This ambition reflects the central shift in the Gavi 5.0 strategy of reaching zero-dose children and missed communities with a full course of vaccines in conjunction with stronger PHC services and an increased focus on programmatic sustainability. It can also be the first step towards comprehensive primary healthcare – providing opportunities for multi-agency and cross-sector coalitions to drive broader social change including gender equality. Improvements in routine immunisation coverage has contributed to a large reduction in child deaths and recent analysis of immunization coverage trends show the importance of centering approaches on equity and underserved communities in order to avoid a further plateau of coverage in the coming decade. Over three-quarters of under-immunised children are now zero dose, heightening the risk of child deaths, disease outbreaks and medical impoverishment. After a successful reduction of 1.7 million zero-dose children over the previous four years, 2020 saw an increase of 3.1 million zero-dose children and 3.0 million underimmunised children in Gavi68 countries compared to 2019.Īvailable data suggests the largest disruptions were concentrated in Q2 2020, with the majority of countries restoring routine immunisation services in the second half of the year.
The estimated decline in DTP3 coverage was almost entirely due to a nearly 30% increase in zero-dose children, highlighting the importance of reaching children with a first dose of vaccine. Therefore, Gavi’s mission to save lives by strengthening routine immunisation services and reaching zero dose children and missed communities has become even more urgent, along with supporting countries to deliver COVID-19 vaccines.ĬOVID-19 related disruptions led to a 4 percentage point drop in coverage in 2020. The most vulnerable populations have been hardest hit by the pandemic. įigure 1: Progress in reaching zero-dose and under-immunised children in Gavi implementing countries (Gavi57 country data). Two-thirds of these children live in extremely poor households suffering from multiple deprivations including lack of access to reproductive health services, water and sanitation. 78% of these children, 12.4 million in total, did not receive a single dose of DTP-containing vaccines and are defined as “zero-dose.” Pre-pandemic analyses suggest nearly 50% of vaccine preventable deaths occur among zero-dose children. In 2020, approximately 16 million of the 72.9 million children targeted with Gavi support did not receive their third dose of DTP-containing vaccine. Communities not receiving immunisation services are likely not receiving any other essential health services. Immunisation now reaches more communities than most other routine health interventions though we are still far from the goal of leaving no one behind with immunisation. In 2019, coverage for the same countries reached 82% before sliding back to 78% due to the COVID-19 pandemic. In Gavi-eligible countries, coverage of key vaccines increased by 3 percentage points from 2015 to 2019, and the number of zero dose children reduced by 14% ( Figure 1). In 2000, just 47% of children in lower-income countries received basic (DTP3) vaccines. These commitments follow decades of progress made by governments with support from the global health community and build on the achievements of the Alliance’s “Coverage & Equity” agenda in Gavi 4.0. Continuous improvements of programmes in range and quality of services.Caregivers bring children to vaccination services.All vaccines in the national schedule along the life course are available to missed communities.High quality immunisation services are sustainably available to missed communities where and when they are needed.The equity goal: Health systems sustainably reach all zero-dose and under-immunised children and their communities with the full range of vaccines as the first step towards providing integrated Primary Health Care (PHC) services. Gavi 5.0 Strategy: “Leaving no-one behind with immunization” by reaching zero-dose and missed communities
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