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1. Measuring routine childhood vaccination coverage in 204 countries and territories, 1980–2019: a systematic analysis for the global burden of disease study 2020, release 1

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Galles N. C., Liu P. Y., Updike R. L., Fullman N., Nguyen J., Rolfe S., Sbarra A. N., Schipp M. F., Marks A., Abady G. G., Abbas K. M., Abbasi S. W., Abbastabar H., Abd-Allah F., Abdoli A., Abolhassani H., Abosetugn A. E., Adabi M., Adamu A. A., Adetokunboh O. O., Adnani Q. E. S., Advani S. M., Afzal S., Aghamir S. M. K., Ahinkorah B. O., Ahmad S., Ahmad T., Ahmadi S., Ahmed H., Ahmed M. B., Ahmed Rashid T., Ahmed Salih Y., Akalu Y., Aklilu A., Akunna C. J., Al Hamad H., Alahdab F., Albano L., Alemayehu Y., Alene K. A., Al-Eyadhy A., Alhassan R. K., Ali L., Aljunid S. M., Almustanyir S., Altirkawi K. A., Alvis-Guzman N., Amu H., Andrei C. L., Andrei T., Ansar A., Ansari-Moghaddam A., Antonazzo I. C., Antony B., Arabloo J., Arab-Zozani M., Artanti K. D., Arulappan J., Awan A. T., Awoke M. A., Ayza M. A., Azarian G., Azzam A. Y., B D. B., Babar Z. -U. -D., Balakrishnan S., Banach M., Bante S. A., Barnighausen T. W., Barqawi H. J., Barrow A., Bassat Q., Bayarmagnai N., Bejarano Ramirez D. F., Bekuma T. T., Belay H. G., Belgaumi U. I., Bhagavathula A. S., Bhandari D., Bhardwaj N., Bhardwaj P., Bhaskar S., Bhattacharyya K., Bibi S., Bijani A., Biondi A., Boloor A., Braithwaite D., Buonsenso D., Butt Z. A., Camargos P., Carreras G., Carvalho F., Castaneda-Orjuela C. A., Chakinala R. C., Charan J., Chatterjee S., Chattu S. K., Chattu V. K., Chowdhury F. R., Christopher D. J., Chu D. -T., Chung S. -C., Cortesi P. A., Costa V. M., Couto R. A. S., Dadras O., Dagnew A. B., Dagnew B., Dai X., Dandona L., Dandona R., De Neve J. -W., Derbew Molla M., Derseh B. T., Desai R., Desta A. A., Dhamnetiya D., Dhimal M. L., Dhimal M., Dianatinasab M., Diaz D., Djalalinia S., Dorostkar F., Edem B., Edinur H. A., Eftekharzadeh S., El Sayed I., El Sayed Zaki M., Elhadi M., El-Jaafary S. I., Elsharkawy A., Enany S., Erkhembayar R., Esezobor C. I., Eskandarieh S., Ezeonwumelu I. J., Ezzikouri S., Fares J., Faris P. S., Feleke B. E., Ferede T. Y., Fernandes E., Fernandes J. C., Ferrara P., Filip I., Fischer F., Francis M. R., Fukumoto T., Gad M. M., Gaidhane S., Gallus S., Garg T., Geberemariyam B. S., Gebre T., Gebregiorgis B. G., Gebremedhin K. B., Gebremichael B., Gessner B. D., Ghadiri K., Ghafourifard M., Ghashghaee A., Gilani S. A., Glavan I. -R., Glushkova E. V., Golechha M., Gonfa K. B., Gopalani S. V., Goudarzi H., Gubari M. I. M., Guo Y., Gupta V. B., Gupta V. K., Gutierrez R. A., Haeuser E., Halwani R., Hamidi S., Hanif A., Haque S., Harapan H., Hargono A., Hashi A., Hassan S., Hassanein M. H., Hassanipour S., Hassankhani H., Hay S. I., Hayat K., Hegazy M. I., Heidari G., Hezam K., Holla R., Hoque M. E., Hosseini M., Hosseinzadeh M., Hostiuc M., Househ M., Hsieh V. C. -R., Huang J., Humayun A., Hussain R., Hussein N. R., Ibitoye S. E., Ilesanmi O. S., Ilic I. M., Ilic M. D., Inamdar S., Iqbal U., Irham L. M., Irvani S. S. N., Islam S. M. S., Ismail N. E., Itumalla R., Jha R. P., Joukar F., Kabir A., Kabir Z., Kalhor R., Kamal Z., Kamande S. M., Kandel H., Karch A., Kassahun G., Kassebaum N. J., Katoto P. D., Kelkay B., Kengne A. P., Khader Y. S., Khajuria H., Khalil I. A., Khan E. A., Khan G., Khan J., Khan M., Khan M. A., Khang Y. -H., Khoja A. T., Khubchandani J., Kim G. R., Kim M. S., Kim Y. J., Kimokoti R. W., Kisa A., Kisa S., Korshunov V. A., Kosen S., Kuate Defo B., Kulkarni V., Kumar A., Kumar G. A., Kumar N., Kwarteng A., La Vecchia C., Lami F. H., Landires I., Lasrado S., Lassi Z. S., Lee H., Lee Y. Y., Levi M., Lewycka S., Li S., Liu X., Lobo S. W., Lopukhov P. D., Lozano R., Lutzky Saute R., Magdy Abd El Razek M., Makki A., Malik A. A., Mansour-Ghanaei F., Mansournia M. A., Mantovani L. G., Martins-Melo F. R., Matthews P. C., Medina J. R. C., Mendoza W., Menezes R. G., Mengesha E. W., Meretoja T. J., Mersha A. G., Mesregah M. K., Mestrovic T., Miazgowski B., Milne G. J., Mirica A., Mirrakhimov E. M., Mirzaei H. R., Misra S., Mithra P., Moghadaszadeh M., Mohamed T. A., Mohammad K. A., Mohammad Y., Mohammadi M., Mohammadian-Hafshejani A., Mohammed A., Mohammed S., Mohapatra A., Mokdad A. H., Molokhia M., Monasta L., Moni M. A., Montasir A. A., Moore C. E., Moradi G., Moradzadeh R., Moraga P., Mueller U. O., Munro S. B., Naghavi M., Naimzada M. D., Naveed M., Nayak B. P., Negoi I., Neupane Kandel S., Nguyen T. H., Nikbakhsh R., Ningrum D. N. A., Nixon M. R., Nnaji C. A., Noubiap J. J., Nunez-Samudio V., Nwatah V. E., Oancea B., Ochir C., Ogbo F. A., Olagunju A. T., Olakunde B. O., Onwujekwe O. E., Otstavnov N., Otstavnov S. S., Owolabi M. O., Padubidri J. R., Pakshir K., Park E. -C., Pashazadeh Kan F., Pathak M., Paudel R., Pawar S., Pereira J., Peres M. F. P., Perianayagam A., Pinheiro M., Pirestani M., Podder V., Polibin R. V., Pollok R. C. G., Postma M. J., Pottoo F. H., Rabiee M., Rabiee N., Radfar A., Rafiei A., Rahimi-Movaghar V., Rahman M., Rahmani A. M., Rahmawaty S., Rajesh A., Ramshaw R. E., Ranasinghe P., Rao C. R., Rao S. J., Rathi P., Rawaf D. L., Rawaf S., Renzaho A. M. N., Rezaei N., Rezai M. S., Rios-Blancas M., Rogowski E. L. B., Ronfani L., Rwegerera G. M., Saad A. M., Sabour S., Saddik B., Saeb M. R., Saeed U., Sahebkar A., Sahraian M. A., Salam N., Salimzadeh H., Samaei M., Samy A. M., Sanabria J., Sanmarchi F., Santric-Milicevic M. M., Sartorius B., Sarveazad A., Sathian B., Sawhney M., Saxena D., Saxena S., Seidu A. -A., Seylani A., Shaikh M. A., Shamsizadeh M., Shetty P. H., Shigematsu M., Shin J. I., Sidemo N. B., Singh A., Singh J. A., Sinha S., Skryabin V. Y., Skryabina A. A., Soheili A., Tadesse E. G., Tamiru A. T., Tan K. -K., Tekalegn Y., Temsah M. -H., Thakur B., Thapar R., Thavamani A., Tobe-Gai R., Tohidinik H. R., Tovani-Palone M. R., Traini E., Tran B. X., Tripathi M., Tsegaye B., Tsegaye G. W., Ullah A., Ullah S., Unim B., Vacante M., Velazquez D. Z., Vo B., Vollmer S., Vu G. T., Vu L. G., Waheed Y., Winkler A. S., Wiysonge C. S., Yigit V., Yirdaw B. W., Yon D. K., Yonemoto N., Yu C., Yuce D., Yunusa I., Zamani M., Zamanian M., Zewdie D. T., Zhang Z. -J., Zhong C., Zumla A., Murray C. J. L., Lim