid multiple outbreaks of life-threatening diseases like measles, yellow fever and diphtheria, we must ensure routine vaccination services are protected in every country in the world."

A WHO survey has found that despite progress when compared to the situation in 2020, more than one-third of respondent countries (37%) still report experiencing disruptions to their routine immunisation services.

Mass immunisation campaigns are also disrupted.

According to new data, 60 of these lifesaving campaigns are currently postponed in 50 countries, putting around 228 million people - mostly children - at risk for diseases such as measles, yellow fever and polio.

Over half of the 50 affected countries are in Africa, highlighting protracted inequities in people's access to critical immunisation services.

Campaigns to immunize against measles, which is one of the most contagious diseases and can result in large outbreaks wherever people are unvaccinated, are the most impacted. 
Measles campaigns account for 23 of the postponed campaigns, affecting an estimated 140 million people. Many have now been delayed for over a year.

"Even before the pandemic, there were worrying signs that we were beginning to lose ground in the fight against preventable child illness, with 20 million children already missing out on critical vaccinations," said Henrietta Fore, Unicef Executive Director.

"The pandemic has made a bad situation worse, causing millions of more children to go unimmunized. Now that vaccines are at the forefront of everyone's minds, we must sustain this energy to help every child catch up on their measles, polio and other vaccines. We have no time to waste. Lost ground means lost lives."

As a result of gaps in vaccination coverage, serious measles outbreaks have recently been reported in countries including the Democratic Republic of the Congo, Pakistan and Yemen, while likely to occur elsewhere as growing numbers of children miss out on lifesaving vaccines, the agencies warn.

These outbreaks are happening in places already grappling with conflict situations as well as service disruptions due to ongoing response measures to Covid-19.

The supply of vaccines and other equipment is also essential for child vaccinations. Due to disruptions at the onset of the Covid-19 pandemic, Unicef delivered 2.01 billion vaccine doses in 2020, compared to 2.29 billion in 2019.

"Millions of children across the world are likely to miss out on basic vaccines as the current pandemic threatens to unravel two decades of progress in routine immunisation", said Dr Berkley, CEO of Gavi, the Vaccine Alliance.

"To support the recovery from Covid-19 and to fight future pandemics, we will need to ensure routine immunisation is prioritized as we also focus on reaching children who do not receive any routine vaccines or zero-dose children. To do this, we need to work together – across development agencies, governments and civil society – to ensure that no child is left behind".

New global immunisation strategy aims to save over 50 million lives

To help tackle these challenges and support the recovery from the Covid-19 pandemic, WHO Unicef, Gavi and other partners today launched the immunisation Agenda 2030 (IA2030), an ambitious new global strategy to maximize the lifesaving impact of vaccines through stronger immunisation systems.

The Agenda focuses on vaccination throughout life, from infancy through to adolescence and older age. If fully implemented, it will avert an estimated 50 million deaths, according to WHO - 75% of them in low- and lower-middle-income countries.

Targets to be achieved by 2030 include:

• Achieve 90% coverage for essential vaccines given in childhood and adolescence.
• Halve the number of children completely missing out on vaccines.
• Complete 500 national or subnational introductions of new or under-utilized vaccines  - such as those for Covid-19, rotavirus, or human papillomavirus (HPV).

To achieve IA2030's ambitious goals, WHO, Unicef, Gavi and partners are calling for bold action.

World leaders and the global health and development community should make explicit commitments to IA2030 and invest in stronger immunisation systems, with tailored approaches for fragile and conflict-affected countries.

immunisation is a vital element of an effective health care system, central to pandemic preparedness and response, and key to preventing the burden of multiple epidemics as societies reopen.

All countries should develop and implement ambitious national immunisation plans that align with the IA2030 framework, and increase investments to make immunisation services accessible to all.
Donors and governments should increase investments in vaccine research and innovation, development, and delivery focused on the needs of underserved populations.

The pharmaceutical industry and scientists, working with governments and funders, should continue to accelerate vaccine R&D, ensure a continuous supply of affordable vaccines to meet global needs, and apply lessons from Covid-19 to other diseases.