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Global health efforts focus on improving immunization rates in children, ensuring equity in COVID-19 vaccine access

April 1, 2021

Courtesy of WHO/Blink Media – Fabeha Monir

Reduced routine childhood immunizations and a slow rollout of COVID-19 immunizations to low- and middle-income countries are emerging threats to the health of children, pediatricians and immunizers worldwide, according to several reports.

Disease risks, myths

According to UNICEF, more than 13 million children did not receive any vaccines before COVID-19 disrupted global immunization efforts. The pandemic has caused mass polio and measles campaigns to be postponed. And for the first time in 28 years, diphtheria-tetanus-pertussis vaccine coverage declined during the first quarter of 2020, according to a report from the World Health Organization (WHO) and UNICEF.

To better understand the impact of COVID-19 on pediatric populations globally, the AAP partnered with the Centers for Disease Control and Prevention Global Immunization Division on a descriptive survey of pediatric providers in Indonesia and Nigeria. A preliminary analysis of the data found that pediatricians, general practitioners, nurse midwives and nurses experienced unilateral declines in the demand for immunizations and routine care since the start of the pandemic.

More than half of providers surveyed also reported receiving an increased number of questions/concerns about vaccine safety and vaccine-associated rumors. However, less than 40% of respondents were using formal strategies to improve families’ comfort in bringing their children for routine care.

The AAP is looking at how to support pediatric providers in countries whose pediatric societies do not have the same level of resources so they can continue reaching children using lessons learned from U.S. successes.

Equitable distribution of COVID-19 vaccine

The AAP issued a Transition Plan for a Leading Nation ( in 2020 to alert the incoming Biden administration about declines in essential health care services for children and their families around the world and access to routine childhood immunizations due to the pandemic.

Among recommendations, the AAP urged the U.S. to support COVAX (, the effort to accelerate development, production and equitable access to COVID-19 vaccines for low- and middle-income countries. COVAX aims to provide up to 2 billion doses of vaccine — covering approximately 3% of low- and middle-income countries’ populations — by the end of 2021.

By the end of May, 237 million doses of vaccines are expected to be allocated to 142 participating economies and countries in COVAX, WHO Director-General Tedros Adhanom Ghebreyesus, Ph.D., said at a press conference. On March 1, Ghana and Cote d'Ivoire began vaccinating health workers, becoming the first countries to start vaccination campaigns with doses supplied through COVAX. Vaccination of health workers in lower-income countries began three months after wealthier nations, he noted.

“Countries are not in a race with each other. This is a common race against the virus,” Dr. Ghebreyesus said. “We're asking all countries to be part of a global effort to suppress the virus everywhere.”

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