S. S., Mosser J. F., Aghamir S., Sahraian M., Mansournia M., Mirzaei H., Temsah M., Andrei C., Glavan I., Antonazzo I., Singh Mtech A., Padubidri J., Babar Z., De Neve J., Noubiap J., Chakinala R., Chattu S., Chattu V., Chu D., Chung S., Kumar G., Gilani S., Gupta V., Hargono Dr A., Islam S., Hsieh V., Irvani S. N., Ismail N., Khang Y., Yon D., Kim G., Park E., Shin J., Kim M., Kim Y., Lee Y., Medina J. C., Naimzada M., Rahmani A., Rezai M., Rao S., Saeb M., Seidu A., Tan K., Tohidinik H., Zhang Z., Galles, N, Liu, P, Updike, R, Fullman, N, Nguyen, J, Rolfe, S, Sbarra, A, Schipp, M, Marks, A, Abady, G, Abbas, K, Abbasi, S, Abbastabar, H, Abd-Allah, F, Abdoli, A, Abolhassani, H, Abosetugn, A, Adabi, M, Adamu, A, Adetokunboh, O, Adnani, Q, Advani, S, Afzal, S, Aghamir, S, Ahinkorah, B, Ahmad, S, Ahmad, T, Ahmadi, S, Ahmed, H, Ahmed, M, Ahmed Rashid, T, Ahmed Salih, Y, Akalu, Y, Aklilu, A, Akunna, C, Al Hamad, H, Alahdab, F, Albano, L, Alemayehu, Y, Alene, K, Al-Eyadhy, A, Alhassan, R, Ali, L, Aljunid, S, Almustanyir, S, Altirkawi, K, Alvis-Guzman, N, Amu, H, Andrei, C, Andrei, T, Ansar, A, Ansari-Moghaddam, A, Antonazzo, I, Antony, B, Arabloo, J, Arab-Zozani, M, Artanti, K, Arulappan, J, Awan, A, Awoke, M, Ayza, M, Azarian, G, Azzam, A, B, D, Babar, Z, Balakrishnan, S, Banach, M, Bante, S, Barnighausen, T, Barqawi, H, Barrow, A, Bassat, Q, Bayarmagnai, N, Bejarano Ramirez, D, Bekuma, T, Belay, H, Belgaumi, U, Bhagavathula, A, Bhandari, D, Bhardwaj, N, Bhardwaj, P, Bhaskar, S, Bhattacharyya, K, Bibi, S, Bijani, A, Biondi, A, Boloor, A, Braithwaite, D, Buonsenso, D, Butt, Z, Camargos, P, Carreras, G, Carvalho, F, Castaneda-Orjuela, C, Chakinala, R, Charan, J, Chatterjee, S, Chattu, S, Chattu, V, Chowdhury, F, Christopher, D, Chu, D, Chung, S, Cortesi, P, Costa, V, Couto, R, Dadras, O, Dagnew, A, Dagnew, B, Dai, X, Dandona, L, Dandona, R, De Neve, J, Derbew Molla, M, Derseh, B, Desai, R, Desta, A, Dhamnetiya, D, Dhimal, M, Dianatinasab, M, Diaz, D, Djalalinia, S, Dorostkar, F, Edem, B, Edinur, H, Eftekharzadeh, S, El Sayed, I, El Sayed Zaki, M, Elhadi, M, El-Jaafary, S, Elsharkawy, A, Enany, S, Erkhembayar, R, Esezobor, C, Eskandarieh, S, Ezeonwumelu, I, Ezzikouri, S, Fares, J, Faris, P, Feleke, B, Ferede, T, Fernandes, E, Fernandes, J, Ferrara, P, Filip, I, Fischer, F, Francis, M, Fukumoto, T, Gad, M, Gaidhane, S, Gallus, S, Garg, T, Geberemariyam, B, Gebre, T, Gebregiorgis, B, Gebremedhin, K, Gebremichael, B, Gessner, B, Ghadiri, K, Ghafourifard, M, Ghashghaee, A, Gilani, S, Glavan, I, Glushkova, E, Golechha, M, Gonfa, K, Gopalani, S, Goudarzi, H, Gubari, M, Guo, Y, Gupta, V, Gutierrez, R, Haeuser, E, Halwani, R, Hamidi, S, Hanif, A, Haque, S, Harapan, H, Hargono, A, Hashi, A, Hassan, S, Hassanein, M, Hassanipour, S, Hassankhani, H, Hay, S, Hayat, K, Hegazy, M, Heidari, G, Hezam, K, Holla, R, Hoque, M, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Househ, M, Hsieh, V, Huang, J, Humayun, A, Hussain, R, Hussein, N, Ibitoye, S, Ilesanmi, O, Ilic, I, Ilic, M, Inamdar, S, Iqbal, U, Irham, L, Irvani, S, Islam, S, Ismail, N, Itumalla, R, Jha, R, Joukar, F, Kabir, A, Kabir, Z, Kalhor, R, Kamal, Z, Kamande, S, Kandel, H, Karch, A, Kassahun, G, Kassebaum, N, Katoto, P, Kelkay, B, Kengne, A, Khader, Y, Khajuria, H, Khalil, I, Khan, E, Khan, G, Khan, J, Khan, M, Khang, Y, Khoja, A, Khubchandani, J, Kim, G, Kim, M, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Korshunov, V, Kosen, S, Kuate Defo, B, Kulkarni, V, Kumar, A, Kumar, G, Kumar, N, Kwarteng, A, La Vecchia, C, Lami, F, Landires, I, Lasrado, S, Lassi, Z, Lee, H, Lee, Y, Levi, M, Lewycka, S, Li, S, Liu, X, Lobo, S, Lopukhov, P, Lozano, R, Lutzky Saute, R, Magdy Abd El Razek, M, Makki, A, Malik, A, Mansour-Ghanaei, F, Mansournia, M, Mantovani, L, Martins-Melo, F, Matthews, P, Medina, J, Mendoza, W, Menezes, R, Mengesha, E, Meretoja, T, Mersha, A, Mesregah, M, Mestrovic, T, Miazgowski, B, Milne, G, Mirica, A, Mirrakhimov, E, Mirzaei, H, Misra, S, Mithra, P, Moghadaszadeh, M, Mohamed, T, Mohammad, K, Mohammad, Y, Mohammadi, M, Mohammadian-Hafshejani, A, Mohammed, A, Mohammed, S, Mohapatra, A, Mokdad, A, Molokhia, M, Monasta, L, Moni, M, Montasir, A, Moore, C, Moradi, G, Moradzadeh, R, Moraga, P, Mueller, U, Munro, S, Naghavi, M, Naimzada, M, Naveed, M, Nayak, B, Negoi, I, Neupane Kandel, S, Nguyen, T, Nikbakhsh, R, Ningrum, D, Nixon, M, Nnaji, C, Noubiap, J, Nunez-Samudio, V, Nwatah, V, Oancea, B, Ochir, C, Ogbo, F, Olagunju, A, Olakunde, B, Onwujekwe, O, Otstavnov, N, Otstavnov, S, Owolabi, M, Padubidri, J, Pakshir, K, Park, E, Pashazadeh Kan, F, Pathak, M, Paudel, R, Pawar, S, Pereira, J, Peres, M, Perianayagam, A, Pinheiro, M, Pirestani, M, Podder, V, Polibin, R, Pollok, R, Postma, M, Pottoo, F, Rabiee, M, Rabiee, N, Radfar, A, Rafiei, A, Rahimi-Movaghar, V, Rahman, M, Rahmani, A, Rahmawaty, S, Rajesh, A, Ramshaw, R, Ranasinghe, P, Rao, C, Rao, S, Rathi, P, Rawaf, D, Rawaf, S, Renzaho, A, Rezaei, N, Rezai, M, Rios-Blancas, M, Rogowski, E, Ronfani, L, Rwegerera, G, Saad, A, Sabour, S, Saddik, B, Saeb, M, Saeed, U, Sahebkar, A, Sahraian, M, Salam, N, Salimzadeh, H, Samaei, M, Samy, A, Sanabria, J, Sanmarchi, F, Santric-Milicevic, M, Sartorius, B, Sarveazad, A, Sathian, B, Sawhney, M, Saxena, D, Saxena, S, Seidu, A, Seylani, A, Shaikh, M, Shamsizadeh, M, Shetty, P, Shigematsu, M, Shin, J, Sidemo, N, Singh, A, Singh, J, Sinha, S, Skryabin, V, Skryabina, A, Soheili, A, Tadesse, E, Tamiru, A, Tan, K, Tekalegn, Y, Temsah, M, Thakur, B, Thapar, R, Thavamani, A, Tobe-Gai, R, Tohidinik, H, Tovani-Palone, M, Traini, E, Tran, B, Tripathi, M, Tsegaye, B, Tsegaye, G, Ullah, A, Ullah, S, Unim, B, Vacante, M, Velazquez, D, Vo, B, Vollmer, S, Vu, G, Vu, L, Waheed, Y, Winkler, A, Wiysonge, C, Yigit, V, Yirdaw, B, Yon, D, Yonemoto, N, Yu, C, Yuce, D, Yunusa, I, Zamani, M, Zamanian, M, Zewdie, D, Zhang, Z, Zhong, C, Zumla, A, Murray, C, Lim, S, Mosser, J, Singh Mtech, A, Hargono Dr, A, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Microbes in Health and Disease (MHD), Tampere University, Health Sciences, HUS Comprehensive Cancer Center, University of Helsinki, Helsinki University Hospital Area, Abbas, Kaja [0000-0003-0563-1576], Veritati - Repositório Institucional da Universidade Católica Portuguesa, and GBD 2020, Release 1, Vaccine Coverage Collaborators

