Immunization has achieved great progress in the past 20 years. Latest data show that worldwide, more than 116 million infants received their full course of three dose diphtheria-tetanus-pertussis (DTP3) vaccine, protecting them from infectious diseases that can cause serious illness, disability or can be fatal.
Since the introduction of the meningitis A vaccine in 2010, more than 280 million people in African countries affected by the disease have been vaccinated. And this has led to the control and near elimination of the deadly disease in the region. Global measles mortality has dropped by 84%, from about 550 000 deaths in 2000 to an estimated 90 000 in 2016. This marks the first-time global measles deaths have fallen below the 100 000 per year level.
Much of the credit for this success goes to Member States and their effective implementation of national immunization programmes with support from global partners, notably those in Gavi, the Vaccine Alliance. This progress can be measured due to the existence of reliable, accurate data on immunization coverage. Armed with this data, WHO, UNICEF, Gavi and other immunization partners can support Member States to better identify where children are not being reached; where the greatest risks of vaccine-preventable disease outbreaks exist; where outbreaks are already taking place; and where efforts need to be expanded and concentrated.
Two decades of strengthening data
2018 marks the 20th anniversary of WHO and UNICEF’s Joint Reporting Form (JRF) on Immunization – a single form used by all countries to record data on national immunization rates and cases of vaccine-preventable diseases; track vaccine supply and pricing; and monitor immunization schedules and policies. Since the introduction of the form in 1998, immunization data for more than 2.7 billion newborns have been recorded using the JRF.
But collection of immunization data did not start as a joint WHO-UNICEF process. While our two organizations both began collecting national immunization coverage data in the late 1970s, as part of the Expanded Programme on Immunization (EPI), which aims to make vaccines available to all children, we collected it independently, at different times of the year, and using different methods.
This approach produced differing global coverage estimates, making it challenging for the international community to use these estimates to target support where it was most needed. The dual reporting approach also placed a heavy burden on countries, requiring them to collect and report data twice each year. The JRF was a game changer – this joint WHO-UNICEF, worldwide immunization data collection process using uniform methodology and resulting in a single set of more robust estimates, which is not only instrumental in helping immunization stakeholders and partners monitor immunization progress towards targets of the Global Vaccine Action Plan, but is also critical in measuring the impact of global immunization investments.
Harnessing science, technology and innovation
In 1998, when the JRF was first launched, most country immunization programmes offered vaccination against six diseases – diphtheria, measles, pertussis, polio, tetanus and tuberculosis – and focused mainly on children under one year of age.
Today, scientific progress and development have expanded the scope of immunization programmes: countries now vaccinate against a minimum of 10 diseases, the number of available vaccines has more than tripled, and vaccinations are now delivered throughout the life-course. These changes have brought a need for more sophisticated monitoring and data systems that can track and manage this increased programme complexity.
In response, innovations in data collection enable the JRF to not only collect data on vaccination coverage and the number of cases of vaccine-preventable diseases, it also tracks the prices of vaccines in 195 countries, and records progress against global immunization goals.
Click here to see the country data.
This data is used in many ways to improve the health and wellbeing of children and adults. These include:
- Uncovering gaps in immunization coverage.
The JRF provides annual estimates on the number of unvaccinated children and highlights inequities in vaccination coverage. With information on the number of children who are unvaccinated in every country, governments and partners are able to target immunization programmes and resources to the places where support is needed most.
- Providing evidence for development of global recommendations
The JRF data serves as a critical resource for global and regional immunization experts and stakeholders, including the WHO Strategic Advisory Group of Experts (SAGE) on immunization and the Gavi Board, providing them with the data and evidence needed to develop recommendations for strengthening of routine immunization and to drive progress towards global immunization goals. In addition to protecting more people from vaccine-preventable diseases, these recommendations help build the foundation for resilient health systems.
- Tracking the introduction and uptake of new and under-utilized vaccines
Making immunization coverage more equitable is essential if we are to achieve immunization for all. The JRF collects data on country introductions of new and under-utilized vaccines, and tracks national immunization schedules to understand which vaccines countries use and at what ages and intervals these are delivered.
- Promoting transparency in vaccine pricing
To maximize the number of people immunized, countries must be able to access affordable vaccines. Vaccine pricing and procurement data from the JRF populates WHO’S Vaccine Product Price Procurement Platform – a database aimed at increasing vaccine price transparency, helping countries make informed procurement decisions and increasing equity between low-, middle- and high-income countries.
As we mark the 20th Anniversary of the JRF and celebrate the dedication of every country to immunization data collection, we must also recognize that more needs to be done. In this context, there is an ever-greater need for resources to support sub-national data collection and dissemination, providing the information and intelligence required to deliver lifesaving vaccines throughout the life-course and to ensure equitable access by everyone.
WHO and UNICEF acknowledge the incredible support and commitment by the Gavi Alliance, key stakeholders and development partners – the achievement of the 2030 Agenda for Sustainable Development, to create a world where vaccines reach everyone, will require all hands on-deck.