The big picture

© UNICEF/HQ02-0238/Geenen
After receiving their individual vaccinations against measles, children wave their campaign cards showing that they have been immunized.

Immunization is one of the most successful and cost-effective public health interventions. According to the latest data, in 2012, global efforts to immunize children with vaccines against life-threatening diseases reached 111 million children and averting an estimated 2 to 3 million deaths per year along with countless episodes of illness and disability.

However, despite significant gains in recent years, in 2012, some 22.6 million children of children under one year of age (almost 20% of children born each year) are not immunized, exposing them to disabilities or premature death. Among immunized children, more than 70% live in the 10 countries with the largest populations and the weakest immunization structures in the world.

Immunization has the potential to boost a country's growth. Immunization makes economic sense. Many analyses weighing the costs versus the benefits of vaccination have shown positive economic impact. What's more, the infrastructure, management and acceptability of immunization programmes offer a platform to deliver other integrated health and nutrition interventions.

Vaccines work by introducing into a person's immune system a harmless form of a bacterium, toxin or virus that a healthy person's body recognizes as unusual and responds by devising a defense (immunity) against it.

The most commonly applied global standard of routine immunization coverage is reflected in an individual's receipt of three doses of DTP (diphtheria, tetanus and pertussis) vaccine, or DTP3. The most recent estimates (2012) show a continuing positive trend in global DTP3 coverage, which was received by 83% of children under one year of age.

Disparities in immunization coverage exist within and among the world's regions and countries.  While DTP3 coverage is estimated at 96% in the industrialized countries, none of the regions in South Asia and sub-Saharan Africa have been able to attain such high coverage, leaving large unimmunizatied populations in the least developed countries.

UNICEF and its partner organizations are responding to the challenge with a global push to ensure that the hardest children to reach – most of them in Africa and Asia – are immunized. Major initiatives are underway to accelerate the development and deployment of new and underused vaccines, for example hepatitis B (Hep B) and Haemophilus influenzae type b (Hib) vaccine. The number of countries using Hep B vaccine for infants has increased from 31 countries in 1992 to 181 in 2012 and for the Hib vaccine, has increased from 177 in 2011 to 184 in 2012

Significant progress has been made to reduce mortality and morbidity due to vaccine preventable diseases such as polio, measles and maternal and neonatal tetanus through supplementary immunization activities or campaigns, in addition to routine vaccination programmes. These campaigns provide valuable opportunities to reach children in older age groups compared to routine vaccination and to introduce other high-impact life-saving interventions such as vitamin A tablets, insecticide treated bed nets and de-worming tablets.

Achievements aside, there are daunting challenges in vaccinating all target children, not least of which is rising cost. Providing traditional and new vaccines can now cost as much as $20 to $40 per child. Other obstacles to higher coverage include non-availability of sustainable resources, poor management and logistics systems, inequity in services, and a lack of community engagement.



Immunization as a priority for UNICEF

UNICEF promotes the worldwide use of immunization and vitamin A supplementation as effective means of achieving international goals: one-third reduction of the under-five mortality rates by 2010 and the Millenium Development Goal of two-thirds reduction in under-five mortality by 2015.

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