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Cited by 215Vaccine Coverage and HesitancyGlobal Maternal and Child HealthImmune responses and vaccinations

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980–2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1

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Galles, Natalie C, Liu, Patrick Y, Updike, Rachel L, Fullman, Nancy, Nguyen, Jason, Rolfe, Sam, Sbarra, Alyssa N, Schipp, Megan F +444 more·2021·The Lancet
DOI 10.1016/s0140-6736(21)00984-3PMC PMC8358924
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Abstract

BACKGROUND: Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. METHODS: For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. FINDINGS: By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4-82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5-42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4-41·3] in 1980 to 83·6% [82·3-84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4-44·1) in 1980 to 79·8% (78·4-81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56·8 million (52·6-60·9) to 14·5 million (13·4-15·9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. INTERPRETATION: After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. FUNDING: Bill & Melinda Gates Foundation.

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  1. [36]Pan American Health Organization Workshop to analyze vaccination coverage in the region of the Americas https://iris.paho.org/bitstream/handle/10665.2/51902/PAHOFPL000220_eng.pdf?sequence=1&isAllowed=y December, 2017

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Galles, N. C., Liu, P. Y., Updike, R. L., Fullman, N., Nguyen, J., Rolfe, S., Sbarra, A. N., Schipp, M. F., Marks, A., Abady, G. G., Abbas, K. M., Abbasi, S. W., Abbastabar, H., Abd-Allah, F., Abdoli, A., Abolhassani, H., Abosetugn, A. E., Adabi, M., Adamu, A. A., Adetokunboh, O. O., Adnani, Q. E. S., Advani, S. M., Afzal, S., Aghamir, S. M. K., Ahinkorah, B. O., Ahmad, S., Ahmad, T., Ahmadi, S., Ahmed, H., Ahmed, M. B., Ahmed Rashid, T., Ahmed Salih, Y., Akalu, Y., Aklilu, A., Akunna, C. J., Al Hamad, H., Alahdab, F., Albano, L., Alemayehu, Y., Alene, K. A., Al-Eyadhy, A., Alhassan, R. K., Ali, L., Aljunid, S. M., Almustanyir, S., Altirkawi, K. A., Alvis-Guzman, N., Amu, H., Andrei, C. L., Andrei, T., Ansar, A., Ansari-Moghaddam, A., Antonazzo, I. C., Antony, B., Arabloo, J., Arab-Zozani, M., Artanti, K. D., Arulappan, J., Awan, A. T., Awoke, M. A., Ayza, M. A., Azarian, G., Azzam, A. Y., B, D. B., Babar, Z.-U.-D., Balakrishnan, S., Banach, M., Bante, S. A., Bärnighausen, T. W., Barqawi, H. J., Barrow, A., Bassat, Q., Bayarmagnai, N., Bejarano Ramirez, D. F., Bekuma, T. T., Belay, H. G., Belgaumi, U. I., Bhagavathula, A. S., Bhandari, D., Bhardwaj, N., Bhardwaj, P., Bhaskar, S., Bhattacharyya, K., Bibi, S., Bijani, A., Biondi, A., Boloor, A., Braithwaite, D., Buonsenso, D., Butt, Z. A., Camargos, P., Carreras, G., Carvalho, F., Castañeda-Orjuela, C. A., Chakinala, R. C., Charan, J., Chatterjee, S., Chattu, S. K., Chattu, V. K., Chowdhury, F. R., Christopher, D. J., Chu, D.-T., Chung, S.-C., Cortesi, P. A., Costa, V. M., Couto, R. A. S., Dadras, O., Dagnew, A. B., Dagnew, B., Dai, X., Dandona, L., Dandona, R., De Neve, J.