Subjects
Vaccine coverage, Vacunación de rutina, Time Factors, Vaccination Coverage, Global Plan of Action on Vaccines, Service delivery framework, IMPACT, Global Health, Cobertura de vacunas, Routine childhood vaccination, Global Burden of Disease, Public Health, Underserved Population, Polio vaccine, 0302 clinical medicine, WORLDWIDE, Routine immunisation, Global health, Medicine, 030212 general & internal medicine, Child, 11 Medical and Health Sciences, General Medicine, Articles, childhood vaccination, GBD, Plan de Acción Mundial sobre Vacunas, 3142 Public health care science, environmental and occupational health, 3. Good health, ddc, Vaccination, Poliovirus Vaccines, Action plan, Life Sciences & Biomedicine, Vacunación infantil, MED/42 - IGIENE GENERALE E APPLICATA, 030231 tropical medicine, Measles Vaccine, 03 medical and health sciences, Medicine, General & Internal, Environmental health, General & Internal Medicine, Humans, IMMUNIZATION COVERAGE, VALIDITY, Vaccination approaches, PROGRESS, Diphtheria-Tetanus-Pertussis Vaccine, CONFLICT, Equity (economics), Science & Technology, business.industry, MORTALITY, GBD 2020, Release 1, Vaccine Coverage Collaborators, Global burden of disease, injury and risk factors, Child vaccination, Global vaccine policies, Políticas mundiales de vacunación, Carga global de enfermedades, lesiones y factores de riesgo, Global vaccination policies, 3121 General medicine, internal medicine and other clinical medicine, Childhood vaccination, Measles vaccine, Routine vaccination, business, Vaccine programme implementation
Abstract

Medir la vacunación infantil de rutina es crucial para informar las políticas mundiales de vacunación y la implementación de programas, y para hacer un seguimiento del progreso hacia los objetivos establecidos por el Plan de Acción Mundial sobre Vacunas (GVAP) y la Agenda de Inmunización 2030. Se necesitan estimaciones sólidas de la cobertura de vacunación de rutina para identificar los éxitos pasados ​​y persistentes. vulnerabilidades. A partir del Estudio de la carga global de enfermedades, lesiones y factores de riesgo (GBD) 2020, versión 1, realizamos un análisis sistemático de las tendencias de cobertura de vacunas a nivel mundial, regional y nacional utilizando un marco estadístico, por vacuna y a lo largo del tiempo. Métodos Para este análisis recopilamos 55 326 observaciones específicas del país, de la cohorte, del año, de la vacuna y de la dosis de la cobertura de vacunación infantil de rutina entre 1980 y 2019. Utilizando el proceso de regresión gaussiana espaciotemporal, Estimaciones específicas por año de 11 indicadores de cobertura de vacunación infantil de rutina para 204 países y territorios desde 1980 hasta 2019, ajustando los sesgos en los datos informados por los países y reflejando los desabastecimientos informados y las interrupciones en el suministro. Analizamos las tendencias mundiales y regionales en la cobertura y el número de niños con dosis cero (definidos como aquellos que nunca recibieron una dosis de vacuna contra la difteria, el tétanos y la tos ferina [DTP]), el progreso hacia los objetivos del GVAP y la relación entre la cobertura de la vacuna y el desarrollo sociodemográfico. Recomendaciones Para 2019, la cobertura mundial de la tercera dosis de DTP (DTP3; 81,6 % [intervalo de incertidumbre del 95 % 80,4–82,7]) se duplicó con creces con respecto a los niveles estimados en 1980 (39,9 % [37,5–42 ·1]), al igual que la cobertura mundial de la vacuna antisarampionosa de primera dosis (MCV1; del 38,5 % [35,4–41,3] en 1980 al 83,6 % [82,3–84,8 ] en 2019). La cobertura de la vacuna antipoliomielítica de tercera dosis (Pol3) también aumentó, del 42,6 % (41,4–44,1) en 1980 al 79,8 % (78,4–81,1) en 2019, y la cobertura mundial de vacunas más nuevas Las vacunas aumentaron rápidamente entre 2000 y 2019. La cantidad mundial de niños que recibieron dosis cero se redujo en casi un 75 % entre 1980 y 2019, de 56,8 millones (52,6–60,9) a 14,5 millones (13,4– 15·9). Sin embargo, durante la última década, la cobertura mundial de vacunas se estabilizó en general; 94 países y territorios registraron una disminución de la cobertura de DTP3 desde 2010. Se estimó que solo 11 países y territorios alcanzaron el objetivo nacional del GVAP de al menos una cobertura del 90 % para todas las vacunas evaluadas en 2019. Interpretación Después de lograr grandes avances en la cobertura de vacunación infantil en todo el mundo, en gran parte del mundo este progreso se estancó o se revirtió de 2010 a 2019. Estos hallazgos subrayan la importancia de revisar las estrategias de inmunización de rutina y los enfoques programáticos, centrando la prestación de servicios en torno a la equidad y las poblaciones desatendidas. Fortalecer los datos de vacunas y los sistemas de monitoreo es crucial para estas actividades, ahora y hasta 2030, para garantizar que todos los niños tengan acceso y puedan beneficiarse de las vacunas que salvan vidas. Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4–82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5–42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4–41·3] in 1980 to 83·6% [82·3–84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4–44·1) in 1980 to 79·8% (78·4–81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56·8 million (52·6–60·9) to 14·5 million (13·4–15·9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines.

