Coverage and numberof infants not vaccinatedfor DTP3 by country, 2019

Immunization Regional Snapshot 2019Eastern and Southern Africa

Coverage levels (%) and numbers of infants un-vaccinated and under-vaccinated for DTP, 2019

>=90%80~89%60~79%<60%

Global and regional coverage of DTP3, 2000–2019

In 2019, the regional coverage of DTP3 was 80%, compared to global average of 85%.

In 2019, the regional coverage of MCV1 was 75% compared to global coverage of 85%

In 2019, 3.4 out of 16.5 million surviving infants in the region did not receive the three recommended doses of DTP vaccine

9 out of 23 countries in the region have reached and sustained the target coverage of 90% or above for DTP3 for the past three years

Vaccination Coverage by country, 2019

*Achieved greater than 90% coverage for at least the past 3 consecutive years

Note: Please find the acronym definitionson page 3

Ethiopia and Angola, with an estimated 1.6 million infants not vaccinated for DTP3, accounted for 46 per cent of the total ESAR un- and under-vaccinated surviving infants.

Countries with dark blue color, Angola, Ethiopia, Madagascar, Somalia, South Africa, and South Sudan have the lowest coverage levels with highest number of not vaccinated infants for DTP3. Botswana, Comoros, Eritrea, Eswatini, Mauritius, and Seychelles have the highest coverage levels with lowest numbers of not vaccinated infants for DTP3.

No. of Unvaccinated Children

Cove

rage

(%)

LOWER

HIGHER

MOREFEWER

Angola

Botswana

Burundi

Comoros

Eritrea

Ethiopia

Kenya

Lesotho

Madagascar

Malawi

Mauritius

Mozambique

Namibia

RwandaSeychelles

Somalia

South Sudan

Eswatini

United Republicof Tanzania

Uganda

Zambia

Zimbabwe

SouthAfrica

Note: Numbers in this graph are the rounded numbers of infants not vaccinated for DTP3.

More than 3 million still not fully vaccinated

Forty per cent of countries to reach and maintain 90% coverage

Measles regional coverage below global levels

Note: This map is not to scale. It does not reflect a position by UNICEF on the legal status of any country or area or the delimitation of any frontiers. Please find more information on how to interpret the map on page 3.

BCG DTP1 DTP3 Polio3 MCV1 MCV2 HepB3 Hib3 Rota PCV3 YFV HPV Angola 69 67 57 51 51 45 53 53 58 53 45 –

Botswana 98 98 95* 96 97 76 95 95 86 92 – 47Burundi 93 97 93* 93 92 80 93 93 95 93* – –

Comoros 94 96 91* 94 90 – 91 91 – – – –Eritrea 97 97 95* 95 99 88 95 95 96 95* – –

Eswatini 98 96 90* 89 81 75 90 90 87 87 – –Ethiopia 69 80 69 72 58 41 68 68 68 63 – 84

Kenya 95 97 92 87 89 45 92 92 92 92 2 –Lesotho 96 92 87 87 90 82 87 87 87 87 – –

Madagascar 70 85 79 80 69 – 79 79 79 79 – –Malawi 91 97 95 94 92 75 95 95 92 95 – –

Mauritius 99 97 96* 97 99 99 97 97 96 97 – 80Mozambique 94 93 88 88 87 85 88 88 88 80 – –

Namibia 94 92 87 84 80 56 87 87 90 57 – –Rwanda 98 99 98* 98 96 92 98 98 98 98* – 94

Seychelles 98 99 99* 99 99 99 99 99 99 92 – 68Somalia 37 52 42 47 46 – 42 42 – – – –

South Africa 84 84 77 77 72 54 77 77 73 76 – 56South Sudan 52 51 49 50 49 – 49 49 – – – –

Uganda 88 99 93* 92 87 – 93 93 87 92* – 64United Republic of Tanzania 91 91 89 89 88 72 89 89 85 83 – 49

Zambia 95 94 88 89 93 66 88 88 90 89 – –Zimbabwe 95 94 90 90 85 75 90 90 92 90 – 67