-W., Derbew Molla, M., Derseh, B. T., Desai, R., Desta, A. A., Dhamnetiya, D., Dhimal, M. L., Dhimal, M., Dianatinasab, M., Diaz, D., Djalalinia, S., Dorostkar, F., Edem, B., Edinur, H. A., Eftekharzadeh, S., El Sayed, I., El Sayed Zaki, M., Elhadi, M., El-Jaafary, S. I., Elsharkawy, A., Enany, S., Erkhembayar, R., Esezobor, C. I., Eskandarieh, S., Ezeonwumelu, I. J., Ezzikouri, S., Fares, J., Faris, P. S., Feleke, B. E., Ferede, T. Y., Fernandes, E., Fernandes, J. C., Ferrara, P., Filip, I., Fischer, F., Francis, M. R., Fukumoto, T., Gad, M. M., Gaidhane, S., Gallus, S., Garg, T., Geberemariyam, B. S., Gebre, T., Gebregiorgis, B. G., Gebremedhin, K. B., Gebremichael, B., Gessner, B. D., Ghadiri, K., Ghafourifard, M., Ghashghaee, A., Gilani, S. A., Glăvan, I.-R., Glushkova, E. V., Golechha, M., Gonfa, K. B., Gopalani, S. V., Goudarzi, H., Gubari, M. I. M., Guo, Y., Gupta, V. B., Gupta, V. K., Gutiérrez, R. A., Haeuser, E., Halwani, R., Hamidi, S., Hanif, A., Haque, S., Harapan, H., Hargono, A., Hashi, A., Hassan, S., Hassanein, M. H., Hassanipour, S., Hassankhani, H., Hay, S. I., Hayat, K., Hegazy, M. I., Heidari, G., Hezam, K., Holla, R., Hoque, M. E., Hosseini, M., Hosseinzadeh, M., Hostiuc, M., Househ, M., Hsieh, V. C.-R., Huang, J., Humayun, A., Hussain, R., Hussein, N. R., Ibitoye, S. E., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Inamdar, S., Iqbal, U., Irham, L. M., Irvani, S. S. N., Islam, S. M. S., Ismail, N. E., Itumalla, R., Jha, R. P., Joukar, F., Kabir, A., Kabir, Z., Kalhor, R., Kamal, Z., Kamande, S. M., Kandel, H., Karch, A., Kassahun, G., Kassebaum, N. J., Katoto, P. D., Kelkay, B., Kengne, A. P., Khader, Y. S., Khajuria, H., Khalil, I. A., Khan, E. A., Khan, G., Khan, J., Khan, M., Khan, M. A., Khang, Y.-H., Khoja, A. T., Khubchandani, J., Kim, G. R., Kim, M. S., Kim, Y. J., Kimokoti, R. W., Kisa, A., Kisa, S., Korshunov, V. A., Kosen, S., Kuate Defo, B., Kulkarni, V., Kumar, A., Kumar, G. A., Kumar, N., Kwarteng, A., La Vecchia, C., Lami, F. H., Landires, I., Lasrado, S., Lassi, Z. S., Lee, H., Lee, Y. Y., Levi, M., Lewycka, S., Li, S., Liu, X., Lobo, S. W., Lopukhov, P. D., Lozano, R., Lutzky Saute, R., Magdy Abd El Razek, M., Makki, A., Malik, A. A., Mansour-Ghanaei, F., Mansournia, M. A., Mantovani, L. G., Martins-Melo, F. R., Matthews, P. C., Medina, J. R. C., Mendoza, W., Menezes, R. G., Mengesha, E. W., Meretoja, T. J., Mersha, A. G., Mesregah, M. K., Mestrovic, T., Miazgowski, B., Milne, G. J., Mirica, A., Mirrakhimov, E. M., Mirzaei, H. R., Misra, S., Mithra, P., Moghadaszadeh, M., Mohamed, T. A., Mohammad, K. A., Mohammad, Y., Mohammadi, M., Mohammadian-Hafshejani, A., Mohammed, A., Mohammed, S., Mohapatra, A., Mokdad, A. H., Molokhia, M., Monasta, L., Moni, M. A., Montasir, A. A., Moore, C. E., Moradi, G., Moradzadeh, R., Moraga, P., Mueller, U. O., Munro, S. B., Naghavi, M., Naimzada, M. D., Naveed, M., Nayak, B. P., Negoi, I., Neupane Kandel, S., Nguyen, T. H., Nikbakhsh, R., Ningrum, D. N. A., Nixon, M. R., Nnaji, C. A., Noubiap, J. J., Nuñez-Samudio, V., Nwatah, V. E., Oancea, B., Ochir, C., Ogbo, F. A., Olagunju, A. T., Olakunde, B. O., Onwujekwe, O. E., Otstavnov, N., Otstavnov, S. S., Owolabi, M. O., Padubidri, J. R., Pakshir, K., Park, E.