Published
2021

2. Measuring routine childhood vaccination coverage in 204 countries and territories, 1980–2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Author

Galles, N, Liu, P, Updike, R, Fullman, N, Nguyen, J, Rolfe, S, Sbarra, A, Schipp, M, Marks, A, Abady, G, Abbas, K, Abbasi, S, Abbastabar, H, Abd-Allah, F, Abdoli, A, Abolhassani, H, Abosetugn, A, Adabi, M, Adamu, A, Adetokunboh, O, Adnani, Q, Advani, S, Afzal, S, Aghamir, S, Ahinkorah, B, Ahmad, S, Ahmad, T, Ahmadi, S, Ahmed, H, Ahmed, M, Ahmed Rashid, T, Ahmed Salih, Y, Akalu, Y, Aklilu, A, Akunna, C, Al Hamad, H, Alahdab, F, Albano, L, Alemayehu, Y, Alene, K, Al-Eyadhy, A, Alhassan, R, Ali, L, Aljunid, S, Almustanyir, S, Altirkawi, K, Alvis-Guzman, N, Amu, H, Andrei, C, Andrei, T, Ansar, A, Ansari-Moghaddam, A, Antonazzo, I, Antony, B, Arabloo, J, Arab-Zozani, M, Artanti, K, Arulappan, J, Awan, A, Awoke, M, Ayza, M, Azarian, G, Azzam, A, B, D, Babar, Z, Balakrishnan, S, Banach, M, Bante, S, Barnighausen, T, Barqawi, H, Barrow, A, Bassat, Q, Bayarmagnai, N, Bejarano Ramirez, D, Bekuma, T, Belay, H, Belgaumi, U, Bhagavathula, A, Bhandari, D, Bhardwaj, N, Bhardwaj, P, Bhaskar, S, Bhattacharyya, K, Bibi, S, Bijani, A, Biondi, A, Boloor, A, Braithwaite, D, Buonsenso, D, Butt, Z, Camargos, P, Carreras, G, Carvalho, F, Castaneda-Orjuela, C, Chakinala, R, Charan, J, Chatterjee, S, Chattu, S, Chattu, V, Chowdhury, F, Christopher, D, Chu, D, Chung, S, Cortesi, P, Costa, V, Couto, R, Dadras, O, Dagnew, A, Dagnew, B, Dai, X, Dandona, L, Dandona, R, De Neve, J, Derbew Molla, M, Derseh, B, Desai, R, Desta, A, Dhamnetiya, D, Dhimal, M, Dianatinasab, M, Diaz, D, Djalalinia, S, Dorostkar, F, Edem, B, Edinur, H, Eftekharzadeh, S, El Sayed, I, El Sayed Zaki, M, Elhadi, M, El-Jaafary, S, Elsharkawy, A, Enany, S, Erkhembayar, R, Esezobor, C, Eskandarieh, S, Ezeonwumelu, I, Ezzikouri, S, Fares, J, Faris, P, Feleke, B, Ferede, T, Fernandes, E, Fernandes, J, Ferrara, P, Filip, I, Fischer, F, Francis, M, Fukumoto, T, Gad, M, Gaidhane, S, Gallus, S, Garg, T, Geberemariyam, B, Gebre, T, Gebregiorgis, B, Gebremedhin, K, Gebremichael, B, Gessner, B, Ghadiri, K, Ghafourifard, M, Ghashghaee, A, Gilani, S, Glavan, I, Glushkova, E, Golechha, M, Gonfa, K, Gopalani, S, Goudarzi, H, Gubari, M, Guo, Y, Gupta, V, Gutierrez, R, Haeuser, E, Halwani, R, Hamidi, S, Hanif, A, Haque, S, Harapan, H, Hargono, A, Hashi, A, Hassan, S, Hassanein, M, Hassanipour, S, Hassankhani, H, Hay, S, Hayat, K, Hegazy, M, Heidari, G, Hezam, K, Holla, R, Hoque, M, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Househ, M, Hsieh, V, Huang, J, Humayun, A, Hussain, R, Hussein, N, Ibitoye, S, Ilesanmi, O, Ilic, I, Ilic, M, Inamdar, S, Iqbal, U, Irham, L, Irvani, S, Islam, S, Ismail, N, Itumalla, R, Jha, R, Joukar, F, Kabir, A, Kabir, Z, Kalhor, R, Kamal, Z, Kamande, S, Kandel, H, Karch, A, Kassahun, G, Kassebaum, N, Katoto, P, Kelkay, B, Kengne, A, Khader, Y, Khajuria, H, Khalil, I, Khan, E, Khan, G, Khan, J, Khan, M, Khang, Y, Khoja, A, Khubchandani, J, Kim, G, Kim, M, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Korshunov, V, Kosen, S, Kuate Defo, B, Kulkarni, V, Kumar, A, Kumar, G, Kumar, N, Kwarteng, A, La Vecchia, C, Lami, F, Landires, I, Lasrado, S, Lassi, Z, Lee, H, Lee, Y, Levi, M, Lewycka, S, Li, S, Liu, X, Lobo, S, Lopukhov, P, Lozano, R, Lutzky Saute, R, Magdy Abd El Razek, M, Makki, A, Malik, A, Mansour-Ghanaei, F, Mansournia, M, Mantovani, L, Martins-Melo, F, Matthews, P, Medina, J, Mendoza, W, Menezes, R, Mengesha, E, Meretoja, T, Mersha, A, Mesregah, M, Mestrovic, T, Miazgowski, B, Milne, G, Mirica, A, Mirrakhimov, E, Mirzaei, H, Misra, S, Mithra, P, Moghadaszadeh, M, Mohamed, T, Mohammad, K, Mohammad, Y, Mohammadi, M, Mohammadian-Hafshejani, A, Mohammed, A, Mohammed, S, Mohapatra, A, Mokdad, A, Molokhia, M, Monasta, L, Moni, M, Montasir, A, Moore, C, Moradi, G, Moradzadeh, R, Moraga, P, Mueller, U, Munro, S, Naghavi, M, Naimzada, M, Naveed, M, Nayak, B, Negoi, I, Neupane Kandel, S, Nguyen, T, Nikbakhsh, R, Ningrum, D, Nixon, M, Nnaji, C, Noubiap, J, Nunez-Samudio, V, Nwatah, V, Oancea, B, Ochir, C, Ogbo, F, Olagunju, A, Olakunde, B, Onwujekwe, O, Otstavnov, N, Otstavnov, S, Owolabi, M, Padubidri, J, Pakshir, K, Park, E, Pashazadeh