- WHO and UNICEF warn of a decline in vaccinations during COVID-19
- SEARCH FOR VACCINES IN HIGHER GEAR ….More than 150 countries engaged in Covid-19 vaccine global access facility – WHO
- Vaccination coverage stalled at 85 per cent for nearly a decade, with 14 million unvaccinated infants yearly –UN agencies
- Seventy-five countries submit expressions of interest to COVAX Facility,
- Join 90 other countries that could be supported by the COVAX Advance Market Commitment (AMC)
The World Health Organisation and UNICEF have called for immediate efforts to vaccinate all children as new data show that, before the COVID-19 pandemic, vaccine coverage stalled at 85 per cent for nearly a decade, with 14 million unvaccinated infants yearly. World Health Organization and UNICEF warned today of an alarming decline in the number of children receiving life-saving vaccines around the world. This is due to disruptions in the delivery and uptake of immunization services caused by the COVID-19 pandemic. According to documents provided by WHO and UNICEF, these disruptions threaten to reverse hard-won progress to reach more children and adolescents with a wider range of vaccines, which has already been hampered by a decade of stalling coverage.
The latest data shows that improvements such as the expansion of the HPV vaccine to 106 countries and greater protection for children against more diseases are in danger of lapsing. For example, preliminary data for the first four months of 2020 points to a substantial drop in the number of children completing three doses of the vaccine against diphtheria, tetanus, and pertussis (DTP3). This is the first time in 28 years that the world could see a reduction in DTP3 coverage – the marker for immunization coverage within and across countries.
“Vaccines are one of the most powerful tools in the history of public health, and more children are now being immunized than ever before,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “But the pandemic has put those gains at risk. The avoidable suffering and death caused by children missing out on routine immunizations could be far greater than COVID-19 itself. But it doesn’t have to be that way. Vaccines can be delivered safely even during the pandemic, and we are calling on countries to ensure these essential life-saving programmes continue.”
COVID-19 disruptions Due to the COVID-19 pandemic, at least 30 measles vaccination campaigns were or are at risk of being cancelled, which could result in further outbreaks in 2020 and beyond. According to a new UNICEF, WHO and Gavi pulse survey, conducted in collaboration with the US Centers for Disease Control, the Sabin Vaccine Institute and Johns Hopkins Bloomberg School of Public Health, three-quarters of the 82 countries that responded reported COVID-19 related disruptions in their immunization programmes as of May 2020.
The reasons for disrupted services vary. Even when services are offered, people are either unable to access them because of reluctance to leave home, transport interruptions, economic hardships, restrictions on movement, or fear of being exposed to people with COVID-19. Many health workers are also unavailable because of restrictions on travel or redeployment to COVID response duties as well as a lack of protective equipment. “COVID-19 has made previously routine vaccination a daunting challenge,” said UNICEF Executive Director Henrietta Fore. “We must prevent a further deterioration in vaccine coverage and urgently resume vaccination programs before children’s lives are threatened by other diseases. We cannot trade one health crisis for another.”
Stagnating global coverage rate: Progress on immunization coverage was stalling before COVID-19 hit, at 85 per cent for DTP3 and measles vaccines. The likelihood that a child born today will be fully vaccinated with all the globally recommended vaccines by the time she reaches the age of 5 is less than 20 per cent. In 2019, nearly 14 million children missed out on life-saving vaccines such as measles and DTP3. Most of these children live in Africa and are likely to lack access to other health services. Two-thirds of them are concentrated in 10 middle- and low-income countries: Angola, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Mexico, Nigeria, Pakistan, and Philippines. Children in middle-income countries account for an increasing share of the burden.
Progress and challenges, by country and region: There has been some progress. Regional coverage for the third dose of DTP in South Asia has increased by 12 percentage points over the last 10 years, notably across India, Nepal and Pakistan. However, that hard-won progress could be undone by COVID-19 related disruptions. Countries that had recorded significant progress, such as Ethiopia and Pakistan, are now also at risk of backsliding if immunization services are not restored as soon as feasible.
The situation is especially concerning for Latin America and the Caribbean, where historically high coverage has slipped over the last decade. In Brazil, Bolivia, Haiti and Venezuela, immunization coverage plummeted by at least 14 percentage points since 2010. These countries are now also confronting moderate to severe COVID19-related disruptions. As the global health community attempts to recover lost ground due to COVID-19 related disruptions, UNICEF and WHO are supporting countries in their efforts to re-imagine immunization and build back better by:
- Restoring services so countries can safely deliver routine immunization services during the COVID-19 pandemic, by adhering to hygiene and physical distancing recommendations and providing protective equipment to health workers;
- Helping health workers communicate actively with caregivers to explain how services have been reconfigured to ensure safety;
- Rectifying coverage and immunity gaps
- Expanding routine services to reach missed communities, where some of the most vulnerable children live.