88 ROSA85 Global

80 ESAR

95 CEECIS

91 MENA

81 LACR

66 WCAR

92 EAPR

7275

7983

85 85

91

84

93 93 94

83

8893

59

65

70

75 7779

93

87 86 91 89

6773

80

4346

58

7063

61

20

40

60

80

100

2000 2005 2010 2015 2019

Cove

rage

(%)

89

Angola

Burundi

Ethiopia

KenyaMadagascar

Malawi

Mozambique

Somalia South Africa

South SudanUnited Republic of Tanzania

Uganda

ZambiaZimbabwe

519,600

1,071,200

115,100 178,900

128,800

348,600 263,900

185,500 223,200

110,400

Sources: WHO-UNICEF Estimates of National Immunization Coverage (WUENIC), revision 2019 / The World Population Prospects – 2020 revision, UN Population Division, New York, USA.

Top 5 countries with the most infants not vaccinated for DTP1 (un-vaccinated) and DTP3 (under-vaccinated), 2017–2019

DTP3 coverage change from 2018 to 2019, by country

Under−vaccinatedUn−vaccinated

Under−vaccinatedUn−vaccinated

Immunization Regional Snapshot 2019 I Eastern and Southern Africa UNICEF

2019

2019

2019

2019

2019

2018

2018

2018

2018

2018

2017

2017

2017

2017

2017

United Republicof Tanzania

South Africa

Somalia

Angola

Ethiopia

Number of infants (in thousands)

Note: Countries with high coverage (>=95%) in 2019 and a change in coverage within 2% from 2018: Botswana, Eritrea, Mauritius, Rwanda, and Seychelles.

Decrease more than -5% Decrease 2% to 5% Change within 2% Increase more than 5%Increase 2% to 5%

Regional Vaccination Trends, 2000–2019

0

10

20

30

40

50

60

70

80

90

100

2000 2005 2010 2015 2019

Cove

rage

(%)

0

10

20

30

40

50

60

70

80

90

100

2000 2005 2010 2015 2019

Cove

rage

(%)

0

10

20

30

40

50

60

70

80

90

100

2000 2005 2010 2015 2019

Cove

rage

(%)

0

10

20

30

40

50

60

70

80

90

100

20102005 2015 2019

Cove

rage

(%)

74

59

9

6

79

65

45

23

82

70

56

33

84

75

85

77

8679

868079

DTP1

DTP3

HEPB3

HIB3

60

6

64

5

67

5

74

6

78

5

76

22

75

47

MCV1

MCV2

6367 69

7578

9

807680

IPV1

POL3

1

29

7

69

58

7476PCV3

ROTAC

0

1

2

3

4

5

2010 20152000 2005 2019

1.61.6 1.7 1.7 1.7

1.4 1.6 1.7 1.41.3 1.3 1.3 1.2 1.1

1.2 1.1 1.2 1 1 1.1

3.1 2.9 2.7 2.6 2.5 2.5 2.4 2.2 2.3 2.2 2.1 2 2.3 2.52.2 2.2 2.2 2.4 2.3 2.3

0 300 600 900

520

1071

349

264

223

437

1091

340

300

219

508

1042

331

278

195

40

50

60

70

80

90

100

40 50 60 70 80 90 100

Year of 2018

Year

of 2

019

Num

ber o

f inf

ants

(mill

ions

)

Angola

Burundi

Eswatini

Ethiopia

Kenya

Lesotho

Madagascar

Malawi

Mozambique

Namibia

Somalia

South Africa

South Sudan

United Republic of Tanzania

Uganda

Zambia

Number of infants in the region not vaccinated for DTP1 (un-vaccinated)* and DTP3 (under-vaccinated), 2000–2019

Note: Zero-dose is defined as un-vaccinated children for DTP1

Immunization Regional Snapshot 2019 I Eastern and Southern Africa UNICEF

Source: Global Routine Immunization Strategies and Practices (GRISP): a companion document to the GLobal Vaccine Action Plan (GVAP). ISBN 978 92 4 151010 3 (NLM classification: WA 115).https://www.who.int/immunization/programmes_systems/policies_strategies/GRISP_infographic_EN.pdf?ua=1

Vaccine coverage: Percentage of infants (children under one year of age) who received certain vaccine-doses. For example, coverage of DTP3 is the percentage of infants that received all three doses of diphtheria, tetanus, and pertussis (DTP) vaccine.

