UN children’s agency says some 67 million children missed routine shots, raising risk of measles and polio outbreaks.

“More than a decade of hard-earned gains in routine childhood immunization have been eroded,” UNICEF warned in its annual State of the World’s Children report which was released on Wednesday, warning that getting back on track would be “challenging”.

Of the 67 million children whose vaccinations were “severely disrupted”, 48 million missed out on routine vaccines entirely, the agency said, warning of the potential for outbreaks of polio and measles.

Vaccine coverage among children declined in 112 countries and the percentage of children vaccinated worldwide slipped 5 percentage points to 81 percent, the lowest since 2008. Africa and South Asia were particularly hard-hit.

“Vaccines have played a really important role in allowing more children to live healthy, long lives,” Brian Keeley, the report’s editor-in-chief, told the AFP news agency. “Any decline at all in vaccination rates is worrying.”

The slide in vaccination rates could be compounded by other crises, Keeley warned, from climate change to food insecurity.

“You’ve got increasing number of conflicts, economic stagnation in a lot of countries, climate emergencies, and so on,” he said. “This all sort of makes it harder and harder for health systems and countries to meet vaccination needs.”

UNICEF called on governments “to double-down on their commitment to increase financing for immunization” with special attention on accelerating “catch-up” vaccinations for those who missed their shots.

Measles killed about 2.6 million people each year, mostly children, before a vaccine was introduced in 1963. The number of deaths had fallen to 128,000 by 2021, but with vaccine coverage declining to 81 percent that year, compared with 86 percent in 2019, the number of cases doubled in 2022.

‘Warning signal’

The UNICEF report also flagged a drop in confidence in the importance of routine childhood vaccines.

In 52 of the 55 countries surveyed, the public perception of vaccines for children declined between 2019 and 2021, the UN agency said.

The data was a “worrying warning signal” of rising vaccine hesitancy amid misinformation, dwindling trust in governments and political polarisation, it said.

“We cannot allow confidence in routine immunizations to become another victim of the pandemic,” Catherine Russell, UNICEF executive director, said in a statement. “Otherwise, the next wave of deaths could be of more children with measles, diphtheria or other preventable diseases.”

In countries including Papua New Guinea and South Korea, agreement with the statement “vaccines are important for children” declined by 44 percent and by more than a third in Ghana, Senegal and Japan.

In the United States, it declined by 13.6 percentage points. In India, China and Mexico, confidence remained broadly the same or increased, the report added.

The report stressed that vaccine confidence can easily shift and the results may not indicate a long-term trend.

Despite the fall in confidence, more than 80 percent of respondents in almost half of the countries surveyed still said childhood vaccines were important.