Despite progress in making immunization more accessible to low-income communities over the last two decades, recent WHO/UNICEF WUENIC data shows that 25 million children worldwide did not receive one or more doses of lifesaving vaccinations in 2021. Of these children, 18 million have never been vaccinated at all, leading to high under-five mortality rates. This group of children is referred to as “Zero Dose Children,” and they are particularly concentrated in the Sahel and the Horn of Africa, where over 5.2 million of them reside across 11 countries.
These 5.2 million children are not receiving life-saving vaccinations due to no or limited access to the health system as a result of conflict, climatic events such as drought and seasonal floods, and movement of populations for different reasons. These communities are often characterized by food insecurity, violence, displaced people, refugees and cross-border migration.
Gavi, the Vaccine Alliance, launched a new partnership, the Zero-dose Immunization Program (ZIP), to help governments reach these vulnerable children. The program will operate for the next two and a half years and will consist of two projects, RAISE 4 Sahel and REACH, led by two consortia of organizations with expertise in operating in complex contexts.
The goal of the ZIP program is to support governments in the Sahel and Horn of Africa to increase vaccination coverage and reach zero-dose children. To achieve this, Gavi is taking a novel approach by partnering with non-traditional and diverse partners such as NGOs and local civil society organizations to reach families and children in areas that governments cannot access, such as cross-border settings and conflict areas.
Who are Zero-Dose Children?
Zero-Dose Children are those who have not received any routine vaccines.
For operational purposes, Gavi defines Zero-Dose Children as those missing a first dose of diphtheria, tetanus, and whooping cough (pertussis) containing vaccine.
Who are Under-Immunised Children?
Under-Immunised Children are those who have not received a full course of
routine vaccines. For operational purposes, Gavi defines Under-Immunised Children as those missing a third dose of diphtheria, tetanus, and whooping cough (pertussis) containing vaccine.
Reaching Kids Where, and How, they Are
Like zero-dose communities all over the world, the populations served by the ZIP consortia in the Sahel and in the Horn of Africa are likely to be missing more than vaccines. Research shows that two-thirds of zero-dose kids live in very poor households facing deprivations including lack of access to reproductive health services, water, and good sanitation.