Un-vaccinated: An infant that did not receive any vaccine. In this regional profile, un-vaccinated is defined as an infant that did not receive any DTP vaccine (not vaccinated for DTP1). It is also used as a proxy for "zero-dose".

Under-vaccinated: An infant that received some but not all the recommended vaccine-doses on the national schedule. In this regional profile, under-vaccinated is defined in relation to the DTP vaccination series not the entire national immunization schedule.

Vaccine-Doses:

• Bacillus Calmette-Guerin (BCG): vaccine against tuberculosis• Diphtheria, tetanus, and pertussis vaccine, first dose (DTP1) andthird dose (DTP3)• Hepatitis B vaccine, third dose (HepB3)• Haemophilus influenzae type B vaccine, third dose (Hib3)• Poliomyelitis vaccine, third dose (Polio3)• Measles containing vaccine, first dose (MCV1) and second dose(MCV2)• Rotavirus vaccine, last dose (Rota)• Pneumococcal vaccine, third dose (PCV3)• Human Papillomavirus vaccine, last dose (HPV): vaccine to protectagainst certain types of human papillomavirus that can lead to canceror genital warts• Yellow Fever vaccine (YFV)

The bi-scale map shows both the level of coverage and the total number of infants not vaccinated for DTP3.

Definitions of immunization terms Interpretation of graphs

GRISP: Global Routine Immunization Strategies and PracticesCoordinating Actions to Achieve Disease Prevention for All

Tailored strategies that identify undervaccinated and unvaccinated persons and regularly provide them with the vaccines they need

Strategies to reach

Strategic multiyear plans and operational annual plans outlining and coordinating strategies and activities, monitored quarterly

Strategic and operational plans

Assurance that sufficient and adequately appropriated funds reach the operational level of the programme regularly

Operational level funding

Regular and systematic capacity building, skills development and supportive supervision for

vaccinators and district managers

Vaccinator and manager skills

The most important factor for all other eight investments to succeed: A capable national team—supplied with sufficient resources and authority—to excellently manage each country's national immunization program

National team

Expanded routine immunization schedules that

cover people's entire lives

Life course vaccination

An information system that identifies and tracks each person's vaccination status

Accurate information system

Modernized vaccine supply chains and management to ensure the correct amounts of the right potent vaccines are available at each vaccination session

Modern vaccine supply chain

Community support

Shared responsibility for immunization delivery between communities and the immunization programme to reach uniformly high

coverage through high demand and quality services

Less than 80% coverage and ranked in the group of countries with the most number of under-vaccinated infants within the region.

80% to 89% coverage and ranked in the group of countries with the most number of under-vaccinated infants within the region.

Greater than or equal to 90% coverage and ranked in the group of countries with the most number of under-vaccinated infants within the region.

Less than 80% coverage and ranked in the middle group of countries in terms of number of under-vaccinated infants within the region.

80% to 89% coverage and ranked in the middle group of countries in terms of number of under-vaccinated infants within the region.

Greater than or equal to 90% coverage and ranked in the middle group of countries in terms of number of under-vaccinated infants within the region.

Less than 80% coverage and ranked in the group of countries with the least number of under-vaccinated infants within the region.

80% to 89% coverage and ranked in the group of countries with the least number of under-vaccinated infants within the region.

Greater than or equal to 90% coverage and ranked in the group of countries with the least number of under-vaccinated infants within the region.

The DTP3 coverage change from 2018 to 2019 scatter plot shows the change in DTP3 coverage between 2018 and 2019. Countries that experienced more than 5 percentage point drop in coverage since the previous year are labelled in dark red. Similarly, countries that experienced more than 5 percentage point increase in coverage since the previous year are labelled in dark blue. Countries with no significant changes (less than 2 percentage points) are labelled in yellow.

The GRISP framework outlines the specific strategies and activities required to ensure the lifesaving power of routine immunization is accessible to all—regardless of who they are or where they live. It breaks down into the following nine areas: