This informal CPD article ‘Understanding Global Immunisation Progress and Challenges: A 2023 Review’ was provided by Cima Care, who offer extensive training in vaccination and public health, advancing global health initiatives.
Have you ever wondered about the current state of global immunisation? Looking back at 2023, we have seen some remarkable achievements alongside continued challenges in protecting children worldwide against preventable diseases. Let's study seven key areas that shaped our public health landscape in 2023.
1. Where Do We Stand Today?
The story of global vaccination in 2023 is one of various progress. Here's what might surprise you: despite best efforts, about 11 million children in developing regions did not receive any essential vaccines last year - which is 500,000 more than the previous year¹⁶. These children are known as "zero-dose," and they convey one of our most demanding public health challenges.
Think about this: while there was work to cover 108 million children with the crucial diphtheria-tetanus-pertussis (DTP) vaccine, maintaining 84% coverage, 14.5 million children still missed their first DTP dose. Even more concerning, 6.5 million did not complete their three-dose series¹.
Remember measles? It is still a significant concern. Coverage dropped from 86% in 2019 to 83% in 2023, leaving 22.2 million children without their first dose⁴. This highly contagious disease is often an early warning of growing immunity gaps.
2. The Good News
There has though been some exciting progress! The Human Papillomavirus (HPV) vaccine has made remarkable strides. First-dose coverage among girls jumped from 20% to 27% in 2023¹. What does this mean in real terms? Over 24.3 million doses were distributed worldwide², making a real difference in cancer prevention. In sub-Saharan Africa alone, there has been an HPV uptake of 28.53% among adolescent girls⁷.
3. Mind the Gap
Here is something that might make you think: while nearly 80% of people in high-income countries have received at least one vaccine dose, the story is quite different in lower-income countries. These countries face a stark challenge - they need to increase their health spending by 30-60% to achieve 70% vaccination rates. Compare this to rich countries, which only need to increase spending by 0.8% for the same coverage³.
4. Spotlight on Africa
Africa's immunisation journey tells a tale of contrasts. While some regions struggle—take Sudan, where vaccination rates dropped from 75% to 57%, leaving 701,000 children unprotected⁵ —others shine brightly. Rwanda, for instance, stands as a beacon of hope with more than 90% coverage for children under five⁸. It is a strong reminder of what is possible with dedicated public health endeavors.
Climate change impacting vaccination efforts
5. Broadening Our Shield
Did you know health services are now defending against more diseases than ever before? In 2023, they achieved 56% coverage against ten major diseases, including polio, measles, and yellow fever¹. Services are not just concentrating on childhood diseases anymore— protection now extends from adolescent tuberculosis prevention to maternal health initiatives⁹.
6. Climate Change: The New Challenge
Here's something you might not have considered: climate change is impacting vaccination efforts in stunning ways. Rising temperatures are not just changing weather patterns—they are expanding the range of vaccine-preventable diseases and making vaccine storage trickier¹¹. But we are adjusting! Scientists are developing heat-stable vaccines and improving cold chain technologies to ensure vaccines stay effective in challenging conditions¹²'¹³.
7. The Future is Here
Remember the buzz around mRNA vaccines? Well, that technology is opening exciting new doors. Scientists are now working on improved vaccines for long-standing challenges like malaria, tuberculosis, and HIV¹⁴. This progress could mean more enduring vaccines that do not need strict storage conditions—imagine what that could mean for reaching remote areas¹¹!
Final Thoughts
As we work towards the Immunisation Agenda 2030 (IA2030)¹⁰, protecting more people against a wider range of diseases requires innovative thinking and teamwork. It will mean bringing together parents, healthcare providers, and medical facilities to tackle key challenges head-on - whether it is reaching under-vaccinated children, addressing misinformation, tracking missed appointments, supporting healthcare workers, or maintaining professional excellence through ongoing education.