Kan, F, Pathak, M, Paudel, R, Pawar, S, Pereira, J, Peres, M, Perianayagam, A, Pinheiro, M, Pirestani, M, Podder, V, Polibin, R, Pollok, R, Postma, M, Pottoo, F, Rabiee, M, Rabiee, N, Radfar, A, Rafiei, A, Rahimi-Movaghar, V, Rahman, M, Rahmani, A, Rahmawaty, S, Rajesh, A, Ramshaw, R, Ranasinghe, P, Rao, C, Rao, S, Rathi, P, Rawaf, D, Rawaf, S, Renzaho, A, Rezaei, N, Rezai, M, Rios-Blancas, M, Rogowski, E, Ronfani, L, Rwegerera, G, Saad, A, Sabour, S, Saddik, B, Saeb, M, Saeed, U, Sahebkar, A, Sahraian, M, Salam, N, Salimzadeh, H, Samaei, M, Samy, A, Sanabria, J, Sanmarchi, F, Santric-Milicevic, M, Sartorius, B, Sarveazad, A, Sathian, B, Sawhney, M, Saxena, D, Saxena, S, Seidu, A, Seylani, A, Shaikh, M, Shamsizadeh, M, Shetty, P, Shigematsu, M, Shin, J, Sidemo, N, Singh, A, Singh, J, Sinha, S, Skryabin, V, Skryabina, A, Soheili, A, Tadesse, E, Tamiru, A, Tan, K, Tekalegn, Y, Temsah, M, Thakur, B, Thapar, R, Thavamani, A, Tobe-Gai, R, Tohidinik, H, Tovani-Palone, M, Traini, E, Tran, B, Tripathi, M, Tsegaye, B, Tsegaye, G, Ullah, A, Ullah, S, Unim, B, Vacante, M, Velazquez, D, Vo, B, Vollmer, S, Vu, G, Vu, L, Waheed, Y, Winkler, A, Wiysonge, C, Yigit, V, Yirdaw, B, Yon, D, Yonemoto, N, Yu, C, Yuce, D, Yunusa, I, Zamani, M, Zamanian, M, Zewdie, D, Zhang, Z, Zhong, C, Zumla, A, Murray, C, Lim, S, Mosser, J, Singh Mtech, A, Hargono Dr, A, Galles N. C., Liu P. Y., Updike R. L., Fullman N., Nguyen J., Rolfe S., Sbarra A. N., Schipp M. F., Marks A., Abady G. G., Abbas K. M., Abbasi S. W., Abbastabar H., Abd-Allah F., Abdoli A., Abolhassani H., Abosetugn A. E., Adabi M., Adamu A. A., Adetokunboh O. O., Adnani Q. E. S., Advani S. M., Afzal S., Aghamir S. M. K., Ahinkorah B. O., Ahmad S., Ahmad T., Ahmadi S., Ahmed H., Ahmed M. B., Ahmed Rashid T., Ahmed Salih Y., Akalu Y., Aklilu A., Akunna C. J., Al Hamad H., Alahdab F., Albano L., Alemayehu Y., Alene K. A., Al-Eyadhy A., Alhassan R. K., Ali L., Aljunid S. M., Almustanyir S., Altirkawi K. A., Alvis-Guzman N., Amu H., Andrei C. L., Andrei T., Ansar A., Ansari-Moghaddam A., Antonazzo I. C., Antony B., Arabloo J., Arab-Zozani M., Artanti K. D., Arulappan J., Awan A. T., Awoke M. A., Ayza M. A., Azarian G., Azzam A. Y., B D. B., Babar Z. -U. -D., Balakrishnan S., Banach M., Bante S. A., Barnighausen T. W., Barqawi H. J., Barrow A., Bassat Q., Bayarmagnai N., Bejarano Ramirez D. F., Bekuma T. T., Belay H. G., Belgaumi U. I., Bhagavathula A. S., Bhandari D., Bhardwaj N., Bhardwaj P., Bhaskar S., Bhattacharyya K., Bibi S., Bijani A., Biondi A., Boloor A., Braithwaite D., Buonsenso D., Butt Z. A., Camargos P., Carreras G., Carvalho F., Castaneda-Orjuela C. A., Chakinala R. C., Charan J., Chatterjee S., Chattu S. K., Chattu V. K., Chowdhury F. R., Christopher D. J., Chu D. -T., Chung S. -C., Cortesi P. A., Costa V. M., Couto R. A. S., Dadras O., Dagnew A. B., Dagnew B., Dai X., Dandona L., Dandona R., De Neve J. -W., Derbew Molla M., Derseh B. T., Desai R., Desta A. A., Dhamnetiya D., Dhimal M. L., Dhimal M., Dianatinasab M., Diaz D., Djalalinia S., Dorostkar F., Edem B., Edinur H. A., Eftekharzadeh S., El Sayed I., El Sayed Zaki M., Elhadi M., El-Jaafary S. I., Elsharkawy A., Enany S., Erkhembayar R., Esezobor C. I., Eskandarieh S., Ezeonwumelu I. J., Ezzikouri S., Fares J., Faris P. S., Feleke B. E., Ferede T. Y., Fernandes E., Fernandes J. C., Ferrara P., Filip I., Fischer F., Francis M. R., Fukumoto T., Gad M. M., Gaidhane S., Gallus S., Garg T., Geberemariyam B. S., Gebre T., Gebregiorgis B. G., Gebremedhin K. B., Gebremichael B., Gessner B. D., Ghadiri K., Ghafourifard M., Ghashghaee A., Gilani S. A., Glavan I. -R., Glushkova E. V., Golechha M., Gonfa K. B., Gopalani S. V., Goudarzi H., Gubari M. I. M., Guo Y., Gupta V. B., Gupta V. K., Gutierrez R. A., Haeuser E., Halwani R., Hamidi S., Hanif A., Haque S., Harapan H., Hargono A., Hashi A., Hassan S., Hassanein M. H., Hassanipour S., Hassankhani H., Hay S. I., Hayat K., Hegazy M. I., Heidari G., Hezam K., Holla R., Hoque M. E., Hosseini M., Hosseinzadeh M., Hostiuc M., Househ M., Hsieh V. C. -R., Huang J., Humayun A., Hussain R., Hussein N. R., Ibitoye S. E., Ilesanmi O. S., Ilic I. M., Ilic M. D., Inamdar S., Iqbal U., Irham L. M., Irvani S. S. N., Islam S. M. S., Ismail N. E., Itumalla R., Jha R. P., Joukar F., Kabir A., Kabir Z., Kalhor R., Kamal Z., Kamande S. M., Kandel H., Karch A., Kassahun G., Kassebaum N. J., Katoto P. D., Kelkay B., Kengne A. P., Khader Y. S., Khajuria H., Khalil I. A., Khan E. A., Khan G., Khan J., Khan M., Khan M. A., Khang Y. -H., Khoja A. T., Khubchandani J., Kim G. R., Kim