Abstract
IntroductionIn 2010, the Global Vaccine Action Plan called on all countries to reach and sustain 90% national coverage and 80% coverage in all districts for the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) by 2015 and for all vaccines in national immunization schedules by 2020. The aims of this study are to analyze recent trends in national vaccination coverage in the World Health Organization African Region andto assess how these trends differ by country income category.MethodsWe compared national vaccination coverage estimates for DTP3 and the first dose of measles-containing vaccine (MCV) obtained from the World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) joint estimates of national immunization coverage for all African Region countries. Using United Nations (UN) population estimates of surviving infants and country income category for the corresponding year, we calculated population-weighted average vaccination coverage by country income category (i.e., low, lower middle, and upper middle-income) for the years 2000, 2005, 2010 and 2015.ResultsDTP3 coverage in the African Region increased from 52% in 2000 to 76% in 2015,and MCV1 coverage increased from 53% to 74% during the same period, but with considerable differences among countries. Thirty-six African Region countries were low income in 2000 with an average DTP3 coverage of 50% while 26 were low income in 2015 with an average coverage of 80%. Five countries were lower middle-income in 2000 with an average DTP3 coverage of 84% while 12 were lower middle-income in 2015 with an average coverage of 69%. Five countries were upper middle-income in 2000 with an average DTP3 coverage of 73% and eight were upper middle-income in 2015 with an average coverage of 76%.ConclusionDisparities in vaccination coverage by country persist in the African Region, with countries that were lower middle-income having the lowest coverage on average in 2015. Monitoring and addressing these disparities is essential for meeting global immunization targets.
Highlights
DTP3 coverage in the African Region increased from 52% in 2000 to 76% in 2015,and MCV1 coverage increased from 53% to 74% during the same period, but with considerable differences among countries
In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan 2011-2020 (GVAP), which calls on all countries to reach and sustain 90% national coverage and 80% coverage in all districts for the third dose of diphtheria-tetanus-pertussis (DTP3) containing vaccine by 2015 and 90% national coverage and 80% coverage in all districts for all vaccines included in national immunization schedules by 2020 [1]
The aims of this study are to analyze recent trends in national and subnational vaccination coverage in the African Region, to assess how these trends differ by country income category and Gavi-eligibility, to review the coverage achieved with recently introduced vaccines in African Region countries and to identify low-income African Region countries which outperform their peers in reaching and sustaining high levels of vaccination coverage
Summary
In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan 2011-2020 (GVAP), which calls on all countries to reach and sustain 90% national coverage and 80% coverage in all districts for the third dose of diphtheria-tetanus-pertussis (DTP3) containing vaccine by 2015 and 90% national coverage and 80% coverage in all districts for all vaccines included in national immunization schedules by 2020 [1]. The GVAP calls for a focus on equity in vaccination coverage through reducing the gap in coverage between low-income countries and high-income countries, and by reducing pockets of low sub-national vaccination coverage. No published analyses have described recent trends in vaccination coverage, equity and vaccine introductions among African Region countries in light of the substantial investments made in these countries over the past 16 years. Examining how these trends differ by country income status and by Gavi-eligibility status may provide useful insight into gaps to be addressed in future work by the countries and their external partners. As global partners such as Gavi, WHO and UNICEF look to further support countries in reaching GVAP goals, identifying countries which have outperformed their peers may yield useful lessons learned for strengthening immunization systems within resourceconstrained settings
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