Childhood vaccination remains among the most effective and cost-effective health interventions and a core component of national disease‑prevention strategies (Chan et al., 2017[1]). High and equitable coverage of childhood vaccination campaigns is essential to interrupt disease transmission and protect all communities from several communicable diseases. Hence, coverage is an important quality of healthcare indicator. The section presents the coverage of vaccination programmes for diphtheria, tetanus toxoid and pertussis (DTP3), measles (Measles-containing-vaccine first and second-dose, MCV1 and MCV2) and hepatitis B (HepB3). Because of their importance and schedule these vaccination programmes represent a full spectrum of challenges related to routine vaccination for children.
In 2024, average DTP3 coverage in LAC was 86% (LAC32), below the 90% level recommended by WHO for programme performance (Figure 7.4) and below the OECD average of 93%. Seventeen of 32 LAC countries reached ≥90% (for example Antigua and Barbuda, Costa Rica, Cuba, Jamaica, Saint Lucia, and Brazil), while four remained <70% (Suriname, Venezuela, Haiti and Bolivia). The LAC average is higher than 2021 (82%) but has not returned to the ~90% regional average observed in 2018 (pre‑pandemic).
While the measles-containing-vaccine first dose (MCV1) averaged 88% in 2024 in the region, about 5‑10% of children fail to develop immunity after the first dose, so the second dose is required to ensure immunity in those at risk (World Health Organization, 2019[2]). MCV2 was notably lower at 76% for LAC32 (Figure 7.5). The OECD averages were 93% (MCV1) and 88% (MCV2). Sixteen of 32 countries achieved ≥90% for MCV1, but only seven did so for MCV2 (Cuba, Guyana, St Vincent and the Grenadines, Uruguay, Saint Kitts and Nevis, El Salvador and Jamaica). Twelve countries had MCV2 <70% (including Brazil, Paraguay, Bahamas, Argentina, Mexico, Haiti, Ecuador, Suriname, Venezuela and Bolivia). WHO’s elimination goal requires ≥95% coverage for both doses – few LAC countries currently sustain that level across MCV1 and MCV2. MCV1 has risen from 83% in 2021 but remains below the ~90% regional average seen in 2018; MCV2 at 76% highlights a persistent second-dose gap relative to pre‑pandemic performance (90% in 2018).
WHO recommends three doses of the Hepatitis B vaccine for all children, with a timely birth dose as part of national immunisation schedules (WHO, 2017[3]). Coverage for this vaccine averaged 86% in LAC in 2024, versus 92% in the OECD (Figure 7.6). Sixteen LAC countries reached ≥90%, but four had <70% coverage (Suriname, Venezuela, Haiti and Bolivia). This represents an improvement from 81% in 2021 but remains short of pre‑pandemic levels (≈90% in 2018 where comparable).
Persistent coverage gaps reflect both service‑delivery and demand-side barriers. Beyond logistical issues, limited provider recommendation, misinformation, and socio-economic barriers continue to hinder vaccination uptake (Guzman-Holst et al., 2020[4]). Strengthening programme quality (appointment reminders/recall, outreach to under-served areas, continuous monitoring of drop-out from dose 1 to dose 2) and targeted community engagement to counter misinformation are priorities to close the MCV2 gap and lift DTP3 and HepB3 coverage above WHO benchmarks.
