WHO and UNICEF: Updates on immunization coverage and how can we improve upon?

Abstract

Sir, Immunization has been globally acknowledged as a cost-effective intervention that can prevent illness, disability, and death, resulting because of vaccine-preventable diseases.[1,2] Even though the recent immunization coverage trends reveal a stable picture with immunization, preventing almost 2-3 million deaths on an annual basis, yet, almost 21.8 million infants worldwide fail to receive basic vaccines.[2] In an attempt to address the problem of averting vaccine-preventable diseases, in the year 2012, the member states of the World Health Assembly adopted the Global Vaccine Action Plan (GVAP).[3] The goal of the plan was to prevent the death of millions of people by 2020 through ensuring universal accessibility to all existing vaccines for all the people, irrespective of their geographical locality.[3] However, to achieve the final goal, six midterm targets were proposed (to be achieved by 2015), namely, 90% immunization coverage against diphtheria, pertussis, and tetanus (DPT), introduction of underutilized vaccines in at least 90 low- or middle-income nations, ensuring no new cases of polio after 2014, elimination of maternal and neonatal tetanus, elimination of measles from three World Health Organization (WHO) regions, and elimination of rubella from two WHO regions.[3,4] In fact, to keep a check on the expansion of immunization services on a national scale, methods such as using routine immunization data, or periodic immunization coverage surveys have been advocated by the WHO.[5] The findings of a report recently released by the WHO and the United Nations Children's Fund (UNICEF) revealed that in contrast to the estimates obtained in the year 2000, the number of member states reaching and maintaining 90% coverage of children with routine lifesaving vaccinations has doubled.[6] In fact, in the year 2014, 129 nations across the world successfully achieved immunization rates of up to 90% with DPT3 vaccine (third dose) among infants.[6] In addition, India, which was considered as home to the largest number of unvaccinated children globally, has now achieved over 80% DPT3 coverage due to the revamping of the national immunization program, following the eradication of polio.[6] But then, the alarming concern is that the global estimates pertaining to five out of the six proposed GVAP targets are offtrack and thus, there is an indispensable need to revisit the approach and redefine the existing strategies to ensure that the immunization services in the remaining 65 nations are strengthened.[4,6] Another shocking estimate suggests that only 19% of children have received the rotavirus vaccine and that most parts of the nation have not even introduced the vaccine despite accounting for the largest share of diarrheal diseases.[6] Moreover, in order to address the existing gap in immunization, strategies such as facilitating integration of immunization with other maternal and child health-related strategies, strengthening the health care delivery system to enable continuation of routine immunization services at times of public health emergencies, and implementing measures to increase the universal accessibility for vaccines, have been advocated by the WHO and the UNICEF.[2,3,4,6,7] To conclude, immunization against vaccine-preventable disease is a lifesaving intervention. Even though the current estimates do not match with our expectations, a significant improvement in immunization coverage has been observed. Thus, it is the responsibility of the policy makers and other stakeholders to strengthen the routine immunization campaign and achieve the ultimate goal of the GVAP. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.