Immunization programs have been disrupted in 68 countries, exposing about 80 million children under the age of one to risk. Diseases such as diphtheria, measles and polio have become an even more realistic threat due to the impact of COVID-19. Decades of progress against vaccine-preventable diseases could be lost if the novel coronavirus continues to keep immunization shipments on hold.
More than 50% of the countries previously mentioned have declared either moderate-to-severe disruptions to immunization routines or a total halt to vaccinations. A month ago, the United Nations Children’s Fund (UNICEF) warned about a 70-80% reduction in immunization supplies which had been planned to be delivered since March. In particular, countries with weak health systems could face disastrous outbreaks in 2020. Because of the decrease in commercial flights and the limited availability of charters, some countries are at risk of running out of vaccines and the supplies designed for unplanned and urgent needs are likely to be depleted.
Immunization on pause. On the brink of catastrophic repercussions
“Immunization is one of the most powerful and fundamental disease prevention tools in the history of public health. Disruption to immunization programs from the COVID-19 pandemic threatens to unwind decades of progress against vaccine-preventable diseases like measles”, declared Tedros Adhanom Ghebreyesus, WHO Director-General.
Preventable diseases could emerge in outbreaks with catastrophic consequences. In the Democratic Republic of Congo, the measles epidemic has caused 332,000 cases and killed over 5,300 children since early 2019. Another 31,000 children were tested positive with cholera during this period. According to UNICEF data regarding vaccination in Congo, more than 86,000 children have not received their oral polio vaccine and almost 75,000 have not had access to a dose of vaccine against hepatitis B, diphtheria, tetanus, whooping cough and Hib.
“These immunizations must restart as soon as possible, or we risk exchanging one deadly outbreak for another,” said Henrietta Fore, UNICEF Executive Director.
The high risk of infection during the early stages of the COVID-19 pandemic has caused countries to pause immunization efforts. At the World Health Organization’s request to postpone preventive immunization, 27 countries have suspended their measles campaigns and other 38 have interrupted their polio campaigns. Being close to being certified as free of wild polio virus, Nigeria has cancelled two polio vaccine campaigns designed to immunize a total of 37.6 million children. The latest data points to millions of measles cases being reported worldwide last year.
Struggling to maintain the routine
As countries continue to address the severe impacts of the pandemic, many have set one more priority among many others – delivering the vaccine to every child who needs it. Uganda has struggled to ensure the immunization routine despite the ongoing difficulties. The country has received 3.8 million doses of the bivalent oral polio vaccine procured by UNICEF, with funding from government, that will be administered to about 900,000 children. Parents are encouraged to access immunization services respecting the precautionary measures, despite their acute concerns about bringing children to the clinic for immunization.
UNICEF has improved disease response by procuring and shipping nearly half a billion doses of different types of vaccines to the Middle East and North Africa since 2017. Last year, roughly 34 million children received lifesaving vaccines in these regions. Despite the restrictions related to COVID-19, UNICEF has been able to deliver about 17.5 million doses of vaccines to the Middle East and North Africa since the beginning of the year.
Left out of the immunization programs
Too many people remain excluded from the immunization system. According to the World Health Organization, 86% of children under the age of five globally were vaccinated with three doses of diphtheria, tetanus and pertussis and one dose of the measles vaccine in 2018, an increase of 14% since 2000. Routine immunization should continue and disrupted vaccination programs should be rescheduled as soon as possible. Countries are advised to start planning the safe resumption of vaccination campaigns in high-risk countries as Global Polio Eradication Initiative (GPEI) has highlighted.
Global Vaccine Summit hosted by the UK government on 4th of June, managed to rise over US$8 billion to protect 300 million children in 68 lower-income countries against deadly diseases from 2021 to 2025 and to support mass vaccination campaigns and rebuild health systems following the COVID-19 pandemic. During the summit, the world’s biggest vaccine manufacturers committed to continue supplying the billions of doses needed to continue increasing vaccine coverage across Africa and Asia. Private sector partners, corporations, foundations and individual philanthropists have become involved in Gavi’s immunization response with funding of more than US$ 70 million to deliver vaccines to another 300 million children.
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