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What can be done to address the decrease in childhood vaccination adherence?

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WORLDWIDE IMMUNIZATION

Before the pandemic, global vaccination coverage had already stagnated, and even declined. A situation that is leading to outbreaks in different pathologies that were controlled

A health worker administers an oral polio vaccine to a child. (Photo. Contact Photo)

The pandemic dealt a severe blow to the universal vaccination coverage. From 2019 to 2020, according to data from the World Health Organization (WHO), coverage fell 3%, from 86% to 83%. It was the year in which the Covid-19 health emergency made it difficult to administer care and vaccination globally. It is estimated that 23 million children under one year of age did not receive basic vaccinations, “which is the highest figure since 2009”, exposes the WHO, 3.4 million children more than the previous year.

Immunization has allowed reduce the mortality of children under 5 years of age by 47% between 2000 and 2019 (from 9.7 million deaths to 5.2 million), according to data from a study published in September 2021 in ‘The Journal of Infectious Diseases’. However, even before the pandemic, it had been observed a stagnation of vaccination coverage and even a decrease. In the same study the authors note that in 2019, “20 million children were unvaccinated or undervaccinated with DTP3, and 14 million of them did not even receive the first dose of DTP, called ‘zero dose’ children.”

If it is possible to recover adherence to the Covid-19 vaccination, “it can also be done for other vaccines”.

They were mainly children from the African continent or East Asia, who due to the lack of resources could not access the inoculations. This has led in recent times to outbreaks such as those of measles, since 40 million children had not received the first dose of the vaccine in 2021, and 14.7 million had not completed the regimen in the world, according to data from a report by the WHO and the Centers for Disease Control and Prevention of the United States (CDC).

But the reduction in vaccination coverage is a problem that is occurring throughout the world as a result of parental reluctance or misinformation on “the safety and development of vaccines”, say Isabelle Munyagaju, Elisa López-Varela and Quique Bassat, IS Global researchers at the Hospital Clínic de Barcelona in an editorial published in ‘The BMJ’. It was a problem that was experienced with the Covid-19 vaccines, 20% of Spanish parents refused to put it on their children, according to the COSMO-Spaib study.

EXPERT RECOMMENDATIONS

What to do to increase vaccination? This is a question that different experts have asked in different scientific studies and editorials. There are problems of economic and personal resources, social awareness, access to sera. And the reality is that with Covid-19, however, it was seen that all this could be avoided with joint work (COVAX) or universal vaccination campaigns.

This is reflected by the Catalan authors, who point out that if it is achieved regain adherence to the Covid-19 vaccination, “It can also be done for other vaccines.” To this end, they point out that countries should include all age groups in their routine immunization programs to reach high-risk groups (older people, health workers, people with underlying disorders) and “include newer adult vaccines such as influenza and shingles.

WHO: “Immunization is an investment in the future, creating a healthier, safer and more prosperous world for all”

Also, they point out, the implementation of digital health should be accelerated, which will allow “more effective” vaccine delivery, monitoring and surveillance. Of course, they also call for increased investment to “guarantee a strong health care workforce both in number and quality of training”; create regional manufacturing and distribution centers for vaccines and health supplies in low- and middle-income countries to facilitate equitable access to vaccines, in the face of the “Covax failure,” and employ social marketing and mobilization activities to address social hesitancy to vaccines and decreased demand for vaccines in routine immunization programs.

In August 2020, the WHO approved the ‘Immunization Agenda 2030: a global strategy to leave no one behind (IA2030)’, what has the goal of “a world in which everyone, everywhere, at any age, fully benefits from vaccines to improve health and well-being.” Personalized programs and focus efforts on immunization as an essential part of Primary Care, since vaccines are the health service that most people receive.

With the efforts and recommendations of experts and organizations, and the experience gained with Covid-19, it is expected to return to the recovery of vaccination coverage, and to improve the historical data. As the WHO points out: “Immunization is an investment in the future, creating a healthier, safer and more prosperous world for all”.

Because health we all need… ConSalud.es

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