The growth of global immunisation

Related Stories

Immunisation has been one of the great success stories of global health. It is estimated to prevent the deaths of two to three million children each year. But another 1.5 million children still die from diseases that could be prevented by routine vaccines.

The eradication of smallpox in 1980 helped encourage global efforts to fight more diseases through immunisation. These maps chart the growth of global vaccine coverage from 1980 and show which countries are doing best - and worst - at protecting their population. The three vaccines illustrated combat five infections and have been chosen as they demonstrate varying levels of progress against several major diseases.

Interactive
  • Measles
  • Hib3
  • DTP3

Measles

Measles is a highly infectious viral disease whose symptoms include a high fever and rash. Complications of measles can include blindness, brain swelling and pneumonia.

A very effective measles vaccine was introduced in the late 1960s and immunisation rates have soared since 1980. As a result, the number of deaths from the disease have plummeted from 2.6 million in 1980 to 156,000 last year.

Lowest vaccination rates

Nigeria42%

Somalia46%

Central African Republic49%

Equatorial Guinea51%

Vanuatu52%

Guinea58%

Measles vaccination coverage (%), 2012

Less than 50% 50-79% 80-89% 90% and above No data

The long view

The past three decades have seen a dramatic increase in measles immunisation and a rapid decline in deaths, but there is concern that global immunisation rates have levelled off in recent years.

By 2012, 84% of children globally got one dose of measles vaccine by their second birthday. Since 2009 the WHO has recommended that all children receive a second dose of the vaccine. Since measles only affects humans it should be possible to eradicate but several targets have been missed.

Growth in measles vaccination coverage

Measles Containing Vaccine (MCV) coverage, 1980-2012 (%)

  • Measles
  • Hib3
  • DTP3

Measles

Measles is a highly infectious viral disease whose symptoms include a high fever and rash. Complications of measles can include blindness, brain swelling and pneumonia.

A very effective measles vaccine was introduced in the late 1960s and immunisation rates have soared since 1980. As a result, the number of deaths from the disease have plummeted from 2.6 million in 1980 to 156,000 last year.

Lowest vaccination rates

Nigeria42%

Somalia46%

Central African Republic49%

Equatorial Guinea51%

Vanuatu52%

Guinea58%

Measles vaccination coverage (%), 2012

Less than 50% 50-79% 80-89% 90% and above No data

The long view

The past three decades have seen a dramatic increase in measles immunisation and a rapid decline in deaths, but there is concern that global immunisation rates have levelled off in recent years.

By 2012, 84% of children globally got one dose of measles vaccine by their second birthday. Since 2009 the WHO has recommended that all children receive a second dose of the vaccine. Since measles only affects humans it should be possible to eradicate but several targets have been missed.

Growth in measles vaccination coverage

Measles Containing Vaccine (MCV) coverage, 1980-2012 (%)

Hib3

Haemophilus influenzae type b (Hib) is a bacterial infection which causes severe pneumonia and meningitis, especially in young children. Children need three doses of the vaccine to be fully protected – hence the map label Hib3.

Hib has been virtually eliminated in developed countries. But more than two decades after an effective vaccine was introduced, half the world’s children are still not getting all three doses.

Lowest vaccination rates

Nigeria10%

Russia18%

Belarus22%

Philippines23%

North Korea32%

Chad45%

Third dose of Haemophilus influenzae type b vaccine - Hib3 (%), 2012

Less than 50% 50-79% 80-89% 90% and above No programme or insufficient data

The long view

The first Hib vaccine was licensed in 1985. While there has been a steady increase in vaccine coverage among wealthy countries, low income countries have lagged behind.

By 2000 Hib was estimated to have caused 386,000 deaths worldwide in children under five. A major health initiative has led to a dramatic increase in coverage in poorer nations - especially across Africa - but coverage in South-east Asia remains extremely poor.

Haemophilus influenzae Type b vaccine coverage

Third dose of Hib, 1980-2012 (%)

DTP3

DTP is a combined vaccine protecting children against diphtheria, tetanus and pertussis (whooping cough). Pertussis remains a major cause of infant death. In 2008 it caused around 195,000 fatalities. Tetanus was responsible for over half a million infant deaths in 1980, but the death rate has since declined. Diptheria is rare except in poorer nations.

The proportion of children receiving all three doses of the vaccine is used as a key indicator of global immunisation coverage. That is because it is given to infants at around two, three and four months and so can show how effective a health service is at organising immunisation.

Lowest vaccination rates

Equatorial Guinea33%

Nigeria41%

Somalia42%

Chad45%

Syria45%

Central African Republic47%

Third dose of diphtheria, tetanus and pertussis vaccine - DTP3 (%), 2012

Less than 50% 50-79% 80-89% 90% and above No data

The long view

In 1980 only richer nations were managing to protect more than half their infants with three doses of DTP vaccine but the subsequent decade saw a dramatic rise in coverage in developing nations. Currently, more than 100 million children get fully immunised against DTP every year, but another 20 million do not get the three doses necessary for full protection.

The one in five children who miss out are almost all among the poorest families from poorer nations. The one in five children who miss out mostly come from the poorest families in the poorest nations. Weak healthcare systems and difficulties reaching remote areas and storing the vaccines at the correct temperature are pressing issues in many of these countries.

DTP3 global vaccination rates (%), 1980-2012

Coverage of third dose of diphtheria, tetanus and pertussis vaccine

Source: WHO and UNICEF estimates of national routine immunization coverage, 2012 data revision (July 2013).

Vaccines: Who's missing out?

The World Health Organisation (WHO) estimates that 1.5 million deaths children under five die each year from diseases that could have been prevented by routine immunisation.

Vaccine-preventable diseases, breakdown

The chart shows that pneumococcal diseases and rotavirus infection are responsible for around two thirds of these deaths. The former causes pneumonia and the latter is the most common cause of severe diarrhoea.

Vaccines against the main causes of both infections have been introduced in the past decade. They are now routinely available in wealthier countries and are being gradually introduced across the developing world.

The Global Alliance for Vaccines and Immunisation (GAVI) has preliminary plans to support the introduction of rotavirus vaccines in more than 30 of the world's poorest countries by 2015.

More than 25 developing countries have begun using pneumococcal vaccines and it hopes to rollout the jab in 45 countries by 2015.

Written and produced by Fergus Walsh, John Walton, Sophia Domfeh, Martyn Rees and Claire Shannon.

More on This Story

Related Stories

The BBC is not responsible for the content of external Internet sites

More Health stories

RSS

BBC © 2014 The BBC is not responsible for the content of external sites. Read more.

This page is best viewed in an up-to-date web browser with style sheets (CSS) enabled. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.