ACCRA, Ghana - The COVID-19 pandemic has caused significant disruptions to health systems, leaving over 60 million children worldwide without access to essential childhood vaccines. As a result, large outbreaks of diseases that primarily affect children are spreading across the globe, causing alarm among health organizations and experts.

According to a recent report from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), by mid-2023, 47 countries have reported serious measles outbreaks, a significant increase compared to only 16 countries in June 2020. Nigeria is currently facing its largest diphtheria outbreak ever recorded, with over 17,000 suspected cases and nearly 600 deaths reported. Additionally, twelve countries, including Afghanistan and Zimbabwe, are experiencing outbreaks of circulating polio virus.

This dire situation is primarily attributed to the millions of children who missed out on their routine immunization programs during the pandemic. These "zero-dose children" make up nearly half of all child deaths from vaccine-preventable illnesses, as reported by Gavi, an organization dedicated to funding vaccinations in low- and middle-income countries. Moreover, an additional 85 million children are underimmunized, having received only partial doses of essential vaccines due to the pandemic.

The consequences of failing to reach these children are becoming increasingly evident. Measles-related deaths have risen by 43% in 2022, reaching 136,200 deaths, in comparison to the previous year. The numbers projected for 2023 indicate a potential doubling of this figure. Ephrem Lemango, associate director of immunization for UNICEF, stressed the direct correlation between declining vaccination coverage during the pandemic and the rise in diseases and child mortality. Urgent actions and investments are needed to catch up on missed vaccinations and combat these outbreaks.

One of the significant challenges ahead lies in reaching and protecting the older children who missed their shots between 2020 and 2022. These children do not fall within the regular age group seen in primary health care centers, posing an extra hurdle for health systems already fragile in many countries. UNICEF has appealed to Gavi for $350 million to procure vaccines and implement catch-up vaccination campaigns targeting children between the ages of 1 and 4 who were missed during the pandemic.

Many developing nations have carried out catch-up campaigns in response to outbreaks in the past, mainly for measles. However, delivering the necessary vaccines and training personnel, often community health workers primarily accustomed to vaccinating infants, presents additional challenges. UNICEF is urging countries to implement catch-up vaccination blitzes to reach the most vulnerable children.

Countries with the highest numbers of zero-dose children include Nigeria, Ethiopia, India, Congo, and Pakistan. These countries face compounded challenges, such as civil conflicts and the influx of climate refugees, which further strain their already fragile health systems.

In Ghana, representative of many low-income countries, the pandemic drastically disrupted routine immunization efforts due to lockdowns and parental fears of infection. Priscilla Obiri, a community health nurse in charge of vaccinations in low-income fishing communities near Accra, reports that up to one-third of the children seen at pop-up vaccination clinics are either incompletely vaccinated or not vaccinated at all. Additional efforts, including community outreach, are required to identify and vaccinate these children.

Unfortunately, misinformation and vaccine hesitancy have further complicated the efforts to regain lost ground. The Vaccine Confidence Project, a research initiative, reveals that between 2015 and 2022, the number of people who believed in the importance of routine immunization for children dropped drastically in 55 countries. Disinformation campaigns and low trust in official guidance have fueled this decline.

Efforts to bridge the vaccination gap must be supported by robust supply chains and increased access to vaccines and healthcare services. Dr. Kwame Amponsah-Achiano, overseeing Ghana's childhood immunization program, states that demand for vaccines remains high in the country, but access constraints need to be addressed to meet the needs of the population.

As health systems recover from the pandemic's disruptions, the global community must act swiftly and decisively to tackle these outbreaks and ensure the well-being of children worldwide. The urgent call for catch-up vaccination campaigns and increased funding is essential to prevent further avoidable child deaths and the spread of vaccine-preventable diseases.