In June 2023 the WHO called for “focused efforts” from countries in the South-East Asia region to provide lifesaving childhood vaccines. Almost 4.6 million children were reported unvaccinated or zero dose in 2021, and countries are trying to achieve or surpass pre-COVID-19 pandemic vaccination coverage levels.  

Pandemic gaps  

Thanks to persistent efforts from the Region, routine immunisation coverage exceeded 90% in 2019. The number of zero dose children declined from over 5 million in 2010 to 2 million in 2019. However, during the pandemic, coverage of DPT3 (a standard indicator of vaccination coverage) declined from 91% in 2019 to 85% in 2020, with a further drop in 2021 to 82%.   

Dr Poonam Khetrapal Singh is Regional Director for WHO South-East Asia and warned that the “number of unvaccinated children more than doubled from 2 million in 2019 to 4.6 million in the Region by 2021”. This happened “despite efforts” to “maintain or restore routine childhood immunisation”.  

“We need to urgently address gaps and challenges aggravated by the COVID-19 pandemic.” 

Dr Khetrapal Singh addressed representatives at a four-day workshop to strengthen immunisation capacities after the pandemic. She emphasised the need to “accurately identify high-risk areas with high numbers of zero-dose children”. Following this, she encouraged improvements to “access and uptake”.  

Catch-up strategy 

The Regional Director suggested that immunisation activities and special campaigns should be reviewed with extra measures adopted where necessary. Countries must also consider the behavioural and social drivers of immunisation so that their interventions and strategies more effectively engage communities and accelerate demand for vaccination. 

Dr Khetrapal Singh also emphasised periodic mapping of at-risk populations and called for the development of appropriate plans to address gaps. She noted that the routine immunisation coverage in the Region has been varied. Although some countries were able to maintain childhood vaccination coverage during the COVID-19 pandemic, others are still seeing sub-optimal coverage.  

Specific cases 

Timor-Leste was one of the countries identified by the Regional Director for introducing pneumococcal vaccines in catch-up campaigns. Nepal was the fourth country globally to introduce the typhoid conjugate vaccine, in 2022. Dr Khetrapal Singh congratulated Bangladesh for restoring immunisation services to pre-COVID-19 levels, India for launching Mission Indradhanush, an intensified vaccination drive, and Indonesia for completing the readiness requirements for the polio vaccine within two weeks of the notification of an outbreak in November last year.  

Measles elimination status was maintained during the COVID-19 response by Bhutan, DPR Korea, Maldives, Sri Lanka, and Timor-Leste. Furthermore, Sri Lanka and Maldives were certified for eliminating rubella in 2020. The Region is still free from wild poliovirus and has sustained its maternal and neonatal tetanus elimination status.  

With this recent history of successful vaccination efforts, the Region is in a strong position to catch up on the immunisation requirements. How do you think this can be achieved? Don’t forget to subscribe to our newsletter for more like this. To read more about routine immunisation concerns click here.