Number of Zero-Dose Children on the Rise in Kenya

Vaccination figures in Kenya are falling short of the 95 percent coverage needed to prevent outbreaks, avert unnecessary diseases and deaths, and achieve measles elimination goals. This concerning trend is highlighted by the rise in the number of ‘zero-dose’ children, who have never received a single dose of any vaccine.

Before reaching the age of two, most Kenyan children are expected to have received over ten doses of vaccines to protect them from preventable diseases. However, more than 14,000 children in Kenya are described as ‘zero-dose’ children, a number that is steadily increasing, according to new data from the World Health Organization (WHO). These unvaccinated children, while indirectly protected by the vaccinated population, are the first to fall ill in the event of an outbreak.

A recent joint report by WHO and UNICEF, released last week, indicates that the number of children in Kenya unvaccinated against dangerous diseases such as polio is on the rise. The report points out that global immunization coverage has remained largely unchanged since 2022 and has yet to return to the levels seen in 2019.

For example, while close to 97 percent of children were being vaccinated against tuberculosis using the BCG vaccine in 2020, that number has now dropped to approximately 90 percent and continues to decline. Pneumococcal vaccination rates in Kenya are also disappointingly low at about 85 percent. The percentage of one-year-olds who have received three doses of the polio vaccine has decreased from 95 percent in 2021 to 90 percent today, though it is slowly rising.

These figures fall short of the 95 percent coverage needed to prevent outbreaks, avert unnecessary diseases and deaths, and achieve measles elimination goals. The Kenya Demographic and Health Survey 2022 revealed that children living in border areas and conflict settings are less likely to be vaccinated. Consequently, northern Kenya still has the lowest basic vaccination coverage in the country.

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The WHO and UNICEF estimates of national immunization coverage provide the world’s largest and most comprehensive dataset on immunization trends for vaccinations against 14 diseases. The data underscores the need for ongoing catch-up, recovery, and system-strengthening efforts.

Globally, the data shows that childhood immunization coverage stalled in 2023, leaving 2.7 million additional children un- and under-vaccinated compared to pre-pandemic levels in 2019. “The latest trends demonstrate that many countries continue to miss far too many children,” said UNICEF Executive Director Catherine Russell. “Closing the immunization gap requires a global effort, with governments, partners, and local leaders investing in primary healthcare and community workers to ensure every child gets vaccinated, and that overall healthcare is strengthened.”

According to the findings, the number of children who received three doses of the vaccine against diphtheria, tetanus, and pertussis (DTP) in 2023 – a key marker for global immunization coverage – stalled at 84 percent (108 million). However, the number of children who did not receive a single dose of the vaccine increased from 13.9 million in 2022 to 14.5 million in 2023.

More than half of unvaccinated children live in 31 countries with fragile, conflict-affected, and vulnerable settings. These children are especially vulnerable to preventable diseases because of disruptions and lack of access to security, nutrition, and health services. Additionally, 6.5 million children did not complete their third dose of the DTP vaccine, which is necessary to achieve disease protection in infancy and early childhood.

The data also shows that vaccination rates against the deadly measles disease have stalled, leaving nearly 35 million children with no or only partial protection. In 2023, only 83 percent of children worldwide received their first dose of the measles vaccine through routine health services. Meanwhile, the number of children receiving their second dose modestly increased from the previous year, reaching 74 percent of children.

“Measles outbreaks are the canary in the coalmine, exposing and exploiting gaps in immunization and hitting the most vulnerable first,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “This is a solvable problem. Measles vaccine is cheap and can be delivered even in the most difficult places. WHO is committed to working with all our partners to support countries to close these gaps and protect the most at-risk children as quickly as possible.”

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These trends reflect ongoing challenges with disruptions in healthcare services, logistical issues, vaccine hesitancy, and inequities in access to services. The increasing number of zero-dose children in Kenya and globally highlights the urgent need for concerted efforts to enhance immunization coverage and protect children from preventable diseases.