UNICEF India released its global flagship report, ‘The State of the World’s Children 2023: For Every Child, Vaccination,’ which highlights the importance of childhood immunization. The report reveals that India, China, and Mexico were the only countries out of 55 studied where the perception of the importance of vaccines for children held firm or improved. However, vaccine confidence marked a decline in over a third of the studied countries, including Ghana, Japan, Papua New Guinea, the Republic of Korea, and Senegal, following the pandemic. The report warns of the growing threat of vaccine hesitancy due to factors such as misleading information and declining trust in vaccine efficacy.
The report also highlights the largest sustained backslide in childhood immunization in 30 years, fueled by the COVID-19 pandemic. The pandemic interrupted childhood vaccination almost everywhere, leading to a total of 67 million children missing out on vaccinations between 2019 and 2021, with vaccination coverage levels decreasing in 112 countries. Moreover, the number of measles cases in 2022 was more than double the total in the previous year, and the number of children paralyzed by polio was up 16% year-on-year in 2022. The report emphasizes the need to ensure vaccination efforts are sustained to prevent future pandemics and reduce morbidity and mortality.
India's Remarkable Success Story in Vaccination Efforts
UNICEF India Representative Cynthia McCaffrey praised India as one of the countries with the highest vaccine confidence in the world. This recognition is a testament to the Government of India's political and social commitment, and the largest vaccines drive during the pandemic has paid off in building confidence and strengthening systems for routine immunization to vaccinate every child. Despite an increase in the number of zero-dose children to three million between 2020 and 2021 during the pandemic, India was able to arrest the backslide and bring down the number to 2.7 million, representing a smaller proportion of India's under-5 child population given its size and the world's largest birth cohort. This achievement can be attributed to sustained evidence-based catch-up campaigns initiated by the government, including the Intensified Mission Indradhanush (IMI), continued provision of comprehensive Primary Health Care services, a strong Routine Immunization program, and dedicated health workers.
Exacerbated Inequities and Challenges Ahead
The pandemic also exacerbated existing inequities, and vaccination is still not available, accessible or affordable for far too many children, especially in the most marginalized communities. The report found that in the poorest households, 1 in 5 children are zero-dose, while in the wealthiest, it is just 1 in 20. Unvaccinated children often live in hard-to-reach communities, such as rural areas or urban slums, and have mothers who have not been able to go to school and who are given little say in family decisions. These challenges are greatest in low- and middle-income countries, where about 1 in 10 children in urban areas are zero dose and 1 in 6 in rural areas. However, continued progress is being made to reach the last mile and the last child.
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