Tackling missed opportunities for vaccination in a new era of immunisation
Authors: Chukwudi A Nnaji, Duduzile Ndwandwe, Maia Lesosky, Hassan Mahomed, Charles S Wiysonge
Journal: The Lancet (2021)

The launch of the Immunisation Agenda 2030 (IA2030) marks the beginning of a new era for accelerating immunisation progress globally. In many ways, the COVID-19 pandemic, with its far-reaching disruption of routine immunisation services, marks a turning point in this transition. The Editors aptly reflect on this important transition and the lessons learned in the past decades.1The Lancet2021: the beginning of a new era of immunisations?.Lancet. 2021; 3971519Summary Full Text Full Text PDF PubMed Scopus (15) Google Scholar Importantly, the Editorial identifies the growing challenges of vaccine hesitancy, misinformation, inequitable access, political inaction, and commercial interest protection as priority issues to be tackled in the new IA2030 era. In addition to these challenges, we make a case for the prioritisation of missed opportunities for vaccination. A missed opportunity for vaccination refers to any contact with health-care services by an individual who is eligible for vaccination, which does not result in the person receiving either one or both of the vaccine doses for which they are eligible.2WHOMethodology for the assessment of missed opportunities for vaccination. World Health Organization, Geneva2017Google Scholar Global immunisation coverage has undeniably stalled below the targets of the Global Vaccine Action Plan.3Nnaji CA Owoyemi AJ Amaechi UA et al.Taking stock of global immunisation coverage progress: the gains, the losses and the journey ahead.Int Health. 2020; (published online Jan 11.)https://doi.org/10.1093/inthealth/ihz120Crossref PubMed Scopus (8) Google Scholar Progress has been further slowed by the disruption to routine immunisation services worldwide as a result of the COVID-19 pandemic.4WHOAt least 80 million children under one at risk of diseases such as diphtheria, measles and polio as COVID-19 disrupts routine vaccination efforts, warn. Gavi, WHO and UNICEF, May 22, 2020https://www.who.int/news/item/22-05-2020-at-least-80-million-children-under-one-at-risk-of-diseases-such-as-diphtheria-measles-and-polio-as-covid-19-disrupts-routine-vaccination-efforts-warn-gavi-who-and-unicefDate accessed: April 27, 2021Google Scholar The prevalence of missed opportunities for vaccination varies within and between countries, reaching 89% in some settings.2WHOMethodology for the assessment of missed opportunities for vaccination. World Health Organization, Geneva2017Google Scholar Thus, addressing missed opportunities for vaccination has become imperative for attaining unmet aspirations in the Global Vaccine Action Plan and for providing catch-up vaccinations to undo the pandemic's damaging impact on immunisation progress. In line with its fourth strategic priority, fulfilling IA2030's vision will require a sound understanding of the burden of missed opportunities for vaccination and its multidimensional determinants at national and sub-national levels, instituting context-appropriate remedial measures, and periodically monitoring progress and adapting corrective interventions. We declare no competing interests. 2021: the beginning of a new era of immunisations?While the world is firmly focused on the efficacy, adverse events, licensing, and roll-out of COVID-19 vaccines, the disruption of and barriers to routine immunisations during the pandemic have garnered much less attention. World Immunization Week (April 24–30) presents an opportunity to reflect on the state of immunisation efforts for vaccine-preventable diseases, how the COVID-19 pandemic has affected progress, and what lessons can accelerate efforts to prevent diseases through immunisation. Full-Text PDF