Although the pandemic has demonstrated the importance of immunization to protect health and prevent outbreaks, millions of children remain without receiving existing vaccines against deadly diseases such as pneumonia, diarrhoea, polio or measles. In 2020, at least 17.1 million children worldwide did not receive a single dose of any vaccine, according to estimates of the World Health Organization (WHO) and Unicef. This is 3.5 million more than in 2019, and they are known as “zero dose” children.
The poorest and most marginalized, who are often the most in need of immunizations, remain the least likely to receive them. Most live in countries affected by conflict, in refugee camps, in urban slums or in remote areas that are difficult to access. From the Global Alliance for Immunization and Vaccination (Gavi, for its acronym in English) regret that, despite progress, millions of minors are still left behind. Of the 17.1 million unimmunized children in 2020, this organization estimates that 12.4 lived in low-income countries and did not receive a single dose, “thereby leaving them vulnerable to some of the deadliest diseases in the world”, emphasizes Cirũ Kariũki , organization spokesperson. For this reason, the Alliance launched at the end of June the Zero Dose Immunization Program (ZIP).
This is a new initiative that will provide two consortiums of organizations with up to 100 million US dollars (nearly 95 million euros) to find and serve, for the next two and a half years, to children who have not received a single injection in the Sahel and Horn of Africa regions. In the SahelWorld Vision will lead the charge to shed light on immunization blind spots in Burkina Faso, Cameroon, Central African Republic (CAR), Chad, Niger, Nigeria and Mali. In the Horn of Africa, the International Rescue Committee (IRC) will lead a network of partners reaching vulnerable “zero dose” populations in Ethiopia, Somalia, South Sudan and Sudan. In the 11 target countries, there were, in 2020, more than four million unimmunized children.
In the 11 target countries there were, in 2020, more than four million children who did not receive a single dose of any vaccine
The initiative, which is part of the new Equity Accelerator Fund The US$500 million (almost €475 million) project from Gavi will start with an initial three-month phase, during which it will identify “zero dose” children and the barriers that impede access to immunization. Minors living in areas outside the Government’s reach, as well as mobile populations and refugees moving across borders, will be prioritized for outreach. At the end of this stage, detailed work plans and objectives of the initiative will be agreed upon. Governments, the Alliance assures, will play a central role in the initiation and implementation phases and will be involved in the decision-making processes.
Why is vaccination important?
“Beyond its capabilities to save lives, immunization allows nations to prosper,” says the Gavi spokeswoman, who recalls that since its creation in 2000, the Alliance has helped vaccinate 900 million children in the countries poorest in the world, avoiding more than 15 million future deaths. This, she points out, has helped halve infant mortality in 73 low-income countries. “The benefits don’t end there: as children become healthier, they, their families, communities and countries are more likely to be economically prosperous and socially stable.” The organization estimates that for every US dollar invested in immunization in Gavi-supported countries in the period 2021-2030, US$21 is saved in healthcare costs and lost wages and productivity due to illness and death.
For every dollar spent on immunization, $21 is saved in health care costs and lost wages and productivity due to illness and death, according to the Vaccine Alliance
Immunization also helps improve global health security, the Alliance notes, at a time of global challenges such as climate change, population growth, urbanization, human migration, fragility and conflict. Expanding vaccination coverage and improving their health systems makes countries more capable of preventing disease outbreaks, and protects millions of people around the world, concludes the Gavi spokeswoman.
In 2021, Unicef vaccinated almost half of the world’s minors
If anyone has something to contribute on the matter, it is Unicef. In collaboration with its allies, supplies vaccines that reach 45% of children under the age of five worldwide. In more than 100 countries, they work with governments, the private sector, non-governmental organizations and other UN agencies to engage communities, buy and distribute vaccines, keep supplies safe and effective, and ensure that even affordable vaccines are available to hardest-to-reach families.
Blanca Carazo, head of Programs and Emergencies at Unicef Spain, delves into the seriousness of the situation: “In 2019 there were 14 million children under one year of age who had not received any dose, and 5.7 who had received one or two, but they had not completed the pattern. A total of 17.9 million. In 2020, that figure rose to 23 million. If the number of unvaccinated babies increases, we are not doing well.” This situation worries him, since, he estimates, vaccines save between two and three million lives each year. In his opinion, they are “a real revolution” and “the best public health tool”.
According to the latest report from Unicef Spain and the Political Watch platform presented on Tuesday of last week in Madrid, various immunization campaigns have been paralyzed in poor countries due to the coronavirus. According to Carazo, the number of unvaccinated children has grown for two other reasons, apart from the pandemic. On the one hand, increasingly fragile health systems that do not ensure access to immunization. “40% of these children live in conflict zones or areas of great fragility, are in refugee camps or are on the move, either because they are nomads or because they are fleeing”, he develops. On the other hand, a greater mistrust of injections and the consequent rise of anti-vaccine movements. “The remaining 60% of unvaccinated children is distributed, and there is a non-negligible number of unvaccinated children in middle-income countries,” he says.
According to the study, measles cases they increased 79% in the first two months of 2022, compared to the same period in 2021. “There is less vaccination against this highly contagious disease and for which the vaccine is fully effective. It is dangerous, especially in emergency contexts, since the probability of a child dying from measles can reach 30%. In a normal context, it is 1% ”, details Carazo, who clarifies that the decrease in vaccination is easily detected by the outbreaks that arise as soon as it begins to decrease. And he gives the case of Syria as an example: polio reappeared in 2014. Before the conflict, there was 90% vaccination, but, after three or four years of war, children were no longer vaccinated and outbreaks arose.
Less is being vaccinated against measles, a highly contagious disease against which the vaccine is fully effective. It is dangerous, especially in emergency contexts: the probability of a child dying from measles can be as high as 30%. In a normal context, it is 1%
Blanca Carazo, head of Programs and Emergencies at Unicef Spain
To finish, Carazo wants to make it clear that Unicef is working “a lot” for vaccination against covid-19. In fact, the organization is responsible for the distribution of doses to low-income countries. “We work with the States to improve their immunization protocols and the cold chain, to train their professionals, to provide water and electricity in health centers. This has to serve so that, later, the health and vaccination systems in general are better and reach more children”, she concludes.
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