BQ Journal Vol 54 - Q1 2024 - 24

Morbidity and Mortality Weekly Report
2021 compared with 2020 (3). This report updates a previous
report, reviews global vaccination coverage trends through
2022, and highlights signs of global but uneven immunization
program recovery in 2022 (4,5).
Methods
WHO and UNICEF produce Estimates of National
Immunization Coverage (WUENIC) at the national, regional,
and global level based on review of country-specific data,
including administrative and survey-based coverage† (6,7). This
report examines trends in coverage with vaccines received from
routine immunization programs through 2022, across all WHO
countries, as well as aggregated trends at WHO regional and
global levels.§ Trends in vaccine coverage are also examined by
World Bank economic classification.¶ Reviewed vaccines include
those typically provided by a national routine immunization
program during the first year of life: Bacille Calmette-Guérin
† Administrative coverage with a given vaccine is calculated as the number of doses
administered in a specified target group divided by the estimated target population.
Doses administered during routine immunization visits are counted, but doses
administered during supplementary immunization activities (mass campaigns)
usually are not. Survey-based vaccination coverage is calculated as the proportion
of persons in a target age group who had received a vaccine dose. During surveys,
a representative sample of households is visited, and caregivers of children in a
specified target age group (e.g., 12-23 months) are interviewed. Vaccination dates
are transcribed from the child's home-based record or health facility records, and
if documented evidence is unavailable, recorded based on caregiver recall.
§ Years 2021 and 2022 are reported for the pandemic period: 2021, because
immunization coverage in 2021 was worse than 2020; and 2022, as the most
recent update.
(BCG); DTPcv1, a third DTPcv dose (DTPcv3); a hepatitis B
birth dose (HepB-BD) and third dose (HepB3); a third dose
of Haemophilus influenzae type b vaccine (Hib3); a first dose
of measles-containing vaccine (MCV1); a third pneumococcal
conjugate vaccine dose (PCV3); a third polio vaccine dose
(Pol3); rotavirus vaccine last dose (Rota, last); and a first rubellacontaining
vaccine dose (RCV1). Reviewed vaccines provided
beyond the first year of life include the second dose of measlescontaining
vaccine (MCV2), and first and last doses of HPV
vaccine (HPV, first; HPV, last).** Zero-dose children represent
those who lack access to or are never reached by immunization
services (2). Children who receive DTPcv1 but not DTPcv3
are considered incompletely vaccinated.†† DTPcv1-to-DTPcv3
and DTPcv1-to-MCV1 dropout rates were calculated as the
¶ Economic classification is based on gross national income (GNI) per capita,
calculated using the World Bank Atlas method (https://datahelpdesk.
worldbank.org/knowledgebase/articles/906519-world-bank-country-andlending-groups).
Low-income economies are defined as those with GNI in
U.S. dollars per capita in 2022 of <$13,845; lower-middle-income, $1,136-
$4,465; upper-middle-income, $4,466-$13,845; and high-income,
>$13,845. For all years shown, Cook Islands and Niue are excluded in this
classification because of lack of available GNI estimates. For 2021 and 2022,
data for Venezuela were also excluded as temporarily unclassified pending
release of revised national accounts statistics.
** Vaccines provided during the first year of life versus after the first year of life
are based on WHO routine immunization schedule (https://cdn.who.int/
media/docs/default-source/immunization/immunization_schedules/table_1_
feb_2023_english.pdf?sfvrsn). The age at which a specific vaccine is delivered
might vary among different country routine immunization schedules based
on its associated country-specific disease incidence.
†† Incompletely vaccinated children might also be referred to as undervaccinated children.
The MMWR series of publications is published by the Office of Science, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human
Services, Atlanta, GA 30329-4027.
Suggested citation: [Author names; first three, then et al., if more than six.] [Report title]. MMWR Morb Mortal Wkly Rep 2023;72:[inclusive page numbers].
Centers for Disease Control and Prevention
Mandy K. Cohen, MD, MPH, Director
Debra Houry, MD, MPH, Chief Medical Officer and Deputy Director for Program and Science
Paul Muntner, PhD, MHS, Acting Director, Office of Science
MMWR Editorial and Production Staff (Weekly)
Charlotte K. Kent, PhD, MPH, Editor in Chief
Rachel Gorwitz, MD, MPH, Acting Executive Editor
Jacqueline Gindler, MD, Editor
Paul Z. Siegel, MD, MPH, Associate Editor
Mary Dott, MD, MPH, Online Editor
Terisa F. Rutledge, Managing Editor
Teresa M. Hood, MS, Lead Technical Writer-Editor
Glenn Damon, Jacqueline Farley, MS,
Tiana Garrett, PhD, MPH, Ashley Morici,
Stacy Simon, MA, Morgan Thompson,
Suzanne Webb, PhD, MA,
Technical Writer-Editors
MMWR Editorial Board
Timothy F. Jones, MD, Chairman
Matthew L. Boulton, MD, MPH
Carolyn Brooks, ScD, MA
Virginia A. Caine, MD
Jonathan E. Fielding, MD, MPH, MBA
David W. Fleming, MD
William E. Halperin, MD, DrPH, MPH
Jewel Mullen, MD, MPH, MPA
Jeff Niederdeppe, PhD
Patricia Quinlisk, MD, MPH
Patrick L. Remington, MD, MPH
Carlos Roig, MS, MA
William Schaffner, MD
Morgan Bobb Swanson, MD, PhD
Martha F. Boyd, Lead Visual Information Specialist
Alexander J. Gottardy, Maureen A. Leahy,
Stephen R. Spriggs, Armina Velarde, Tong Yang,
Visual Information Specialists
Quang M. Doan, MBA, Phyllis H. King,
Terraye M. Starr, Moua Yang,
Information Technology Specialists
Symone Hairston, MPH,
Acting Lead Health Communication Specialist
Kiana Cohen, MPH,
Leslie Hamlin, Lowery Johnson,
Health Communication Specialists
Dewin Jimenez, Will Yang, MA,
Visual Information Specialists
1156
US Department of Health and Human Services | Centers for Disease Control and Prevention | MMWR | October 27, 2023 | Vol. 72 | No. 43
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https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-andlending-groups https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-andlending-groups https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-andlending-groups https://cdn.who.int/media/docs/default-source/immunization/immunization_schedules/table_1_feb_2023_english.pdf?sfvrsn https://cdn.who.int/media/docs/default-source/immunization/immunization_schedules/table_1_feb_2023_english.pdf?sfvrsn https://cdn.who.int/media/docs/default-source/immunization/immunization_schedules/table_1_feb_2023_english.pdf?sfvrsn

BQ Journal Vol 54 - Q1 2024

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