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References:
1-.Global childhood immunization levels stalled in 2023, leaving many without life-saving protection [Internet]. www.who.int. Available from: https://www.who.int/news/item/15-07-2024-global-childhood-immunization-levels-stalled-in-2023-leaving-many-without-life-saving-protection
2- 2023 End of Year Results Summary Extended Narrative [Internet]. NNICEF. Denmark: UNICEF; 2024 Apr [cited 2024 Sep 8] p. 1–10. Available from: https://www.unicef.org/media/155741/file/Supply-Division-2023-COAR.pdf
3- United Nations Development Programme. Global Dashboard for Vaccine Equity | Data Futures Platform [Internet]. UNDP. 2021. Available from: https://data.undp.org/insights/vaccine-equity
4- WHO. Immunization coverage [Internet]. Who.int. World Health Organization: WHO; 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/immunization-coverage
5- 1.AMB. UN: “700k+ children unvaccinated as immunisation plummets in Sudan” - Dabanga Radio TV Online [Internet]. Dabanga Radio TV Online. Radio Dabanga; 2024 [cited 2024 Sep 9]. Available from: https://www.dabangasudan.org/en/all-news/article/un-700k-children-unvaccinated-as-immunisation-plummets-in-sudan
6- Global partners announce a new effort – “The Big Catch-up” – to vaccinate millions of children and restore immunization progress lost during the pandemic [Internet]. www.who.int. Available from: https://www.who.int/news/item/24-04-2023-global-partners-announce-a-new-effort-the-big-catch-up-to-vaccinate-millions-of-children-and-restore-immunization-progress-lost-during-the-pandemic
7- Asgedom YS, Kebede TM, Seifu BL, Mare KU, Asmare ZA, Asebe HA, Kase BF, Shibeshi AH, Tebeje TM, Sabo KG, Fente BM. Human papillomavirus vaccination uptake and determinant factors among adolescent schoolgirls in sub-Saharan Africa: A systematic review and meta-analysis. Human Vaccines & Immunotherapeutics. 2024 Dec 31;20(1):2326295.
8- Asempah E, Wiktorowicz ME. Understanding HPV Vaccination Policymaking in Rwanda: A Case of Health Prioritization and Public-Private-Partnership in a Low-Resource Setting. International Journal of Environmental Research and Public Health. 2023 Oct 30;20(21):6998.
9- Vaccine Investment Strategy 2024 [Internet]. www.gavi.org. Available from: https://www.gavi.org/our-alliance/strategy/vaccine-investment-strategy-2024
10- Explaining the Immunization Agenda 2030 [Internet]. www.who.int. Available from: https://www.who.int/teams/immunization-vaccines-and-biologicals/strategies/ia2030/explaining-the-immunization-agenda-2030
11- Leedom M. How climate change is changing vaccination planning. BMJ: British Medical Journal (Online). 2024 Mar 19;384:q360.
12- Kim CL, Agampodi S, Marks F, Kim JH, Excler JL. Mitigating the effects of climate change on human health with vaccines and vaccinations. Frontiers in Public Health. 2023 Oct 12;11:1252910.
13- A one health approach to vaccine and climate research | Science for Africa Foundation [Internet]. Scienceforafrica.foundation. 2024 [cited 2024 Sep 7]. Available from: https://scienceforafrica.foundation/media-center/one-health-approach-vaccine-and-climate-research
14- Matarazzo L, Bettencourt PJ. mRNA vaccines: a new opportunity for malaria, tuberculosis and HIV. Frontiers in Immunology. 2023 Apr 24;14:1172691.
15- Moderna Advances Multiple Vaccine Programs to Late-Stage Clinical Trials [Internet]. investors.modernatx.com. Available from: https://investors.modernatx.com/news/news-details/2024/Moderna-Advances-Multiple-Vaccine-Programs-to-Late-Stage-Clinical-Trials/default.aspx
16- Global immunisation in 2023: 7 things you need to know [Internet]. Gavi.org. 2023 [cited 2024 Sep 7]. Available from: https://www.gavi.org/vaccineswork/global-immunisation-2023-7-things-you-need-know