M. S., Kim Y. J., Kimokoti R. W., Kisa A., Kisa S., Korshunov V. A., Kosen S., Kuate Defo B., Kulkarni V., Kumar A., Kumar G. A., Kumar N., Kwarteng A., La Vecchia C., Lami F. H., Landires I., Lasrado S., Lassi Z. S., Lee H., Lee Y. Y., Levi M., Lewycka S., Li S., Liu X., Lobo S. W., Lopukhov P. D., Lozano R., Lutzky Saute R., Magdy Abd El Razek M., Makki A., Malik A. A., Mansour-Ghanaei F., Mansournia M. A., Mantovani L. G., Martins-Melo F. R., Matthews P. C., Medina J. R. C., Mendoza W., Menezes R. G., Mengesha E. W., Meretoja T. J., Mersha A. G., Mesregah M. K., Mestrovic T., Miazgowski B., Milne G. J., Mirica A., Mirrakhimov E. M., Mirzaei H. R., Misra S., Mithra P., Moghadaszadeh M., Mohamed T. A., Mohammad K. A., Mohammad Y., Mohammadi M., Mohammadian-Hafshejani A., Mohammed A., Mohammed S., Mohapatra A., Mokdad A. H., Molokhia M., Monasta L., Moni M. A., Montasir A. A., Moore C. E., Moradi G., Moradzadeh R., Moraga P., Mueller U. O., Munro S. B., Naghavi M., Naimzada M. D., Naveed M., Nayak B. P., Negoi I., Neupane Kandel S., Nguyen T. H., Nikbakhsh R., Ningrum D. N. A., Nixon M. R., Nnaji C. A., Noubiap J. J., Nunez-Samudio V., Nwatah V. E., Oancea B., Ochir C., Ogbo F. A., Olagunju A. T., Olakunde B. O., Onwujekwe O. E., Otstavnov N., Otstavnov S. S., Owolabi M. O., Padubidri J. R., Pakshir K., Park E. -C., Pashazadeh Kan F., Pathak M., Paudel R., Pawar S., Pereira J., Peres M. F. P., Perianayagam A., Pinheiro M., Pirestani M., Podder V., Polibin R. V., Pollok R. C. G., Postma M. J., Pottoo F. H., Rabiee M., Rabiee N., Radfar A., Rafiei A., Rahimi-Movaghar V., Rahman M., Rahmani A. M., Rahmawaty S., Rajesh A., Ramshaw R. E., Ranasinghe P., Rao C. R., Rao S. J., Rathi P., Rawaf D. L., Rawaf S., Renzaho A. M. N., Rezaei N., Rezai M. S., Rios-Blancas M., Rogowski E. L. B., Ronfani L., Rwegerera G. M., Saad A. M., Sabour S., Saddik B., Saeb M. R., Saeed U., Sahebkar A., Sahraian M. A., Salam N., Salimzadeh H., Samaei M., Samy A. M., Sanabria J., Sanmarchi F., Santric-Milicevic M. M., Sartorius B., Sarveazad A., Sathian B., Sawhney M., Saxena D., Saxena S., Seidu A. -A., Seylani A., Shaikh M. A., Shamsizadeh M., Shetty P. H., Shigematsu M., Shin J. I., Sidemo N. B., Singh A., Singh J. A., Sinha S., Skryabin V. Y., Skryabina A. A., Soheili A., Tadesse E. G., Tamiru A. T., Tan K. -K., Tekalegn Y., Temsah M. -H., Thakur B., Thapar R., Thavamani A., Tobe-Gai R., Tohidinik H. R., Tovani-Palone M. R., Traini E., Tran B. X., Tripathi M., Tsegaye B., Tsegaye G. W., Ullah A., Ullah S., Unim B., Vacante M., Velazquez D. Z., Vo B., Vollmer S., Vu G. T., Vu L. G., Waheed Y., Winkler A. S., Wiysonge C. S., Yigit V., Yirdaw B. W., Yon D. K., Yonemoto N., Yu C., Yuce D., Yunusa I., Zamani M., Zamanian M., Zewdie D. T., Zhang Z. -J., Zhong C., Zumla A., Murray C. J. L., Lim S. S., Mosser J. F., Aghamir S., Sahraian M., Mansournia M., Mirzaei H., Temsah M., Andrei C., Glavan I., Antonazzo I., Singh Mtech A., Padubidri J., Babar Z., De Neve J., Noubiap J., Chakinala R., Chattu S., Chattu V., Chu D., Chung S., Kumar G., Gilani S., Gupta V., Hargono Dr A., Islam S., Hsieh V., Irvani S. N., Ismail N., Khang Y., Yon D., Kim G., Park E., Shin J., Kim M., Kim Y., Lee Y., Medina J. C., Naimzada M., Rahmani A., Rezai M., Rao S., Saeb M., Seidu A., Tan K., Tohidinik H., Zhang Z., Galles, N, Liu, P, Updike, R, Fullman, N, Nguyen, J, Rolfe, S, Sbarra, A, Schipp, M, Marks, A, Abady, G, Abbas, K, Abbasi, S, Abbastabar, H, Abd-Allah, F, Abdoli, A, Abolhassani, H, Abosetugn, A, Adabi, M, Adamu, A, Adetokunboh, O, Adnani, Q, Advani, S, Afzal, S, Aghamir, S, Ahinkorah, B, Ahmad, S, Ahmad, T, Ahmadi, S, Ahmed, H, Ahmed, M, Ahmed Rashid, T, Ahmed Salih, Y, Akalu, Y, Aklilu, A, Akunna, C, Al Hamad, H, Alahdab, F, Albano, L, Alemayehu, Y, Alene, K, Al-Eyadhy, A, Alhassan, R, Ali, L, Aljunid, S, Almustanyir, S, Altirkawi, K, Alvis-Guzman, N, Amu, H, Andrei, C, Andrei, T, Ansar, A, Ansari-Moghaddam, A, Antonazzo, I, Antony, B, Arabloo, J, Arab-Zozani, M, Artanti, K, Arulappan, J, Awan, A, Awoke, M, Ayza, M, Azarian, G, Azzam, A, B, D, Babar, Z, Balakrishnan, S, Banach, M, Bante, S, Barnighausen, T, Barqawi, H, Barrow, A, Bassat, Q, Bayarmagnai, N, Bejarano