Current status   

DPT3 immunization coverage, 2008

DPT comprises a series of immunizations to prevent diphtheria, pertussis and tetanus. To be fully immunized, children must receive three doses of the vaccine before their first birthday. Complete coverage with DPT (DPT3) is a particularly valuable indicator of countries' performance of routine immunization and is often considered the best indicator of access to basic services, including health services.

Basic immunization schedule recommended for all children by the WHO Expanded Programme on Immunization

* An additional dose of oral polio vaccine administered at birth is only recommended in endemic or recently endemic countries.

For a comprehensive summary of recommended routine immunizations for children, go to http://www.who.int/immunization/policy/Immunization_routine_table2.pdf

Coverage for DPT3 increased to 82 per cent worldwide, but the number of developing countries estimated to have met the target of 80 per cent DPT3 coverage in every district has decreased from 44 in 2004 to 41 in 2008.

  Of the world’s 23.5 million children not immunized with DPT3, 16.5 million live in 10 countries

Absolute numbers of unvaccinated infants are highest in the most populous developing countries, some of which enjoy fairly high rates of immunization coverage. Efforts to raise global immunization will need a strong focus on the countries where the highest numbers of unvaccinated children live – while also ensuring that the countries where children are most likely to miss out on immunization are not neglected in the search for greater global impact.

Future directions

With renewed commitment, increases in routine coverage and the better availability of new vaccines, great progress can be achieved in reducing child deaths, even in the poorest countries and under difficult circumstances. Strategies to reach every district include re-establishing outreach services, district level microplanning, providing supportive supervision and linking communities with services.

In addition, campaigns such as those for polio eradication and measles mortality reduction have helped strengthen the cold chain and injection safety. A major advance in addressing maternal and neonatal tetanus in 2003–2005 was tackling cultural and geographical barriers through the use of new technologies and strategies. Support from GAVI for the introduction of new vaccines, including training, demand creation and cold-chain expansion, helped boost immunization activities.