Why Are Childhood Vaccine Rates Dropping Worldwide?

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By Crystal Bruce, Health Communications Specialist IV

Imagine there’s an infectious disease spreading through your community. Children are getting sick and are dying. Then someone comes along and says: “Here’s something that will protect your kids from this disease for the rest of their lives. And they can have it, for free.” You would be very relieved, right? That’s the power of childhood vaccines.  We know they save lives. Thanks to vaccination, polio – a crippling and potentially fatal disease – has nearly been eradicated worldwide. 

However, global health officials have seen signs that efforts to immunize children against preventable illnesses were falling even before the pandemic. For example, the number of children globally to get at least the first dose of the measles vaccine has been stalled for more than a decade at around 86 percent. Health experts recommend vaccination levels of 95 percent to protect against an outbreak of measles. 

Many of the children who are not being vaccinated are those in underserved communities around the world. As these countries try to get and administer COVID-19 vaccines to as many people as they can, they continue to lose ground on other vaccinations, leaving children at risk for devastating but preventable diseases. So why have we been seeing this downward trend? 

  • In 2019, the World Health Organization (WHO) named vaccine hesitancy as one of the top ten threats to global health. Skepticism about vaccines is not new; it is as old as vaccines themselves. When the smallpox vaccine was developed, it was met with skepticism and mistrust in science. The reasons are complex. WHO identified complacency, difficulty in accessing vaccines, and the spread of mis/disinformation – a BIG driver of vaccine hesitancy. Getting people to overcome their hesitancy will require restoring their trust in science, their leaders, and each other.  
  • The pandemic made an already bad situation worse. During the height of the pandemic, over 68 countries suspended routine vaccination services, putting at least 80 million children under the age of one at risk. Health systems in low/middle-income countries are already under strain, so, even temporary disruptions can cause a resurgence of other diseases. As COVID-19 restrictions are relaxed, experts warn there may be outbreaks of vaccine-preventable diseases such as diphtheria, tetanus, pertussis, measles, and polio. Since the pandemic began, health care has been focused on emergency care, leaving primary care behind. 
  • Regional instability has also contributed to the decrease in childhood vaccines. While there has been some progress in areas like South Asia, Latin America, and the Caribbean have seen their childhood vaccine rates fall. In Brazil, Bolivia, Haiti and Venezuela, immunization coverage plummeted by at least 14 percent since 2010. In 2019, there was an outbreak of measles in 31 states, totaling 1,280 cases – the greatest number of cases reported in the U.S. since 1992. Most cases were among people who weren’t vaccinated against measles.  

The issues affecting childhood vaccination rates today are largely the same as those first raised in response to the smallpox vaccine: side effects, concerns about others intruding on our own personal health decisions, and a general mistrust of science-based information. So, what can we do? It begins with building trust. Vaccine confidence means we have trust in: 

  • The recommended vaccines; 
  • Those who administer vaccines; and 
  • The processes and policies that lead to vaccine development, licensure, manufacturing, and recommendations for use. 

WHO is working with countries and partners to achieve 90 percent coverage for essential childhood vaccines. The agency has laid out guidance on how communities can reach that goal. We at Karna have taken on this challenge, as well. A large part of our work with CDC’s COVID-19 Vaccine Task Force focuses on helping communities find ways to promote reliable fact-based information and counter vaccine mis/disinformation. We want to replace vaccine hesitancy with vaccine confidence and help create a world where everyone, everywhere can be healthy and protected.  

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