Ramirez, D, Bekuma, T, Belay, H, Belgaumi, U, Bhagavathula, A, Bhandari, D, Bhardwaj, N, Bhardwaj, P, Bhaskar, S, Bhattacharyya, K, Bibi, S, Bijani, A, Biondi, A, Boloor, A, Braithwaite, D, Buonsenso, D, Butt, Z, Camargos, P, Carreras, G, Carvalho, F, Castaneda-Orjuela, C, Chakinala, R, Charan, J, Chatterjee, S, Chattu, S, Chattu, V, Chowdhury, F, Christopher, D, Chu, D, Chung, S, Cortesi, P, Costa, V, Couto, R, Dadras, O, Dagnew, A, Dagnew, B, Dai, X, Dandona, L, Dandona, R, De Neve, J, Derbew Molla, M, Derseh, B, Desai, R, Desta, A, Dhamnetiya, D, Dhimal, M, Dianatinasab, M, Diaz, D, Djalalinia, S, Dorostkar, F, Edem, B, Edinur, H, Eftekharzadeh, S, El Sayed, I, El Sayed Zaki, M, Elhadi, M, El-Jaafary, S, Elsharkawy, A, Enany, S, Erkhembayar, R, Esezobor, C, Eskandarieh, S, Ezeonwumelu, I, Ezzikouri, S, Fares, J, Faris, P, Feleke, B, Ferede, T, Fernandes, E, Fernandes, J, Ferrara, P, Filip, I, Fischer, F, Francis, M, Fukumoto, T, Gad, M, Gaidhane, S, Gallus, S, Garg, T, Geberemariyam, B, Gebre, T, Gebregiorgis, B, Gebremedhin, K, Gebremichael, B, Gessner, B, Ghadiri, K, Ghafourifard, M, Ghashghaee, A, Gilani, S, Glavan, I, Glushkova, E, Golechha, M, Gonfa, K, Gopalani, S, Goudarzi, H, Gubari, M, Guo, Y, Gupta, V, Gutierrez, R, Haeuser, E, Halwani, R, Hamidi, S, Hanif, A, Haque, S, Harapan, H, Hargono, A, Hashi, A, Hassan, S, Hassanein, M, Hassanipour, S, Hassankhani, H, Hay, S, Hayat, K, Hegazy, M, Heidari, G, Hezam, K, Holla, R, Hoque, M, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Househ, M, Hsieh, V, Huang, J, Humayun, A, Hussain, R, Hussein, N, Ibitoye, S, Ilesanmi, O, Ilic, I, Ilic, M, Inamdar, S, Iqbal, U, Irham, L, Irvani, S, Islam, S, Ismail, N, Itumalla, R, Jha, R, Joukar, F, Kabir, A, Kabir, Z, Kalhor, R, Kamal, Z, Kamande, S, Kandel, H, Karch, A, Kassahun, G, Kassebaum, N, Katoto, P, Kelkay, B, Kengne, A, Khader, Y, Khajuria, H, Khalil, I, Khan, E, Khan, G, Khan, J, Khan, M, Khang, Y, Khoja, A, Khubchandani, J, Kim, G, Kim, M, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Korshunov, V, Kosen, S, Kuate Defo, B, Kulkarni, V, Kumar, A, Kumar, G, Kumar, N, Kwarteng, A, La Vecchia, C, Lami, F, Landires, I, Lasrado, S, Lassi, Z, Lee, H, Lee, Y, Levi, M, Lewycka, S, Li, S, Liu, X, Lobo, S, Lopukhov, P, Lozano, R, Lutzky Saute, R, Magdy Abd El Razek, M, Makki, A, Malik, A, Mansour-Ghanaei, F, Mansournia, M, Mantovani, L, Martins-Melo, F, Matthews, P, Medina, J, Mendoza, W, Menezes, R, Mengesha, E, Meretoja, T, Mersha, A, Mesregah, M, Mestrovic, T, Miazgowski, B, Milne, G, Mirica, A, Mirrakhimov, E, Mirzaei, H, Misra, S, Mithra, P, Moghadaszadeh, M, Mohamed, T, Mohammad, K, Mohammad, Y, Mohammadi, M, Mohammadian-Hafshejani, A, Mohammed, A, Mohammed, S, Mohapatra, A, Mokdad, A, Molokhia, M, Monasta, L, Moni, M, Montasir, A, Moore, C, Moradi, G, Moradzadeh, R, Moraga, P, Mueller, U, Munro, S, Naghavi, M, Naimzada, M, Naveed, M, Nayak, B, Negoi, I, Neupane Kandel, S, Nguyen, T, Nikbakhsh, R, Ningrum, D, Nixon, M, Nnaji, C, Noubiap, J, Nunez-Samudio, V, Nwatah, V, Oancea, B, Ochir, C, Ogbo, F, Olagunju, A, Olakunde, B, Onwujekwe, O, Otstavnov, N, Otstavnov, S, Owolabi, M, Padubidri, J, Pakshir, K, Park, E, Pashazadeh Kan, F, Pathak, M, Paudel, R, Pawar, S, Pereira, J, Peres, M, Perianayagam, A, Pinheiro, M, Pirestani, M, Podder, V, Polibin, R, Pollok, R, Postma, M, Pottoo, F, Rabiee, M, Rabiee, N, Radfar, A, Rafiei, A, Rahimi-Movaghar, V, Rahman, M, Rahmani, A, Rahmawaty, S, Rajesh, A, Ramshaw, R, Ranasinghe, P, Rao, C, Rao, S, Rathi, P, Rawaf, D, Rawaf, S, Renzaho, A, Rezaei, N, Rezai, M, Rios-Blancas, M, Rogowski, E, Ronfani, L, Rwegerera, G, Saad, A, Sabour, S, Saddik, B, Saeb, M, Saeed, U, Sahebkar, A, Sahraian, M, Salam, N, Salimzadeh, H, Samaei, M, Samy, A, Sanabria, J, Sanmarchi, F, Santric-Milicevic, M, Sartorius, B, Sarveazad, A, Sathian, B, Sawhney, M, Saxena, D, Saxena, S, Seidu, A, Seylani, A, Shaikh, M, Shamsizadeh, M, Shetty, P, Shigematsu, M, Shin, J, Sidemo, N, Singh, A, Singh, J, Sinha, S, Skryabin, V, Skryabina, A, Soheili, A, Tadesse, E, Tamiru, A, Tan, K, Tekalegn, Y, Temsah, M, Thakur, B, Thapar, R, Thavamani, A, Tobe-Gai, R, Tohidinik, H, Tovani-Palone, M, Traini, E, Tran, B, Tripathi, M, Tsegaye, B, Tsegaye, G, Ullah, A, Ullah, S, Unim, B, Vacante, M, Velazquez, D, Vo, B, Vollmer, S, Vu, G, Vu, L, Waheed, Y, Winkler, A, Wiysonge, C, Yigit, V, Yirdaw, B, Yon, D, Yonemoto, N, Yu, C, Yuce, D, Yunusa, I, Zamani, M, Zamanian, M, Zewdie, D, Zhang, Z, Zhong, C, Zumla, A, Murray, C, Lim, S, Mosser, J, Singh Mtech, A, Hargono Dr, A, Galles N. 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Abstract

