Global Routine Vaccination Coverage, 2010

Morbidity and Mortality Weekly Report. 2011;60(44):1520-1522. 

In This Article

Editorial Note

In 2010, an estimated 109.4 million infants worldwide had received at least 3 doses of DTP vaccine, a slight increase compared with the 108.5 million estimated by WHO and UNICEF in 2009. However, approximately 19.3 million children worldwide did not receive some or all routinely recommended childhood vaccines, leaving them susceptible to vaccine-preventable causes of disease and death. Approximately half of these undervaccinated children live in one of only three countries, and nearly two thirds live in 10 countries, underscoring the need to prioritize efforts in those countries with the highest numbers of unvaccinated children.

Among the 130 countries that met the 2010 GIVS target of ≥90% national DTP3 coverage, 111 (58%) of 193 countries sustained ≥90% coverage during 2008–2010.§ The number of countries achieving ≥80% DTP3 coverage in every district increased from 48 (25%) in 2009 to 59 (31%) in 2010[5] but falls far short of the GIVS target for all countries to achieve this target by 2010. High national vaccination coverage, however, might obscure subpopulations with low coverage; these groups are susceptible to sustained disease transmission after an importation. During 2010, for example, a substantial increase in reported measles cases occurred in several European countries with reported MCV1 coverage levels of 90%–97%.[6] In Africa, measles outbreaks of 100 or more cases were reported in 28 (61%) of 46 countries during 2009 and 2010, accounting for approximately 166,000 measles cases.[7] Estimated MCV1 coverage in 2010 ranged from 46% to 94% in these countries and was 90% or higher in seven countries.

By 2010, the majority of countries had introduced HepB and Hib vaccines. As would be expected, in those countries that introduced combination vaccines containing DTP, HepB, and Hib antigens, coverage with HepB3 and Hib3 was similar to that for DTP3 within the first few years of introduction. However, for the newer monovalent vaccines, such as rotavirus vaccine and PCV, coverage will need to be closely monitored.

Administrative vaccination coverage data are more timely and easier to collect than other types of coverage data; however, the reporting of vaccine doses administered and census data are not always accurate, which can overestimate or underestimate coverage.[8] WHO recommends that countries conduct regular vaccination coverage surveys to validate reported administrative coverage.[4] Although surveys more closely reflect actual coverage, they are costly and difficult to conduct, and because data are collected retrospectively, surveys cannot be used for immediate assessment of immunization programs and decision-making. A WHO advisory committee is evaluating methods to improve the validity of the WHO/UNICEF coverage estimates.[9] Despite improvements in global routine vaccination coverage during the past decade,[3] there continue to be regional and local disparities in vaccination coverage resulting from limited resources, competing health priorities, poor health system management, and inadequate monitoring and supervision. Recognizing that vaccination is one of the most cost-effective means of preventing disease, the Decade of Vaccines Collaboration, a partnership among WHO, UNICEF, the Bill and Melinda Gates Foundation, and other global immunization partners, was launched in December 2010. This collaboration will develop a global vaccination action plan focusing on increasing delivery of and expanding global access to vaccines, enhancing public and political support for vaccines and vaccination programs, and promoting vaccine-related research and development. In addition to ensuring that all children are fully vaccinated, strengthening routine vaccination programs will provide the infrastructure and platform for the sustained success of the global polio eradication and measles elimination initiatives, the global introduction of new and underutilized vaccines, and the implementation of other priority child health interventions.

§ Additional information available at http://www.who.int/entity/immunization_monitoring/data/coverage_estimates_series.xls.
Additional information available at http://www.dovcollaboration.org.

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