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A new report by UNICEF has revealed that 67 million children missed out on one or more vaccinations over the past three years due to disruptions caused by various factors, including the diversion of scarce resources, conflict and fragility, and decreased confidence in the importance of vaccines.

UNICEF warns that the COVID-19 pandemic has caused a significant decline in public perception of the importance of vaccines for children in 52 out of 55 countries studied. The report, titled “The State of the World’s Children 2023: For Every Child, Vaccination,” reveals that the perception of the importance of vaccines for children declined by more than a third in some countries, including the Republic of Korea, Papua New Guinea, Ghana, Senegal, and Japan, after the pandemic’s onset. The data collected by The Vaccine Confidence Project and published by UNICEF indicates that China, India, and Mexico were the only countries studied where the data suggests the perception of the importance of vaccines held firm or even improved. The report further reveals that people under 35 and women were more likely to report less confidence about vaccines for children after the start of the pandemic.

Vaccine confidence is time-specific and volatile, and further data collection and analysis will be necessary to determine whether the findings are indicative of a longer-term trend. The report warns that despite the overall support for vaccines remaining relatively strong, the confluence of several factors suggests that the threat of vaccine hesitancy may be growing. These factors include uncertainty about the response to the pandemic, growing access to misleading information, declining trust in expertise, and political polarisation.

Catherine Russell, UNICEF Executive Director, stated, “At the height of the pandemic, scientists rapidly developed vaccines that saved countless lives. But despite this historic achievement, fear and disinformation about all types of vaccines circulated as widely as the virus itself. This data is a worrying warning signal. We cannot allow confidence in routine immunizations to become another victim of the pandemic. Otherwise, the next wave of deaths could be of more children with measles, diphtheria, or other preventable diseases.”

The decline in confidence comes amid the largest sustained backslide in childhood immunisation in 30 years, fuelled by the COVID-19 pandemic. Childhood vaccination was interrupted almost everywhere due to intense demands on health systems, the diversion of immunisation resources to COVID-19 vaccination, health worker shortages, and stay-at-home measures. The report warns that a total of 67 million children missed out on vaccinations between 2019 and 2021, with vaccination coverage levels decreasing in 112 countries. Children born just before or during the pandemic are now moving past the age when they would typically be vaccinated, highlighting the need for urgent action to catch up on those who were missed and prevent deadly disease outbreaks.

The report indicates that in 2022, for example, the number of measles cases was more than double the total in the previous year, and the number of children paralysed by polio was up 16 per cent year-on-year. Comparing the 2019 to 2021 period with the previous three-year period, there was an eight-fold increase in the number of children paralysed by polio, underscoring the need to ensure vaccination efforts are sustained.

The pandemic exacerbated existing inequities, with vaccination remaining unavailable, inaccessible, or unaffordable for far too many children, especially in the most marginalised communities. Even before the pandemic, progress on vaccination had stalled for almost a decade as the world struggled to reach the most marginalised children. Of the 67 million children who missed out on routine vaccination.

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