Efforts to vaccinate children worldwide against deadly diseases such as measles and diphtheria began to recover in 2022 after a historic backslide caused by the Covid-19 pandemic, according to figures from the World Health Organisation and UN Children's Fund (Unicef).
But the recovery remains uneven, with strong returns in large lower-middle income countries such as India and Indonesia masking continuing problems in many smaller and poorer countries, the agencies said on Tuesday.
In 2022, 20.5 million children missed one or more routine childhood vaccines, down from 24.4 million children in 2021.
Despite the progress, the numbers are still higher than in 2019, when 18.4 million children were not fully protected.
The numbers are estimated from 183 countries, using data based on the three-dose diphtheria, tetanus and pertussis (whooping cough) inoculation.
They include children who had no vaccines at all or who missed any of the doses necessary for protection.
Globally, coverage rates were at 86 per cent pre-pandemic, and 84 per cent in 2022.
WHO Director General Dr Tedros Adhanom Ghebreyesus said the numbers were “encouraging”, but there were concerns the most vulnerable were being left behind.
“When countries and regions lag, children pay the price,” Dr Tedros said.
Of the 73 countries that had substantial declines in routine coverage during the pandemic, 34 – including countries such as Angola and Syria – have had no improvement since or even got worse.
Fifteen have recovered to pre-pandemic levels and 24 were on the route to recovery, the WHO and Unicef said.
The agencies also warned that measles vaccinations had not recovered as quickly, with 21.9 million children globally missing their first dose in 2022 – 2.7 million more than in 2019 – and 13.3 million their second.
In low-income countries, coverage rates for measles continued to decline last year, to 66 per cent compared with 67 per cent in 2021, said Kate O'Brien, WHO head of immunisation.
Measles outbreaks are already on the rise.
“When children are not vaccinated, that means they are not immune to life-threatening diseases,” Ms O'Brien told Reuters. “Children are going to die."
Only rates of the HPV vaccination, which prevents cervical cancer, have recovered to pre-pandemic levels.
But they remain below the 90 per cent target, at 67 per cent in the high-income countries and 55 per cent in the low and middle-income countries where the shot has been introduced.
Alongside Gavi, the Bill and Melinda Gates Foundation and other partners, the WHO and Unicef launched a push this year to help countries catch up on childhood vaccination.