Unicef: Millions of children were left without a vaccine in the pandemic – 04/20/2023 – Health

The Covid-19 pandemic has left countless marks on people across the world over the last three years, and perhaps the biggest of them has been on children.

The closure of schools for a long period, the isolation of family members and the lack of school-age contact with other children possibly delayed child development and even affected the circulation of common childhood viruses, which dropped in the first two years of the pandemic.

In addition, the pandemic left a deep mark on vaccination indicators: worldwide, 48 million children did not receive any recommended dose of the DTP vaccine (diphtheria, tetanus and pertussis), which protects against bacterial infections in childhood. And, considering the need for vaccine boosters during the first 15 months of life, there are 67 million children with vaccine delay.

The numbers appear in the annual global report of Unicef ​​”State of the World’s Children 2023: For every child, vaccination”, released this Thursday (20). In Brazil alone, the numbers indicate 1.6 million children left without vaccination, and another 2.4 million with vaccination delay, alarming data for the protection of the health of minors.

In addition to the delay in vaccination, the survey also points to a drop in global confidence in immunizers in 52 countries, with only three showing an increase in the population’s confidence in vaccination: India, China and Mexico. In the case of Brazil, confidence in vaccines fell from 99.1% in 2019 to 88.8%, a reduction of about ten percentage points.

For Cristina Albuquerque, UNICEF’s head of health in the country, it is urgent to try to recover the vaccination of children still at the appropriate age for immunization. “If we don’t go after children who were not vaccinated in the period 2019 to 2021, these children are at risk of being at the mercy of childhood infectious diseases,” she said.

As vaccination coverage is falling all over the world, not just in Brazil, the report by the United Nations Fund for Children points out some guidelines to try to recover vaccination, such as, for example, reestablishing the link between communities and families (with, for example, action by religious leaders to encourage immunization) and active search, looking for children who have not received any doses or are actively behind on vaccines.

“It is important that immunization in states and municipalities is homogeneous. It is no use having a municipality with high coverage and having pockets of low coverage, because the infectious agent will continue to circulate there”, says Albuquerque. “No child is safe until all are protected.”

Albuquerque’s view echoes the research slogan: “For every child, vaccination”, also indicating the change presented in the report to report the number of children without vaccine, and not the vaccination rate. “The measure of vaccination coverage is important and correct from the point of view of public health, but we chose to bring the number in millions of unvaccinated or non-immunized children”, he says.

In 2019, about 13.3 million children in the world were on zero dose and 5.9 million on delayed doses (referring to DTP3, or third booster). That number jumped to 18.2 million and 6.8 million respectively in 2021, or 1 in 5 children in poor or vulnerable settings.

In the case of Brazil, there are almost 1 in 3 children with zero dose, totaling 1.6 million. This puts the country on the list of the 20 with the highest number of children without vaccination. In wealthy countries, 1 in 20 children are not adequately immunized.

The Unicef ​​survey also points out that around 40% of children who are without the first dose of the DTP vaccine in the entire region of Latin America and the Caribbean are in Brazil.

“And this is a very big concern, since everything that happens in a continental country the size of Brazil impacts the entire region”, says Albuquerque.

The methodology adopted in the study was to calculate the number of children who did not receive the first dose of the DTP vaccine, which in Brazil is also called pentavalent, as it protects against five types of bacterial infections.

Complete DTP immunization is done with a dose at two months of age followed by two boosters: one at four and another at six months. Similar, the polio vaccine, also with three doses, also indicates a delay of about 1.66 million children in Brazil. Regionally, peripheral and rural areas of the country are the ones with the highest number of children with immunization delay.

“When we talk about the number of children, the most populous regions have the highest number of children who are not protected, although vaccination coverage is lower in the states of the North and Northeast”, says Albuquerque.

Data were collected in 112 countries by local governments for the period from 2019 to 2021 and sent to Unicef ​​to calculate overdue doses until July 2022. Data from the Ministry of Health point to a drop in different types of immunizers, reaching the lowest mark in 2022.

Next week, between April 24th and 30th, Vaccination Week in the Americas will be celebrated. The Minister of Health, Nísia Trindade, was present at the launch ceremony of the report, in the auditorium of PAHO (Pan American Health Organization), the arm of the WHO (World Health Organization) in the Americas, and reaffirmed the current government’s commitment to recover vaccination.

“We reached more than 95% adherence to the polio vaccine alone, and today we have the tragic numbers presented in the survey, which raises great concern about the lack of protection for our children”, he said. “This commitment is not only from Health, but from all ministries, state secretaries, mayors and governors, and the participation of the civil community is also essential.”

According to Youssouf Abdel-Jelil, UNICEF representative in Brazil, the country, through its PNI (National Immunization Program) knows how to carry out national vaccination campaigns, and will certainly be successful in recovering the numbers. “The country has always been an example and has one of the largest public health systems in the world that needs to be valued and reconstituted. The efforts need to be collective.”

For Eder Gatti, director of the Department of Immunization and Vaccine-preventable Diseases at the Ministry of Health, Brazil has about 3 million live births per year and, calculating the possible delay of the pandemic, it is likely that more than 9 million children have not received vaccines in recent years. “We are going to work on several fronts with schools, an awareness campaign, actions aimed at health professionals, multi-vaccination to make up for this delay”, he said.