MMWR Morb Mortal Wkly Rep. 2019 Oct 25;68(42):937-942. doi: 10.15585/mmwr.mm6842a1.
Endorsed by the World Health Assembly in 2012, the Global Vaccine Action Plan 2011-2020 (GVAP) (1) calls on all countries to reach ≥90% national coverage with all vaccines in the country's national immunization schedule by 2020. Building on previous analyses (2) and using the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) global vaccination coverage estimates as of 2018, this report presents global, regional, and national vaccination coverage estimates and trends, including vaccination dropout rates. According to these estimates, global coverage with the first dose of diphtheria and tetanus toxoids and pertussis-containing vaccine (DTP1) remained relatively unchanged from 2010 (89%) to 2018 (90%). Global coverage with the third DTP dose (DTP3) followed a similar global trend to that of DTP1, remaining relatively consistent from 2010 (84%) to 2018 (86%) (3). Globally, 19.4 million children (14%) were not fully vaccinated in 2018, and among them, 13.5 million (70%) did not receive any DTP doses. Overall, dropout rates from DTP1 to DTP3 decreased globally from 6% in 2010 to 4% in 2018. Global coverage with the first dose of measles-containing vaccine (MCV1) remained between 84% and 86% during 2010-2018. Among countries that offer a second MCV dose (MCV2) during the second year of life, coverage increased from 19% in 2007 to 54% in 2018; among countries offering MCV2 to older age groups (children aged 3-14 years), coverage also increased, from 36% in 2007 to 69% in 2018 (3). Globally, the estimated difference in coverage with MCV1 and MCV2 in 2018 was 17%. However, among new and underused vaccines, global coverage increased from 2007 to 2018 for completed series of rotavirus vaccine, pneumococcal conjugate vaccine (PCV), rubella vaccine, Haemophilus influenzae type b vaccine (Hib), and hepatitis B vaccine (HepB). To reach global vaccination coverage goals for vaccines recommended during childhood, adolescence, and adulthood, tailored strategies that address local determinants for incomplete vaccination are needed, including targeting hard-to-reach and hard-to-vaccinate populations.
2012 年，世界卫生大会批准了《全球疫苗行动计划 2011-2020 年》（GVAP）（1），该计划呼吁所有国家到 2020 年，将国家免疫规划中所有疫苗的全国覆盖率提高到≥90%。本报告基于之前的分析（2），并利用世界卫生组织（世卫组织）和联合国儿童基金会（儿基会）截至 2018 年的全球疫苗接种覆盖率估计数，介绍了全球、区域和国家的疫苗接种覆盖率估计数和趋势，包括疫苗接种中断率。根据这些估计数，2010 年（89%）至 2018 年（90%），白喉、破伤风类毒素和无细胞百日咳疫苗（DTP1）的全球首剂覆盖率保持相对不变。全球第三剂 DTP 疫苗（DTP3）的覆盖率与 DTP1 相似，从 2010 年的 84%到 2018 年的 86%，基本保持一致（3）。2018 年，全球仍有 1940 万儿童（14%）未完全接种疫苗，其中 1350 万（70%）儿童未接种任何 DTP 疫苗。总体而言，2010 年至 2018 年，DTP1 到 DTP3 的疫苗接种中断率从 6%下降到 4%。2010-2018 年，含麻疹疫苗（MCV1）的全球首剂覆盖率保持在 84%至 86%之间。在为 2 岁以下儿童提供第二剂 MCV 疫苗的国家中，覆盖率从 2007 年的 19%增加到 2018 年的 54%；在为年龄较大的儿童（3-14 岁）提供 MCV2 的国家中，覆盖率也有所增加，从 2007 年的 36%增加到 2018 年的 69%（3）。全球范围内，2018 年 MCV1 和 MCV2 的覆盖率估计相差 17%。然而，在新出现的和使用不足的疫苗中，轮状病毒疫苗、肺炎球菌结合疫苗（PCV）、风疹疫苗、b 型流感嗜血杆菌疫苗（Hib）和乙型肝炎疫苗（HepB）的全球覆盖率从 2007 年到 2018 年有所增加。为了实现儿童、青少年和成人时期推荐疫苗的全球疫苗接种覆盖率目标，需要制定有针对性的战略，解决不完全接种的地方决定因素，包括针对难以覆盖和难以接种的人群。
