In the last 10 years, Latin America and the Caribbean has gone from having one of the highest rates of childhood vaccination in the world to one of the lowest.

That is the revelation made by the United Nations Children’s Fund ( UNICEF) with the launch of The State of the World’s Children 2023: For Every Child, Vaccination.

The State of the World’s Children is UNICEF’s flagship report and the 2023 edition is the first edition of the report solely dedicated to routine immunization, a UNICEF release states.

In Latin America and the Caribbean, coverage of the third dose of the diphtheria-tetanus-pertussis vaccine (DTP3) among children under one dropped 18 percentage points, from 93 per cent in 2012 to 75 per cent in 2021. This is the region’s lowest routine immunization rate in almost 30 years, placing Latin America and the Caribbean below the global average (81 per cent) and just ahead of Eastern and Southern Africa (74 per cent).

According to the latest World Health Organization and UNICEF estimates, Latin America and the Caribbean’s backslide in immunization has left 2.4 million children – one in four children under the age of one – unprotected from vaccine-preventable diseases. More than 1.7 million of them are “zero-dose”, meaning they have not been vaccinated at all. Children in the poorest families are almost three times as likely to be zero-dose as children in the wealthiest families, new analysis in the report reveals.

“For years, countries in Latin America and the Caribbean had some of the world’s highest childhood vaccination rates. Now the region has some of the lowest. This is one of the most serious childhood immunization crises the region has seen in almost 30 years,” said Garry Conille, UNICEF Regional Director for Latin America and the Caribbean.

“Diseases like diphtheria, measles and polio, once thought eradicated in many countries, are making a comeback across the region, putting the lives of the most marginalized children – and everyone’s well-being – at risk.”

Latin America and the Caribbean’s decline in childhood immunization may be driven by multiple factors, the release notes.

On the one hand, natural disasters, violence, urbanization, instability, and migration have all contributed to growing inequalities. Uneven public spending in health across the region and reduced investment in some countries has left the most marginalized communities cut off from quality primary health care. The COVID-19 pandemic exacerbated these challenges, interrupting childhood vaccination due to intense demands on health systems and stay-at-home measures. There are also signs of declining vaccination confidence in some countries in recent years.

The report highlights that immunization not only saves lives but also is a proven strategy for reducing future health care costs and supporting economic growth. Immunization generates strong returns on investment – as much as US$26 for every US$1 invested.

“With one of the best track records in childhood vaccination, Latin America and the Caribbean has no excuses. Ten years ago, this region proved it could protect children from life-threatening diseases. There is no reason why we can’t do it again now, with more knowledge, capacity and resources,” said Garry Conille. “Vaccination is one of the simplest and most cost-effective public health interventions. To regain lost ground and ensure every child is vaccinated, governments and partners must invest in immunization and primary health care. We can prevent childhood diseases now or all pay the price later.”

To recover from backsliding and reduce the number of zero dose children in Latin America and the Caribbean, UNICEF calls on governments and partners to: Urgently identify and vaccinate all children, especially children in the poorest households, indigenous children and afro-descendant children who have missed vaccinations Prioritize funding to immunization services and primary health care. Build resilient health systems through investment in health workers, innovation and manufacturing of vaccine supplies in the region. Strengthen demand for vaccines, including by building confidence.