Top 5 Takeaways

1. Decline in Global Vaccination Coverage: In 2020, global coverage for DTP3 and Pol3 decreased to 83%, and MCV1 coverage decreased to 84%, marking a drop from 2019 levels.
2. Increase in Zero-Dose Children: The number of zero-dose children, those who did not receive the first DTP dose, increased by 3.5 million from 2019, totaling 17.1 million in 2020.
3. Regional Variations: DTP3 coverage ranged from 72% in the African Region to 95% in the Western Pacific Region, with the latter being the only region with unchanged coverage from 2019 to 2020.
4. Impact of COVID-19: The COVID-19 pandemic significantly disrupted immunization programs, leading to decreased access due to physical distancing, transportation reductions, and supply chain interruptions.
5. Need for Targeted Strategies: Full recovery from COVID-19 disruptions requires targeted, context-specific strategies to identify and catch up zero-dose and undervaccinated children, and to minimize missed vaccinations.

Original Article Author and Citation

Corresponding Author

Pierre Muhoza, pmuhoza@cdc.gov

Suggested Citation

Muhoza P, Danovaro-Holliday MC, Diallo MS, et al. Routine Vaccination Coverage — Worldwide, 2020. MMWR Morb Mortal Wkly Rep 2021;70:1495–1500. DOI: http://dx.doi.org/10.15585/mmwr.mm7043a1

Summary

This report presents global, regional, and national vaccination coverage estimates and trends as of 2020. It highlights a decline in global vaccination coverage for DTP3, Pol3, and MCV1 in 2020 compared to 2019, largely due to disruptions caused by the COVID-19 pandemic. The number of zero-dose children increased significantly, emphasizing the need for targeted strategies to address these gaps.

Methods

WHO and UNICEF derived national vaccination coverage estimates through annual country-by-country review of available data, including administrative and survey-based coverage. DTP3 coverage by age 12 months was used as an indicator of immunization program performance.

Discussion

The decline in vaccination coverage in 2020 is attributed to the COVID-19 pandemic, which disrupted immunization programs globally. The report emphasizes the need for targeted, context-specific strategies to identify and catch up zero-dose and undervaccinated children and to minimize missed vaccinations. The impacts varied across regions, with the largest declines observed in the South-East Asia and Eastern Mediterranean regions.

Conclusion

Addressing the immunity gaps caused by pandemic-related disruptions is critical to prevent vaccine-preventable disease outbreaks. Targeted and context-specific approaches are needed to eliminate barriers to vaccination, particularly in communities with large populations of zero-dose children. Developing catch-up vaccination frameworks within routine immunization programs is essential for resilience against future disruptions.

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