Aguinaga-Ontoso Ines, Guillen-Aguinaga Laura, Guillen-Aguinaga Sara, Alas-Brun Rosa, Guillen-Aguinaga Miriam, Aguinaga-Ontoso Enrique, Onambele Luc, Guillen-Grima Francisco
Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain.
Group of Clinical Epidemiology, Area of Epidemiology and Public Health, Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain.
Vaccines (Basel). 2025 Aug 19;13(8):877. doi: 10.3390/vaccines13080877.
BACKGROUND/OBJECTIVES: DTP3 (diphtheria-tetanus-pertussis vaccine, third dose) coverage is a key indicator of the strength and continuity of routine immunization programs, which demonstrably reduces the burden of infectious diseases globally. This study aims to assess trends in DTP3 vaccination coverage across Asian regions and countries from 2012 to 2023, focusing on changes associated with the COVID-19 pandemic.
DTP3 vaccination data were obtained from official WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) and analyzed using Joinpoint regression to detect statistically significant changes in vaccination trends. Data were grouped by five Asian subregions based on the UN geoscheme (Central, Eastern, Southeastern, Southern, and Western Asia), and trends were weighted using birth cohort sizes. The presence of joinpoints and annual percentage changes (APCs) was calculated, and potential pandemic-related disruptions were contextualized.
At the continental level, Asia experienced a modest 0.4% annual increase in DTP3 coverage between 2012 and 2023, with a significant joinpoint detected in 2018. Following this, Southeast Asia's coverage declined at an annual rate of -4.32% before beginning to recover in 2021, while South Asia showed a similar pattern. Country-level analysis revealed significant heterogeneity, with a comparison between 2019 and 2023 showing profound post-pandemic declines in some nations, such as Lebanon (-21%) and Myanmar (-9.4%), while others, like Iraq and the Philippines, achieved substantial recoveries with coverage increasing by over 6 percentage points. These trends contrasted with persistent declines in fragile states (e.g., Afghanistan, Yemen) and sustained high coverage in others (e.g., Bangladesh, Israel). The pandemic, systemic weaknesses, emerging vaccine hesitancy, and misinformation were identified as key influences.
There is progress in DTP3 coverage across Asia. There were pandemic-related disruptions, particularly in regions with fragile health systems. Strategies to address zero-dose and dropout children, improve service continuity, and counter misinformation are essential to meet immunization targets under the Immunization Agenda 2030.
背景/目标：白喉-破伤风-百日咳三联疫苗第三剂（DTP3）接种率是常规免疫规划力度和连续性的关键指标，该指标显著降低了全球传染病负担。本研究旨在评估2012年至2023年亚洲各地区和国家DTP3疫苗接种率的趋势，重点关注与新冠疫情相关的变化。
DTP3疫苗接种数据来自世界卫生组织/联合国儿童基金会的国家免疫接种覆盖率官方估计值（WUENIC），并使用Joinpoint回归进行分析，以检测疫苗接种趋势的统计学显著变化。数据根据联合国地理区域划分方案按亚洲五个次区域进行分组（中亚、东亚、东南亚、南亚和西亚），并使用出生队列规模进行趋势加权。计算连接点的存在情况和年度百分比变化（APC），并将潜在的与疫情相关的干扰情况进行背景分析。
在大陆层面，2012年至2023年期间亚洲的DTP3接种率年均适度增长0.4%，2018年检测到一个显著的连接点。此后，东南亚的接种率在2021年开始恢复之前以-4.32%的年率下降，南亚也呈现出类似模式。国家层面的分析显示出显著的异质性，2019年与2023年的比较表明，一些国家在疫情后出现了大幅下降，如黎巴嫩（-21%）和缅甸（-9.4%），而其他国家，如伊拉克和菲律宾，则实现了大幅回升，接种率提高了6个多百分点。这些趋势与脆弱国家（如阿富汗、也门）的持续下降以及其他国家（如孟加拉国、以色列）的持续高接种率形成对比。疫情、系统弱点、新出现的疫苗犹豫和错误信息被确定为关键影响因素。
亚洲在DTP3接种率方面取得了进展。存在与疫情相关的干扰，特别是在卫生系统脆弱的地区。应对零剂次和失访儿童、改善服务连续性以及对抗错误信息的策略对于实现《2030年免疫议程》下的免疫目标至关重要。
