WHO warns of slow introduction of recommended vaccines

Key takeaways:

• The proportion of countries that have introduced four WHO-recommended vaccines is between 57% and 72%.
• Enhanced efforts are needed to increase uptake and ensure equitable distribution, researchers said.

The introduction of eight WHO-recommended vaccines into national immunization schedules slowed during the COVID-19 pandemic, researchers reported in MMWR.

Prior to the pandemic, the annual number of countries introducing the recommended vaccines was increasing. However, by 2021, just 17% of countries routinely offered all eight, according to the new report.

Most countries offered pneumococcal conjugate, rubella, measles and Haemophilus influenzae type b (Hib) vaccines, but uptake of four other vaccines ranged from just 57% to 72%.

According to the report, the annual number of vaccine introductions worldwide declined sharply at the start of the COVID-19 pandemic, from 48 in 2019 to 15 in 2020, before rising to 26 in 2021.

“To achieve WHO Global Immunization Agenda goals, increased efforts to accelerate introductions of new and underused vaccines are urgently needed,” the CDC said in a summary of the findings sent to reporters. “Equitable access to vaccines is critical, including vaccines delivered beyond the first year of life.”

According to the report, a hepatitis B birth dose and vaccines against HPV, rotavirus, and diphtheria, tetanus and pertussis (DTaP) were offered by only 57%, 59%, 60% and 72% of countries in their routine immunization schedules, respectively.

It was more common for countries to routinely include pneumococcal conjugate (78%), rubella (89%), measles (94%) and Hib (99%).

By 2021, only 33 of 194 countries provided all eight as part of their routine immunization schedules, including only one low-income country.

The most underutilized vaccines in low-income countries included an initial booster of DTaP, the HBV birth dose, and the HPV vaccine, according to the researchers. “In high-income countries, [rotavirus] vaccine is the most underutilized vaccine,” they added. “Global partners including Gavi, the Vaccine Alliance, have been working to address challenges around supply and affordability so that the growing portfolio of newly licensed vaccines can be introduced worldwide more rapidly,” the authors wrote.

They said it was “encouraging” that although COVID-19 caused disruptions to essential health services, countries continued to introduce vaccines into their national schedules but added that “urgent recovery actions” are still needed.

“The COVID-19 vaccination response during the pandemic has highlighted the importance of building strong vaccination delivery platforms through childhood and across the life-course,” they wrote.