联合国儿童基金会：2023年全球儿童报告_226页_8mb

The State of the World's Children 2023: For Every Child, Vaccination

Core Content

The State of the World's Children 2023 report, published by UNICEF Innocenti, highlights the importance of vaccination for every child and the challenges that remain in achieving this goal. It emphasizes the equity agenda in immunization, focusing on reducing disparities in vaccine access and coverage.

Main Points

1. Impact of the COVID-19 Pandemic on Vaccination

• The pandemic significantly disrupted routine immunization, leading to 67 million children missing out on vaccines between 2019 and 2021, with 48 million missing out entirely.
• This setback reversed progress made over the past decade, pushing vaccination rates back to levels last seen in 2008.
• The report notes that the measles mortality rate dropped from 2.6 million to 128,000 globally between 1963 and 2021, but still remains too high.
• HPV vaccine coverage is particularly low, with only 1 in 8 girls receiving it, despite its role in preventing cervical cancer.

2. Zero-Dose Children

• Zero-dose children (unvaccinated) and under-vaccinated children are at high risk of preventable diseases.
• Socioeconomic factors play a major role in vaccine access:
  • Poverty: In the poorest households, 20% of children are zero-dose, compared to 5% in the wealthiest.
  • Location: Remote and underserved areas face significant challenges.
  • Marginalization: Children from marginalized communities are least likely to be vaccinated.
  • Crisis: Conflict and fragile settings exacerbate vaccine access issues, with 20% of unvaccinated children living in such areas in 2018.

3. Primary Health Care and Immunization Integration

• Strengthening primary health care systems is essential to ensure sustainable immunization coverage.
• Health workforce (mostly women) are critical in delivering vaccines, but they often face low pay, informal employment, and lack of career opportunities.
• Integrating immunization into primary health care allows for continuous and predictable services, which is vital for reaching underserved populations.

4. Building Vaccine Confidence

• Vaccine hesitancy is rising in many countries, undermining immunization efforts.
• Community engagement, dialogue, and ownership are key to rebuilding trust.
• Social data and listening can help identify and address concerns.
• Pro-vaccine education and messaging should be tailored to different demographics, including gender-sensitive approaches.

5. Funding and Innovation for the Future

• Funding immunization is critical, especially in low- and middle-income countries.
• Innovations in vaccine development, logistics, and digital tools are essential to improving vaccine delivery and coverage.
• Local manufacturing should be strengthened to ensure resilient vaccine supply chains.

Key Recommendations

1. Vaccinate every child, everywhere – Ensure no child is left behind.
2. Strengthen demand for and confidence in vaccination – Promote trust and awareness.
3. Invest more and better in immunization and health – Prioritize funding for health systems.
4. Build resilient systems – Strengthen primary health care and prepare for future shocks.

Key Statistics

• 4.4 million lives are saved annually by vaccines, with potential to rise to 5.8 million by 2030 if Immunization Agenda 2030 (IA2030) goals are met.
• Every dollar spent on vaccination delivers a return of US$26.
• Zero-dose children have increased slightly over the past two decades, despite global efforts.

Case Studies

• Somalia: Highlighted the challenges of reaching children in conflict zones.
• Indonesia: Demonstrated the importance of catch-up and recovery efforts post-pandemic.
• Cambodia: Showcased the impact of socioeconomic inequality on vaccination coverage.
• Nigeria: Emphasized the role of community engagement and health worker support.
• Nicaragua: Focused on gender disparities and marginalized communities.
• Yemen: Addressed the need for community-based solutions and health worker support.
• Pakistan: Highlighted the importance of access and affordability.
• Haiti: Showcased the role of public-private partnerships in improving vaccine delivery.
• Kyrgyzstan: Focused on building vaccine confidence through dialogue and education.
• Ecuador: Demonstrated the impact of systemic reforms in health services.

Conclusion

The report underscores the urgent need for investment in primary health care, health workers, and community engagement to ensure that every child is vaccinated. It calls for greater political will, financial commitment, and innovative approaches to overcome the challenges of inequity, poverty, and vaccine hesitancy.