Brazzaville – Around 7.7 million African children missed out on vital first doses of Diphtheria-Tetanus-Pertussis, Measles and Polio vaccines in 2020. The nearly 10% rise in missed vaccinations on the previous year in Africa was driven by disruptions to health services by the COVID-19 pandemic, new data by the United Nations Children’s Fund (UNICEF) and World health Organization (WHO) show.

Three African countries are among the top 10 countries globally to record the greatest number of unvaccinated children in 2020 for the first dose of Diphtheria-Tetanus-Pertussis (DTP -1) and Measles: Ethiopia, Nigeria and the Democratic Republic of Congo. Overall, Africa still accounts for the highest percentage of ‘zero dose’ children (those who have not received DTP -1) in the world.

Despite impressive efforts to scale up supplemental immunization campaigns while grappling with the myriad demands of the pandemic, the 7.7 million children in Africa that missed DTP-1 vaccines make up 45% of the global figure.

The WHO-UNICEF Estimates of National Immunization Coverage—published on 15 July—are the first to reflect global service disruptions due to COVID-19. In 2020, 3.7 million more children globally missed out on routine immunization than in 2019. In Africa, 1.7 million children did not receive their third dose of the DTP containing vaccine in 2020.

Data for the WHO African Region showed reductions in percentage coverage across the board between 2019 and 2020. Coverage for the DTP-1 vaccine fell by a percentage point to 79% in 2020, for DTP-3 from 74% to 72%, and for MCV1 from 70% to 68%. Globally, DTP-1 coverage fell from 90% to 87% between 2019 and 2020, from 86% to 83% for DTP-3, and 86% to 84% for MCV1.

These vaccination rates are far below the 90% coverage target of Africa’s Regional Vaccine Action Plan and far below the 95% coverage recommended by WHO to protect against measles. The global Immunization Agenda 2030 meanwhile, has the ambitious target of achieving 90% coverage for all essential childhood vaccinations in the next nine years.

Between January 2020 and April 2021, eight African countries reported major measles outbreaks affecting tens of thousands of children largely due to low routine immunization coverage or delayed vaccination campaigns. In addition, in 2020 the quality of measles surveillance in Africa fell to its lowest level in seven years, with only 11 countries meeting their target.

Dr Tedros Adhanom Ghebreyesus, WHO Director-General, expressed concern that while countries were focusing on COVID-19 vaccines, children were being put at risk.

“We have gone backwards on other vaccinations, leaving children at risk from devastating but preventable diseases like measles, polio or meningitis,” he said, warning that multiple disease outbreaks could be catastrophic for communities and health systems already under pressure from COVID-19.

“This makes it even more urgent than ever to invest in childhood vaccinations and to ensure that every child is reached,” Dr Tedros cautioned.