- 37 lakh more children globally missed routine vaccines in 2020 than in 2019
- Just 10 countries account for 62% of all under or unvaccinated children
- Losing out on routine immunisation can endanger children’s health: UNICEF
New Delhi: As the world continues to fight against COVID-19 and mitigate its multifaceted impacts on the lives of people including children, health systems, food security, livelihood and economy, the United Nations Children’s Emergency Fund (UNICEF) has highlighted another fallout of the pandemic. It has warned that the disruption in health services caused by the pandemic has derailed the routine vaccination programmes in many countries because of which over 2.3 core of the world’s children missed out on basic childhood vaccines in 2020 with India having the highest number of unvaccinated and under-vaccinated children. Due to this, children were left unprotected from various vaccine-preventable diseases like diphtheria, tetanus, pertussis among others. The data published by UNICEF along with the World Health Organisation (WHO) has highlighted that India has observed the highest decline in its immunisation rate.
India Worst Hit With Low Routine Immunisation
According to the UNICEF, India, which has the world’s largest immunisation programme tops the list of countries with the highest number of unprotected children worldwide at 35 lakh, an increase of 14 lakh compared with 2019, when the number of unprotected children was 21 lakh.
The country also recorded the greatest increase in children not receiving the first dose of diphtheria-tetanus-pertussis combined vaccine (DTP) in 2020, said UNICEF. In 2019, over 14 lakh did not receive their first dose of DTP, which jumped to over 30 lakh in 2020, shows the UNICEF data.
India is experiencing a particularly large drop, with DTP coverage falling from 91 per cent to 85 per cent, said WHO.
Along with DTP, the Universal Immunization Programme (UIP) which is completely funded by the Government of India provides vaccination to prevent Polio, Measles, disease by Rotavirus, a severe form of childhood Tuberculosis and Hepatitis B, Haemophilus Influenza Type B and Diarrhoea.
While talking to NDTV about the decline in the immunisation rate in India reported by UNICEF, a senior official in the National Health Mission (Immunisation) of the Ministry of Health and Family Welfare (MoHFW), who asked to remain anonymous, said that the vaccination had definitely slowed down during the three months of strict lockdown due to COVID last year but it was never completely stopped. He said,
Resources in terms of human and capital were diverted towards COVID response. ASHAs (Accredited Social Health Activist) and Anganwadi workers were required to dedicate their time and efforts towards fighting COVID. But in about one month, vaccination resumed at almost all places. The pandemic has definitely slowed down the pace though because of the social distancing and other restrictions.
On how the government plans to speed up the routine immunisation programme in order to bridge the gap and increase coverage, the official said,
The government is ramping up the routine vaccination. There are camps taking place regularly. Even in the wake of COVID, we were able to conduct a successful Polio vaccine drive where we vaccinated over 17 crore children in a single day. Vaccinating children and protecting them from life-threatening diseases is extremely important for their future and the future of the country.
Dr Aviral Roy, Consultant, Critical Care, Medica Superspeciality Hospital, Kolkata said that while it is concerning that a huge number of children in India missed out on vaccination due to COVID but the pandemic has brought with it unprecedented situations and so one can expect this. He said,
During the lockdown, the priority was to respond to the pandemic. All Primary Healthcare Centres (PHCs), Anganwadi centres, hospitals, doctors were together focusing on the fight the pandemic and tackle the rising number of cases. So it is not shocking to know that there have been disruptions in other health services. It was actually expected. It is one of the fallout of medical emergencies like the ongoing COVID-19. That being said, I would like to point out that as a doctor we are very concerned about the health of the children and of their parents. While the parents must go and get themselves immunised against the coronavirus, they must also ensure that their children are properly vaccinated against vaccine-preventable disease as well.
However, Richa Chintan, member, Jan Swasthya Abhiyan (People’s Health Movement) said that the UNICEF data is a wake-up call that all routine vaccinations be administered as scheduled, as it is an essential health activity. She said,
There is an urgent need of restoring services. Children are most vulnerable and while we cannot immunise them against COVID-19 yet, we cannot delay protecting them from other life-threatening diseases. The policymakers and public healthcare providers must prepare strategies on an urgent basis to safely deliver routine immunisation during COVID. We have recently seen the horrors of the wave; we also know that the third wave is inevitable. Not vaccinating children against other diseases will only accumulate a more vulnerable population.
Widening Vaccine Inequities Worldwide
UNICEF said that the data shows the widening of already immense inequities in vaccine access. It also shows:
- The year 2020 recorded the highest number of children who were unvaccinated or under-vaccinated in over a decade and 37 lakh more than in 2019.
- About 1.7 crore children worldwide did not receive even a single vaccine during 2020.
- As compared with 2019, 35 lakh more children across the world missed their first dose of DTP while 30 lakh more children missed their first measles dose.
- Southeast Asian and Eastern Mediterranean Regions were most affected due to the disruptions in immunisation services.
- At nearly 44 lakh, South Asia recorded the highest number of children who failed to receive any routine vaccination in the past ten years, in 2020.
- Just 10 countries account for 62 per cent of all under or unvaccinated children globally.
While commenting on the state of routine immunisation around the world amid Covid, Tedros Adhanom Ghebreyesus, Director-general, WHO said,
Even as countries clamour to get their hands on COVID-19 vaccines, we have gone backwards on other vaccinations, leaving children at the risk from devastating but preventable diseases like Measles, Polio or Meningitis. Multiple disease outbreaks would be catastrophic for communities and health systems already battling COVID-19, making it more urgent than ever to invest in childhood vaccination and ensure every child is reached.
Emphasising the importance of vaccination, Dr Roy, said that vaccines prompt the child’s immune system to develop antibodies and added that a gap of a week or two will not have any negative impact on the child’s health if the disease is not highly prevalent in the area where the child lives. He said,
Vaccines work by imitating the infection these are meant to prevent so that the antibodies can then fight the disease itself. The vaccines timeline is usually spaced out in the time between birth and five years of age. While the parents, public healthcare providers and policymakers must make all efforts to get children vaccinated on time, a little bit of postponement because of a pandemic will not be too dangerous when the particular disease is not prevalent. A gap of a week or two or even three is ok. But do not miss the vaccine altogether and also there is no need to restart the whole process if there has been a delay.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.