Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Background: Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. // Methods: For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. // Findings: By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4–82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5–42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4–41·3] in 1980 to 83·6% [82·3–84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4–44·1) in 1980 to 79·8% (78·4–81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56·8 million (52·6–60·9) to 14·5 million (13·4–15·9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. // Interpretation: After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines

Seasonal variation in the copepod community structure from a tropical Amazon estuary, Northern Brazil

The main purpose of this study was to investigate the seasonal variation of copepod community structure during the months of July, September and November 2003 (dry season) and January, March and May 2004 (rainy season) in the Curuçá estuary, northern Brazil. Samples were collected during neap tides via gentle 200µm mesh net tows from a small powerboat. Measurements of surface water conductivity were accomplished in situ using an electronic conductivimeter and salinity was later obtained through the transformation of the conductivity values. Salinity varied seasonally from 7.2 ± 0.1 to 39.2 ± 1.8 (mean ± standard deviation) and was influenced mainly by differences in the amount of rainfall between the studied sampling seasons. In total, 30 Copepoda taxa were identified and Acartia tonsa comprised the most representative species throughout the entire studied period followed by Acartia lilljeborgii, Subeucalanus pileatus and Paracalanus quasimodo. In the present study, the density values, ecological indexes and copepod species dominance presented a clear seasonal pattern, showing that the studied area may be considered seasonally heterogeneous in relation to the investigated parameters.<br>O presente estudo teve como objetivo principal avaliar a variação sazonal na estrutura da comunidade dos copépodos durante os meses de julho, setembro e novembro de 2003 (período seco) e janeiro, março e maio de 2004 (período chuvoso) no estuário do Curuçá, Norte do Brasil. As amostras foram coletadas nas marés de quadratura com auxílio de uma rede deplâncton com 200µm de abertura de malha, rebocada por meio de uma pequena embarcação a motor. As medidas de condutividade da água foram realizadas in situ utilizando-se um condutivímetro eletrônico e a salinidade foi posteriormente obtida através da transformação dos valores de condutividade. Os valores de salinidade variaram sazonalmente de 7, 2 ± 0, 1a 39, 2 ± 1, 8 (média ± desvio padrão), tendo sido principalmente influenciados pelas diferenças nas taxas de precipitação entre os períodos de amostragem estudados. Foram identificados no total 30 táxons, com Acartia tonsa constituindo a espécie mais representativa durante todo o período de estudo,seguida por Acartia lilljeborgii, Subeucalanus pileatus e Paracalanus quasimodo. Durante este trabalho, os valores de densidade, índices ecológicos e dominância das espécies de copépodos apresentaram um padrão sazonal claro, mostrando que a área estudada pode ser considerada sazonalmente heterogênea em relação a estes parâmetros investigados