Number of ‘zero-dose’ children on the rise in Kenya

Before they clock two years, most Kenyan children will have received more than ten doses of vaccines to protect them from preventable diseases.

But more than 14,000 children – described as zero-dose children – have never received a single dose, and the number is growing, according to new data by the World Health Organization.

Unvaccinated children may enjoy indirect protection through the vaccinated children, but in an outbreak, they get sick first.

The joint WHO-Unicef report, released last week, shows in Kenya the number of children unvaccinated against dangerous diseases such as polio, is increasing.

“These trends, show that global immunization coverage has remained largely unchanged since 2022 and – more alarmingly – has still not returned to 2019 levels,” the two UN bodies said.

For instance, while close to 97 per cent of the children were being vaccinated against tuberculosis using BCG vaccine in 2020, that number has dropped to about 90 per cent.

It is still dropping.

Pneumoccocal vaccination rates in Kenya are also disappointingly low at about 85 per cent.

The percentage of one-year-olds who have received three doses of polio vaccine dropped from 95 per cent in 2021 to 90 today, but is slowly rising.

These figures fall short of the 95 per cent coverage needed to prevent outbreaks, avert unnecessary disease and deaths, and achieve measles elimination goals.

The Kenya Demographic and Health Survey 2022 showed children living in border areas and conflict settings are less likely to be vaccinated.

Consequently, northern Kenya still has the lowest basic vaccination coverage in the country.

The WHO and Unicef estimates of national immunisation coverage provide the world’s largest and most comprehensive dataset on immunisation trends for vaccinations against 14 diseases.

The data underscores the need for ongoing catch-up, recovery and system-strengthening efforts.

Globally, the data shows childhood immunisation coverage stalled in 2023, leaving 2.7 million additional children un- and under-vaccinated compared to pre-pandemic levels in 2019.

“The latest trends demonstrate that many countries continue to miss far too many children,” said Unicef executive director Catherine Russell.

“Closing the immunisation gap requires a global effort, with governments, partners, and local leaders investing in primary healthcare and community workers to ensure every child gets vaccinated, and that overall healthcare is strengthened.”

According to the findings, the number of children who received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP) in 2023 – a key marker for global immunization coverage – stalled at 84 per cent (108 million).

However, the number of children who did not receive a single dose of the vaccine increased from 13.9 million in 2022 to 14.5 million in 2023.

More than half of unvaccinated children live in the 31 countries with fragile, conflict-affected and vulnerable settings, where children are especially vulnerable to preventable diseases because of disruptions and lack of access to security, nutrition, and health services.

Additionally, 6.5 million children did not complete their third dose of the DTP vaccine, which is necessary to achieve disease protection in infancy and early childhood.

These trends, which show that global immunisation coverage has remained largely unchanged since 2022 and – more alarmingly – has still not returned to 2019 levels, reflect ongoing challenges with disruptions in healthcare services, logistical challenges, vaccine hesitancy and inequities in access to services.

The data further show that vaccination rates against the deadly measles disease stalled, leaving nearly 35 million children with no or only partial protection.

In 2023, only 83 per cent of children worldwide received their first dose of the measles vaccine through routine health services, while the number of children receiving their second dose modestly increased from the previous year, reaching 74 per cent of children.

“Measles outbreaks are the canary in the coalmine, exposing and exploiting gaps in immunisation and hitting the most vulnerable first,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

 “This is a solvable problem. Measles vaccine is cheap and can be delivered even in the most difficult places. WHO is committed to working with all our partners to support countries to close these gaps and protect the most at-risk children as quickly as possible.”