Despite low cost vaccines, too few children and women immunized – UN report

With vaccine-preventable diseases killing some 1.4 million children under five annually, the United Nations Children’s Fund (UNICEF) warned today that an estimated 27 million children and 40 million pregnant women are not being immunized each year and 41 countries are protecting fewer youngsters than a decade ago.

“Immunization is one of the safest and most cost-effective interventions we know. We need to protect the gains we have made in many countries and expand our efforts in others,” UNICEF Executive Director Ann M. Veneman said of the country-by-country data contained in a new agency report, Progress for Children.

Immunization is currently preventing some 2 million deaths among children under five every year and the study shows that 103 countries are already protecting 90 per cent of their children against vaccine-preventable diseases while another 16 are making steady progress. But in 74 countries programmes have not kept up, or progress is too slow, particularly in West and Central Africa.

The major killers are measles, haemophilus influenzae type b (Hib), whooping cough (pertussis) and neonatal tetanus, all of which are preventable with vaccines that are currently available at low cost.

In the near future, an additional 1.1 million deaths could be prevented with vaccines against pneumococcus and rotavirus, important causes of severe pneumonia and diarrhea in developing countries. In total, immunization programmes could reduce deaths among children under five by almost one-quarter if coverage of more than 90 per cent can be attained for routine immunization.

“By improving immunization coverage, bringing on new vaccines when they become available and linking immunization with other interventions, such as distribution of malaria bed-nets, we can contribute dramatically to the key Millennium Development Goal (MDG)of improving child survival,” Ms. Veneman said of the target of reducing under-five mortality by two-thirds by 2015.

The report shows some harsh regional inequities. In 2003, the last year for which there is comprehensive data, 90 per cent of children in industrialized countries were protected by immunization and most countries in Latin America and the Caribbean, Central and Eastern Europe, the Commonwealth of Independent States, Middle East and North Africa have also made progress.

But the majority of countries in West and Central Africa, where only 52 per cent of children are routinely vaccinated, still need to rapidly improve their immunization programmes. The news, however, is not all bad. Coverage rates in some resource-poor countries have improved dramatically. Eritrea has expanded routine immunization coverage from 18 per cent in 1990 to 84 per cent in 2003, Niger from 25 per cent to 64 per cent and Uganda from 52 per cent to 82 per cent.

In addition, measles-related mortality, according to a recent article published in the Lancet, has dropped by almost half over the last five years, thanks to the success of mass measles immunization campaigns. Within five years, measles could be the first in the list of key vaccine-preventable diseases that become rare in developing countries.