2023年全球儿童报告（英）-226页_8mb

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

Core Content

This report, published by UNICEF Innocenti, highlights the importance of vaccination in protecting children's health and well-being globally. It emphasizes that while vaccines have saved millions of lives, the goal of vaccinating every child remains unmet due to various challenges. The report explores the impact of the COVID-19 pandemic on immunization, the issue of zero-dose children, and the need for stronger primary health care systems and vaccine confidence.

Main Points

The Impact of the Pandemic on Vaccination

• The COVID-19 pandemic disrupted routine immunization, causing a reduction in vaccination rates to levels not seen since 2008.
• 67 million children missed out on routine immunization between 2019 and 2021, with 48 million missing out entirely.
• The pandemic exacerbated existing health system weaknesses, including shortages of health workers, logistical challenges, and reduced access to services.
• Measles outbreaks increased due to disrupted vaccination schedules.
• HPV vaccination rates dropped, with only 1 in 8 girls receiving the vaccine, which protects against cervical cancer.

Zero-Dose Children

• Zero-dose children are those who have not received any vaccines, and undervaccinated children are those who have not received the recommended number.
• These children are often found in poor, marginalized, and underserved communities.
• Socioeconomic factors significantly influence vaccination rates:
  • Poverty is a major determinant, with 1 in 5 children in the poorest households being zero-dose, compared to 1 in 20 in the wealthiest.
  • Location plays a role, with West and Central Africa showing a larger gap between the poorest and wealthiest households.
  • Marginalization and crisis (such as conflict or natural disasters) also contribute to low immunization rates.
• Conflict-affected and fragile settings account for 2 in 5 of the zero-dose children globally (in 2018).

Equity and Access

• The report stresses the need for an equity agenda to ensure that every child has access to vaccines.
• Vaccine confidence is crucial for achieving immunization goals, but it is waning in many countries.
• Women, especially community health workers, are key to delivering immunization services, yet they often face low pay, informal employment, and lack of career opportunities.

Solutions

• Strengthen primary health care systems to provide continuous and predictable services.
• Integrate immunization services into broader primary health care platforms.
• Enhance vaccine confidence through community engagement, dialogue, and education.
• Improve access and availability by addressing logistical challenges, affordability, and geographic barriers.
• Invest in health workers with better pay, working conditions, and career development opportunities.
• Use digital tools and social listening to monitor public sentiment and improve communication strategies.

Key Messages

• Vaccines save lives, but many children are still not being vaccinated.
• The pandemic has set back immunization efforts, and recovery is needed.
• Zero-dose children are a result of inequity, poverty, and lack of access.
• Vaccine confidence is essential for achieving immunization goals.
• Strengthening primary health care and supporting health workers are critical for sustainable immunization.

Recommendations

1. Vaccinate every child, everywhere.
2. Strengthen demand for vaccination and build vaccine confidence.
3. Increase investment in immunization and health services.
4. Build resilient systems that can withstand future shocks.

Conclusion

The report underscores the importance of vaccination in child survival and development, and calls for a global commitment to ensure equitable access. It highlights the need for innovation, funding, and community involvement to overcome current and future challenges in immunization.