Background: Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods: For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings: By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4–82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5–42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4–41·3] in 1980 to 83·6% [82·3–84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4–44·1) in 1980 to 79·8% (78·4–81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019

Published
2021

3. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study

Author

Gregory A. Roth, George A. Mensah, Catherine O. Johnson, Giovanni Addolorato, Enrico Ammirati, Larry M. Baddour, Noël C. Barengo, Andrea Z. Beaton, Emelia J. Benjamin, Catherine P. Benziger, Aimé Bonny, Michael Brauer, Marianne Brodmann, Thomas J. Cahill, Jonathan Carapetis, Alberico L. Catapano, Sumeet S. Chugh, Leslie T. Cooper, Josef Coresh, Michael Criqui, Nicole DeCleene, Kim A. Eagle, Sophia Emmons-Bell, Valery L. Feigin, Joaquim Fernández-Solà, Gerry Fowkes, Emmanuela Gakidou, Scott M. Grundy, Feng J. He, George Howard, Frank Hu, Lesley Inker, Ganesan Karthikeyan, Nicholas Kassebaum, Walter Koroshetz, Carl Lavie, Donald Lloyd-Jones, Hong S. Lu, Antonio Mirijello, Awoke Misganaw Temesgen, Ali Mokdad, Andrew E. Moran, Paul Muntner, Jagat Narula, Bruce Neal, Mpiko Ntsekhe, Glaucia Moraes de Oliveira, Catherine Otto, Mayowa Owolabi, Michael Pratt, Sanjay Rajagopalan, Marissa Reitsma, Antonio Luiz P. Ribeiro, Nancy Rigotti, Anthony Rodgers, Craig Sable, Saate Shakil, Karen Sliwa-Hahnle, Benjamin Stark, Johan Sundström, Patrick Timpel, Imad M. Tleyjeh, Marco Valgimigli, Theo Vos, Paul K. Whelton, Magdi Yacoub, Liesl Zuhlke, Christopher Murray, Valentin Fuster, Noel C. Barengo, Andrea Beaton, Aime Bonny, Jonathan R. Carapetis, Sumeet Chugh, Michael H. Criqui, Nicole K. DeCleene, Joaquim Fernández-Sola, F. Gerry R. Fowkes, Nicholas J. Kassebaum, Walter J. Koroshetz, Awoke T. Misganaw, Ali H. Mokdad, Gláucia M.M. Oliveira, Catherine M. Otto, Mayowa O. Owolabi, Marissa B. Reitsma, Nancy A. Rigotti, Craig A. Sable, Saate S. Shakil, Karen Sliwa, Benjamin A. Stark, Imad I. Tleyjeh, Liesl J. Zuhlke, Mohsen Abbasi-Kangevari, Alireza Abdi, Aidin Abedi, Victor Aboyans, Woldu A. Abrha, Eman Abu-Gharbieh, Abdelrahman I. Abushouk, Dilaram Acharya, Tim Adair, Oladimeji M. Adebayo, Zanfina Ademi, Shailesh M. Advani, Khashayar Afshari, Ashkan Afshin, Gina Agarwal, Pradyumna Agasthi, Sohail Ahmad, Sepideh Ahmadi, Muktar B. Ahmed, Budi Aji, Yonas Akalu, Wuraola Akande-Sholabi, Addis Aklilu, Chisom J. Akunna, Fares Alahdab, Ayman Al-Eyadhy, Khalid F. Alhabib, Sheikh M. Alif, Vahid Alipour, Syed M. Aljunid, François Alla, Amir Almasi-Hashiani, Sami Almustanyir, Rajaa M. Al-Raddadi, Adeladza K. Amegah, Saeed Amini, Arya Aminorroaya, Hubert Amu, Dickson A. Amugsi, Robert Ancuceanu, Deanna Anderlini, Tudorel Andrei, Catalina Liliana Andrei, Alireza Ansari-Moghaddam, Zelalem A. Anteneh, Ippazio Cosimo Antonazzo, Benny Antony, Razique Anwer, Lambert T. Appiah, Jalal Arabloo, Johan Ärnlöv, Kurnia D. Artanti, Zerihun Ataro, Marcel Ausloos, Leticia Avila-Burgos, Asma T. Awan, Mamaru A. Awoke, Henok T. Ayele, Muluken A. Ayza, Samad Azari, Darshan B. B, Nafiseh Baheiraei, Atif A. Baig, Ahad Bakhtiari, Maciej Banach, Palash C. Banik, Emerson A. Baptista, Miguel A. 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Pribadi, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Ivo Rakovac, Pradhum Ram, Sudha Ramalingam, Juwel Rana, Priyanga Ranasinghe, Sowmya J. Rao, Priya Rathi, Lal Rawal, Wasiq F. Rawasia, Reza Rawassizadeh, Giuseppe Remuzzi, Andre M.N. Renzaho, Aziz Rezapour, Seyed Mohammad Riahi, Ross L. Roberts-Thomson, Leonardo Roever, Peter Rohloff, Michele Romoli, Gholamreza Roshandel, Godfrey M. Rwegerera, Seyedmohammad Saadatagah, Maha M. Saber-Ayad, Siamak Sabour, Simona Sacco, Masoumeh Sadeghi, Sahar Saeedi Moghaddam, Saeed Safari, Amirhossein Sahebkar, Sana Salehi, Hamideh Salimzadeh, Mehrnoosh Samaei, Abdallah M. Samy, Itamar S. Santos, Milena M. Santric-Milicevic, Nizal Sarrafzadegan, Arash Sarveazad, Thirunavukkarasu Sathish, Monika Sawhney, Mete Saylan, Maria I. Schmidt, Aletta E. Schutte, Subramanian Senthilkumaran, Sadaf G. Sepanlou, Feng Sha, Saeed Shahabi, Izza Shahid, Masood A. Shaikh, Mahdi Shamali, Morteza Shamsizadeh, Md Shajedur Rahman Shawon, Aziz Sheikh, Mika Shigematsu, Min-Jeong Shin, Jae Il Shin, Rahman Shiri, Ivy Shiue, Kerem Shuval, Soraya Siabani, Tariq J. Siddiqi, Diego A.S. Silva, Jasvinder A. Singh, Ambrish Singh Mtech, Valentin Y. Skryabin, Anna A. Skryabina, Amin Soheili, Emma E. Spurlock, Leo Stockfelt, Stefan Stortecky, Saverio Stranges, Rizwan Suliankatchi Abdulkader, Hooman Tadbiri, Eyayou G. Tadesse, Degena B. Tadesse, Masih Tajdini, Md Tariqujjaman, Berhane F. Teklehaimanot, Mohamad-Hani Temsah, Ayenew K. Tesema, Bhaskar Thakur, Kavumpurathu R. Thankappan, Rekha Thapar, Amanda G. Thrift, Binod Timalsina, Marcello Tonelli, Mathilde Touvier, Marcos R. Tovani-Palone, Avnish Tripathi, Jaya P. Tripathy, Thomas C. Truelsen, Guesh M. Tsegay, Gebiyaw W. Tsegaye, Nikolaos Tsilimparis, Biruk S. Tusa, Stefanos Tyrovolas, Krishna Kishore Umapathi, Brigid Unim, Bhaskaran Unnikrishnan, Muhammad S. Usman, Muthiah Vaduganathan, Pascual R. Valdez, Tommi J. Vasankari, Diana Z. Velazquez, Narayanaswamy Venketasubramanian, Giang T. Vu, Isidora S. Vujcic, Yasir Waheed, Yanzhong Wang, Fang Wang, Jingkai Wei, Robert G. Weintraub, Abrha H. Weldemariam, Ronny Westerman, Andrea S. Winkler, Charles S. Wiysonge, Charles D.A. Wolfe, Befikadu Legesse Wubishet, Gelin Xu, Ali Yadollahpour, Kazumasa Yamagishi, Lijing L. Yan, Srikanth Yandrapalli, Yuichiro Yano, Hiroshi Yatsuya, Tomas Y. Yeheyis, Yigizie Yeshaw, Christopher S. Yilgwan, Naohiro Yonemoto, Chuanhua Yu, Hasan Yusefzadeh, Geevar Zachariah, Sojib Bin Zaman, Muhammed S. Zaman, Maryam Zamanian, Ramin Zand, Alireza Zandifar, Afshin Zarghi, Mikhail S. Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Yunquan Zhang, Wangjian Zhang, Chenwen Zhong, Zhiyong Zou, Yves Miel H. Zuniga, and Christopher J.L. Murray

Subjects
BMI, body mass index, GBD, Global Burden of Diseases, Injuries, and Risk Factors Study, IS, ischemic stroke, 030204 cardiovascular system & hematology, MV, mitral valve, SDI, sociodemographic index, Global Health, UI, uncertainty interval, Global Burden of Disease, GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group, 0302 clinical medicine, Cost of Illness, LDL, low-density lipoprotein, Case fatality rate, Global health, 030212 general & internal medicine, IKF, impaired kidney function, 1102 Cardiorespiratory Medicine and Haematology, Incidence (epidemiology), Health Policy, IHD, ischemic heart disease, 1. No poverty, AC, alcoholic cardiomyopathy, 3. Good health, HICs, high-income countries, Cardiovascular Diseases, DALYs, disability-adjusted life years, TMREL, theoretical minimum risk exposure level, Public Health, HHD, hypertensive heart disease, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, AF, atrial fibrillation, Population health, CVD, cardiovascular disease, LMICs, low- and middle-income countries, PM, particulate matter, 1117 Public Health and Health Services, 03 medical and health sciences, JACC State-of-the-Art Review, RHD, rheumatic heart disease, Environmental health, medicine, Humans, LPA, low physical activity, YLLs, years of life lost, Health policy, Disease burden, PAD, peripheral artery disease, business.industry, SBP, systolic blood pressure, Public health, CKD, chronic kidney disease, The Present and Future, AFL, atrial flutter, Correction, HAP, household air pollution, ICD, International Classification of Diseases, CAVD, calcific aortic valve disease, YLDs, years lived with disability, Years of potential life lost, CHA, congenital heart anomalies, Cardiovascular System & Hematology, Heart Disease Risk Factors, business, population health
Abstract

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases., Central Illustration, Highlights • The burden of CVD, in number of DALYs and deaths, continues to increase globally. • CVD burden attributable to modifiable risk factors continues to increase globally. • Countries should invest in existing cost-effective public health programs and clinical interventions to target modifiable risks, promote healthy aging across the lifespan, and reduce disability and premature death due to CVD.

Published
2020

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