BQ Journal Vol 54 - Q1 2024 - 26

Morbidity and Mortality Weekly Report
TABLE 1. Numbers and global percentages of surviving infants who did not receive the first dose of diphtheria-tetanus-pertussis-containing vaccine
(zero-dose children),* by World Health Organization Region, World Bank economic classification, and Gavi, the Vaccine Alliance eligibility - worldwide,
2019, 2021, and 2022
WHO Region†
Year/Characteristic
2019
No. of countries
No. of surviving infants (millions)
Global % of surviving infants
No. of zero-dose children (millions)
Global % of zero-dose children
2021
No. of countries
No. of surviving infants (millions)
Global % of surviving infants
No. of zero-dose children (millions)
Global % of zero-dose children
2022
No. of countries
No. of surviving infants (millions)
Global % of surviving infants
No. of zero-dose children (millions)
Global % of zero-dose children
Global
194
134.3
12.9
194
130.5
18.1
194
130.6
14.3
AFR AMR EMR EUR SEAR WPR
47
35
1.5
21
- 27.5 10.4 13.5
6.2
- 48.2 11.7 14.6
47
7.6
35
21
- 29.2 10.4 14.0
1.8
47
35
1.3
21
- 29.5 10.4 14.0
7.8
- 54.3
1.7
2.1
1.9
53
11
2.0
27
37.0 14.0 18.1 10.5 33.3 21.4
7.8 24.8 15.9
0.3
2.0 15.2
53
11
4.6
1.1
8.3
27
38.1 13.6 18.2 10.2 32.8 17.6
7.8 25.1 13.5
0.3
- 42.1 10.2 11.5
1.8 25.6
53
11
2.1
27
38.6 13.6 18.2 10.1 32.7 17.4
7.7 25.0 13.4
0.3
9.1 12.0
2.2 15.0
1.1
7.5
1.6
8.7
Income classification§
LowLower-middle Upper-middle
26
23.0
17.1
3.9
29.8
26
24.0
18.4
4.9
27.2
26
23.3
17.8
4.7
33.1
54
64.6
48.1
6.8
52.5
54
64.5
49.4
9.9
54.4
54
64.5
49.4
7.3
50.8
52
35.0
26.0
2.2
16.7
52
30.7
23.5
3.1
17.2
52
30.4
23.3
1.9
13.4
High
59
12.0
9.0
0.3
2.3
59
11.8
9.1
0.3
1.7
59
11.8
9.0
0.3
1.9
Among
Gavi-eligible
countries¶
57
74.3
55.3
9.0
69.4
57
75.2
57.7
12.4
68.3
57
75.7
58.0
10.2
71.4
Abbreviations: AFR = African Region; AMR = Region of the Americas; DTPcv = diphtheria-tetanus-pertussis-containing vaccine; DTPcv1 = first dose of DTPcv;
EMR = Eastern Mediterranean Region; EUR = European Region; GNI = gross national income; SEAR = South-East Asia Region; USD = U.S. dollars; WHO = World Health
Organization; WPR = Western Pacific Region.
* Zero-dose children are surviving children who lack documentation of receipt of a dose of DTPcv1 by age 12 months. The 2022 WHO and UNICEF estimates of national
immunization coverage used the 2022 World Population Prospect from the United Nations Population Division for estimates of national immunization coverage
and for calculations of regional and global vaccination coverage figures. Estimates of live births and surviving infants in the 2022 World Population Prospect changed
from previous years.
† Included countries are WHO countries.
§ Economic classification is based on 2022 GNI per capita, calculated using the World Bank Atlas method in USD (https://datahelpdesk.worldbank.org/knowledgebase/
articles/906519-world-bank-country-and-lending-groups). Categorization is based on the World Bank's economic classification for 2022, in which low-income
economies are defined as those with GNI in USD per capita of ≤$1,135; lower middle-income economies, GNI = $1,136-$4,465; upper middle-income, GNI = $4,466-
$13,845; and high-income, GNI >$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.
¶ Gavi is a public-private global health partnership that aims to increase access to immunization in poor countries. Eligibility is defined as a country's average 3-year
GNI per capita in USD. As GNI increases, a country moves through Gavi's different eligibility phases until reaching the transition phase in which GNI exceeds the
eligibility threshold (https://www.gavi.org/types-support/sustainability/eligibility). Gavi operates on a 5-year strategic period. For Gavi 4.0 (2016-2020), the number
of countries decreased to 68 with the same GNI per capita threshold. For Gavi 5.0 (2021-2025), the number of countries remained at 57 but average 3-year GNI per
capita threshold was increased to ≤$1,630. For analysis, this report retrospectively looks back at the current 57 Gavi-funded countries to compare across years.
who had started, but not completed the 3-dose DTPcv series)
worldwide remained relatively unchanged (6.3 and 6.2 million,
respectively), but higher than the number in 2019 (5.5 million)
(Figure). In 2022, most (84%) zero-dose children lived
in low- and lower-middle-income countries, and 71% lived in
countries eligible for support from Gavi, the Vaccine Alliance
(Table 1).
Measles-Containing Vaccines
From 2021 to 2022, global MCV1 coverage increased from
81% to 83% yet remained below the 2019 coverage level
(86%). MCV1 coverage in all regions was lower in 2022 than
in 2019, except for the Eastern Mediterranean Region, where
it had returned to the 2019 prepandemic level (83%).
Among all 194 WHO countries, 115 (59%) reported lower
MCV1 coverage in 2022 than in 2019. Global MCV2 coverage
1158
US Department of Health and Human Services | Centers for Disease Control and Prevention | MMWR | October 27, 2023 | Vol. 72 | No. 43
Diagnostics I Pharmaceuticals I DxRx Solutions I Continuing Education I News
A HENRY SCHEIN PUBLICATION
BIOTHERAPEUTICS
Diagnostic and Pharmaceutical News for You and Your Medical Practice
26
increased from 71% in 2019 to 74% in 2022, principally
reflecting the introduction of MCV2 in 11 countries, mostly
in AFR, during 2019-2022 (Table 2).
Other Vaccines
Global coverage with the following childhood vaccines
increased from 2021 to 2022, but coverage levels in 2022
remained lower than those in 2019: BCG (87%), HepB3
(84%), Pol3 (84%), and RCV1 (68%) remained lower than in
2019 (89%, 86%, 87%, and 69%, respectively). As a result of
recent vaccine introductions, coverage with the following vaccines
increased from 2019 to 2022: HPV, first (19% to 21%);
HPV, last (14% to 15%); PCV3 (51% to 60%); and Rota,
last (40% to 51%). Coverage remained relatively unchanged
from 2012 to 2022 for HepB-BD (from 44% to 45%) and
Hib3 (74% to 76%).
https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups https://www.gavi.org/types-support/sustainability/eligibility
BQ Journal Vol 54 - Q1 2024

Table of Contents for the Digital Edition of BQ Journal Vol 54 - Q1 2024
