Greater efforts needed to get routine immunization back to pre-COVID-19 times: WHO

New Delhi, 16 July: The World Health Organization today called for greater efforts in the South-East Asia Region to revive routine immunization rates to pre-COVID-19 times, as despite concerted efforts by countries, challenges and gaps persist.

“Commendably the Region has administered 3 billion doses of COVID-19 vaccines to date, since January 2021 when the first dose of vaccine was administered in the South-East Asia Region. As we focus on further scaling up COVID-19 vaccination coverage, we must also do all we can to ensure no child is deprived of life-saving vaccines offered under routine immunization services,” *said Dr Poonam Khetrapal Singh, Regional Director WHO South-East Asia.*

“Many counties have demonstrated that routine immunization can be maintained or scaled up along with COVID-19 vaccination”, *she said.* “This speaks for a very committed health work force which has to manage both considerable challenges.”

*Bangladesh, Maldives, Sri Lanka and Thailand* maintained high vaccination rates over 95% DTP3 coverage throughout the COVID-19 pandemic. *Bhutan* witnessed a slight decline in 2020 but surpassed its pre-pandemic coverage of 97% to record 98% DTP3 coverage in 2021. Globally, DTP3 (third dose of vaccines for diphtheria, tetanus and pertussis) in one-year old children, is a proxy indicator for immunization coverage. Nepal substantially revived routine immunization coverage for DTP3 from 84% in 2020 to 91% in 2021. These six countries have also achieved high COVID-19 vaccination coverage.

*Routine immunization coverage declines* witnessed in 2020 in India and Timor-Leste seem to have stabilized in 2021 indicating programme recoveries as well. In 2021 India provided close to 2 billion doses of COVID-19 and other childhood vaccines taken together, over 5 times more vaccines administered in the country during the year than in 2020.

All countries in the South-East Asia Region focused on routine immunization while prioritizing essential services during the pandemic and concerted efforts continue to be made to scale-up vaccination coverage, with a focus on identifying and vaccinating ‘missed children’.

Efforts for measles and rubella elimination, a flagship priority in the Region, continued during the pandemic. Nepal substantially increased the coverage for second dose of measles and rubella vaccine from *76% in 2019* to *87% in 2021.* Bangladesh, Bhutan, Maldives, and Sri Lanka maintained their respective coverage rates throughout the pandemic.

To revitalize routine immunization coverage following the COVID-19 pandemic, WHO convened a South-East Asia Regional Working Group on Immunization in March this year focusing on programme intensification. Strengthening catch-up campaigns, tracking unvaccinated and under vaccinated children, combining COVID-19 vaccination with routine immunization, training of health workers and addressing concerns of communities, were stressed.

However, concerns and challenges remain. Routine immunization *coverage dropped in Myanmar* , also due to the political situation and in DPR Korea as the country closed its borders including for essential medicines and supplies.

“WHO is cognizant of the efforts and is supporting Member States improve routine immunization coverage. With stepped up efforts in recent months, we hope to see a speedy scale-up of DTP3 coverage to the pre-pandemic level of 91% in 2019 from 82% in 2021 and second dose measles and rubella vaccine coverage to beyond 83% in 2019 from 78% in 2021,” *the Regional Director said.*

*In Bangladesh* , WHO is supporting development of a National Immunization Strategy to sustain coverage and address sub-national gaps in immunization in urban and hard-to-reach populations. Routine immunization and surveillance for vaccine preventable diseases has been strengthened amongst the refugee populations in Cox’s Bazar.

*In India* , periodic intensification of routine immunization is carried out through ‘Mission Indradhanush’. WHO has supported detailed mapping and categorization of low coverage areas in states; guiding short and medium term plans to improve coverage in all such areas.

*Indonesia* is implementing a catch up immunization with all vaccines along with a national measles and rubella vaccination campaign in two phases – from May 2022 in 27 provinces and beginning August in the remaining seven provinces.

*Nepal* has extended catch-up vaccination for children up to the age of 5 years. Efforts are on to achieve ‘full immunization’ status at Pallikas (municipalities) level.

*Myanmar* conducted an evaluation of its routine immunization programme last month and has drawn up a plan to revive routine immunization coverage with support of WHO, UNICEF, Gavi, The Vaccine Alliance, and other partners and non-governmental organizations.

WHO is providing technical support to Timor-Leste to boost routine immunization and COVID-19 vaccine coverage in hard-to-reach areas, enhance management capacities, strengthen cold chain and data management systems at the sub-national level.