Current status

DTP3 immunization coverage, 2006

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* for infants recommended by the WHO Expanded Programme on Immunization**

Age	Vaccines	Scheme A**	Scheme B**
Birth	BCG, OPV 0	HB1
6 weeks	DPT 1, OPV 1	HB2	HB1
10 weeks	DPT 2, OPV 2		HB2
14 weeks	DPT 3, OPV 3	HB3	HB3
9 months	Measles Yellow fever***

* This overview gives an indication of the basic vaccination schedule, which varies by country. In Costa Rica, for example, the measles vaccine is given at 15 months. With the introduction of new vaccines, the vaccination schedule is getting more complex.
** Scheme A is recommended in countries where perinatal transmission of hepatitis B virus is frequent (e.g. South-East Asia). Scheme B may be used in countries where perinatal transmission is less frequent (e.g. sub-Saharan Africa).
*** In countries where yellow fever poses a risk.
Source: State of the world's vaccines and immunization, WHO, UNICEF 1996

Coverage for DPT3 increased to 79 per cent worldwide, and the number of developing countries estimated to have met the target of 80 per cent DPT3 coverage in every district has increased to 71 in 2006 from 41 in 2004.

OF THE WORLD’S 26 MILLION CHILDREN NOT IMMUNIZED WITH DPT3, 20 MILLION LIVE IN 10 COUNTRIES: Number of children not immunized with DPT3 (2006)

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 most 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 to 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.