-C., Pashazadeh Kan, F., Pathak, M., Paudel, R., Pawar, S., Pereira, J., Peres, M. F. P., Perianayagam, A., Pinheiro, M., Pirestani, M., Podder, V., Polibin, R. V., Pollok, R. C. G., Postma, M. J., Pottoo, F. H., Rabiee, M., Rabiee, N., Radfar, A., Rafiei, A., Rahimi-Movaghar, V., Rahman, M., Rahmani, A. M., Rahmawaty, S., Rajesh, A., Ramshaw, R. E., Ranasinghe, P., Rao, C. R., Rao, S. J., Rathi, P., Rawaf, D. L., Rawaf, S., Renzaho, A. M. N., Rezaei, N., Rezai, M. S., Rios-Blancas, M., Rogowski, E. L. B., Ronfani, L., Rwegerera, G. M., Saad, A. M., Sabour, S., Saddik, B., Saeb, M. R., Saeed, U., Sahebkar, A., Sahraian, M. A., Salam, N., Salimzadeh, H., Samaei, M., Samy, A. M., Sanabria, J., Sanmarchi, F., Santric-Milicevic, M. M., Sartorius, B., Sarveazad, A., Sathian, B., Sawhney, M., Saxena, D., Saxena, S., Seidu, A.-A., Seylani, A., Shaikh, M. A., Shamsizadeh, M., Shetty, P. H., Shigematsu, M., Shin, J. I., Sidemo, N. B., Singh, A., Singh, J. A., Sinha, S., Skryabin, V. Y., Skryabina, A. A., Soheili, A., Tadesse, E. G., Tamiru, A. T., Tan, K.-K., Tekalegn, Y., Temsah, M.-H., Thakur, B., Thapar, R., Thavamani, A., Tobe-Gai, R., Tohidinik, H. R., Tovani-Palone, M. R., Traini, E., Tran, B. X., Tripathi, M., Tsegaye, B., Tsegaye, G. W., Ullah, A., Ullah, S., Ullah, S., Unim, B., Vacante, M., Velazquez, D. Z., Vo, B., Vollmer, S., Vu, G. T., Vu, L. G., Waheed, Y., Winkler, A. S., Wiysonge, C. S., Yiğit, V., Yirdaw, B. W., Yon, D. K., Yonemoto, N., Yu, C., Yuce, D., Yunusa, I., Zamani, M., Zamanian, M., Zewdie, D. T., Zhang, Z.-J., Zhong, C., Zumla, A., Murray, C. J. L., Lim, S. S., & Mosser, J. F.
Affiliations
  • Institute for Health Metrics and Evaluation (US)
  • University of Washington (US)
  • Karolinska University Hospital (SE)
  • Cairo University (EG)
Corresponding author
Mosser, Jonathan F
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2021-08
Volume
398
Issue
10299
Pages
503-521
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(21)00984-3
PMC
PMC8358924
OpenAlex
W3181093306
Cited by
215
References
46
Citations by year
2026: 21 · 2025: 31 · 2024: 51 · 2023: 50 · 2022: 48 · 2021: 13 · 2020: 1
FWCI
22.51
Type
journal article
Language
en
Open access
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Funders
  • National Institute for Health Research Southampton Biomedical Research Centre
  • Bill & Melinda Gates Foundation (OPP1182474)
  • National Health and Medical Research Council
  • NSW Health Pathology
  • Manipal Academy of Higher Education
  • Ministério da Ciência, Tecnologia e Ensino Superior (SFRH/BHD/110001/2015, DL57/2016/CP1334/CT0006)
  • Research Management Centre, International Islamic University Malaysia
  • National Heart Foundation of Australia
  • Secretaría Nacional de Ciencia, Tecnología e Innovación
  • Secretaria Nacional de Ciencia y Tecnología
  • South African Medical Research Council
  • Department of Science and Innovation, South Africa
  • Fundação para a Ciência e a Tecnologia
  • Department of Health and Social Care
  • Alexander von Humboldt-Stiftung
  • World Health Organization
  • Bundesministerium für Bildung und Forschung (UID/MULTI/04378/2019, UID/QUI/50006/2019)
  • Wellcome Trust (110110Z/15/Z)
  • Universiti Kebangsaan Malaysia
  • NSW Ministry of Health
  • National Research Foundation
  • King's College London
  • Tampereen Yliopisto
Topics
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
Keywords
childhood vaccination coverage, routine immunization, zero-dose children, DTP vaccine, measles-containing vaccine, polio vaccine, vaccine stockouts, Global Vaccine Action Plan, Immunization Agenda 2030
MeSH terms
Global Burden of Disease, Vaccination Coverage, Child, Humans, Measles Vaccine, Time Factors, Global Health, Diphtheria-Tetanus-Pertussis Vaccine, Poliovirus Vaccines

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