Meanwhile, another statement from the Geneva headquarters of the World Health Organisation says ‘’seventy-five countries have submitted expressions of interest to protect their populations and those of other nations through joining the COVAX Facility, a mechanism designed to guarantee rapid, fair and equitable access to COVID-19 vaccines worldwide. The 75 countries, which would finance the vaccines from their own public finance budgets, partner with up to 90 lower-income countries that could be supported through voluntary donations to Gavi’s COVAX Advance Market Commitment (AMC). Together, this group of up to 165 countries represents more than 60% of the world’s population. Among the group are representatives from every continent and more than half of the world’s G20 economies.
“COVAX is the only truly global solution to the COVID-19 pandemic,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. ““For the vast majority of countries, whether they can afford to pay for their own doses or require assistance, it means receiving a guaranteed share of doses and avoiding being pushed to the back of the queue, as we saw during the H1N1 pandemic a decade ago. Even for those countries that are able to secure their own agreements with vaccine manufacturers, this mechanism represents, through its world-leading portfolio of vaccine candidates, a means of reducing the risks associated with individual candidates failing to show efficacy or gain licensure.”
The COVAX Facility forms a key part of the COVAX pillar (COVAX) of the Access to COVID-19 Tools (ACT) Accelerator, a ground-breaking global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. COVAX is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO, working in partnership with developed and developing country vaccine manufacturers. COVAX aims to accelerate the development and manufacture of COVID-19 vaccines and to guarantee fair and equitable access for every country in the world.
It will achieve this by sharing the risks associated with vaccine development, investing in manufacturing upfront so vaccines can be deployed at scale as soon as they are proven successful, and pooling procurement and purchasing power to achieve sufficient volumes to end the acute phase of the pandemic by 2021. “This early level of interest represents a tremendous vote of confidence in COVAX and our shared goal to protect people around the globe through the fair allocation of a COVID-19 vaccine,” said Dr Richard Hatchett, CEO of CEPI. “COVAX offers an innovative solution to the gravest public health crisis in living memory. It will speed up the availability of safe and effective vaccines through early investment in manufacturing capacity, and maximise the chances of success by backing a broad and diverse portfolio of vaccine candidates.
Through COVAX our aspiration is to be able to vaccinate the most vulnerable 20% of the population of every country that participates, regardless of income level, by the end of 2021. Ensuring fair access is not only a matter of equity; it is the fastest way to end this pandemic” The goal of COVAX is by the end of 2021 to deliver two billion doses of safe, effective vaccines that have passed regulatory approval and/or WHO prequalification. These vaccines will be delivered equally to all participating countries, proportional to their populations, initially prioritizing healthcare workers then expanding to cover 20% of the population of participating countries. Further doses will then be made available based on country need, vulnerability and COVID-19 threat. The COVAX Facility will also maintain a buffer of doses for emergency and humanitarian use, including dealing with severe outbreaks before they spiral out of control.
“The COVID-19 pandemic, like every health crisis, also presents us with opportunities,” said Dr. Soumya Swaminathan, WHO Chief Scientist. “A vaccine that is affordable and accessible to all will help us address systemic health inequalities. We need all countries to support COVAX to achieve this goal and bring an end to the acute phase of the pandemic.” The success of these efforts will ultimately depend on securing enough funding from governments and commitments from vaccine manufacturers to participate at a scale large enough to deliver a global solution. The formal expressions of interest submitted are non-binding; the COVAX pillar will now begin a process of consultation with all 165 countries, with countries funding vaccines through their own domestic budgets being required to provide an upfront payment and a commitment to purchase doses by the end of August to secure involvement in the COVAX Facility.
Significant progress has been achieved by the COVAX partners to date, with seven of the nine candidate vaccines supported by CEPI already in clinical trials. A memorandum of understanding with AstraZeneca also commits them to supply 300 million doses of COVID-19 vaccines to COVAX. In addition, in June Gavi launched the COVAX Advance Market Commitment (AMC), a financing instrument aimed at incentivizing vaccine manufacturers to produce sufficient quantities of eventual COVID-19 vaccines to ensure access for developing countries. The AMC has already raised close to US$ 600 million against an initial target of US$ 2 billion from high-income donors as well as the private sector. The Gavi Alliance will also work with the developing countries to assure the readiness of supply and cold chain and training to reach high-risk groups.