WHO/UNICEF program aims for 90% coverage of DTP3 vaccine

CDC. MMWR. 2010;59:1367-1371.

A global health program established by WHO and UNICEF continues to work toward a goal of 90% coverage for the three-dose diphtheria-tetanus-pertussis vaccine among infants aged 12 months in WHO member states.

In addition, the Global Immunization Vision and Strategy (GIVS) aimed to achieve 80% coverage in every district or equivalent administrative unit by the end of 2010. Sustaining these goals through 2015 is also an established program goal, according to a recent Morbidity and Mortality Weekly Report that summarized coverage rates for 2000-2009.

The agreed-upon indicator of immunization program performance is three-dose diphtheria-tetanus-pertussis (DTP3) coverage by aged 12 months. Global coverage of children with DTP3 vaccine during the first year of life has increased from 74% in 2000 to 82% in 2009. The overall increase has been attributed to vaccination coverage improvements in African, Eastern Mediterranean and Western Pacific WHO regions.

However, there are substantial regional variations in coverage. Approximately 23 million children, half of whom live in India and Nigeria, did not receive DTP3 coverage during the first year of life.

In an accompanying editorial, researchers from the CDC said the global increase in vaccination coverage can obscure regional and local deficits in access to health services resulting from weak health systems, poor planning and resource management, limited outreach, inadequate supervision and ineffective use of data.

“Countries such as Nigeria and India, home to approximately half the world’s children who are not fully protected with three doses of DTP, will need to establish efficient, effective vaccination services that reach underserved populations to achieve vaccination targets,” the researchers said.

Further reductions in morbidity and mortality are expected with the introduction of vaccines that are new to these countries, such as the Haemophilus influenzae type b vaccine, hepatitis B vaccine, pneumococcal conjugate vaccine and rotavirus vaccine. Several countries, including China, India, Indonesia and Nigeria, have yet to introduce all of these vaccines, and therefore, some of these countries will not reach the 2010 vaccine goals.

Ensuring ongoing funding for existing vaccines, as well as the introduction of new and underutilized vaccines that have the potential to reduce childhood morbidity and mortality, will be a challenge. To achieve the GIVS goals and increase vaccination coverage, it is critical to strengthen immunization systems and prioritize and implement effective strategies in all countries, according to the MMWR report.

WHO and UNICEF created the GIVS in 2005 to protect more people against more diseases, by increasing vaccination coverage, introducing new vaccines and linking vaccination with provision of other health services.

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