Nigeria is on top of the list of global unvaccinated children with about 4 million children missing out in the first dose of the measles vaccines, the United Nation Children’s Fund (UNICEF) has said.

The global agency said Nigeria has the highest number of children under one year who missed out on the first dose, at nearly 4 million.

An estimated 169 million children globally missed out on the first dose of the measles vaccine between 2010 and 2017, or 21.1 million children a year on average, UNICEF also said.

Nigeria is followed closely by India with 2.9 million.

In low and middle-income countries, the situation is critical. In 2017, for example, other countries with huge statistics are Pakistan and Indonesia (1.2 million each) and Ethiopia (1.1 million).

The global body warns that against the widening pockets of unvaccinated children, which according to him have created a pathway to the measles outbreaks hitting several countries around the world today.

In the first three months of this year, more than 110,000 measles cases were reported worldwide – up nearly 300 per cent from the same period last year. An estimated 110,000 people, most of them children, died from measles in 2017, a 22 per cent increase from the year before.

Two doses of the measles vaccine are essential to protect children from the disease, but due to lack of access, poor health systems, complacency, and in some cases, fear or scepticism about vaccines, the global coverage of the first dose of the measles vaccine was reported at 85 per cent in 2017.

The figure has remained relatively constant over the last decade, despite population growth.

Global coverage for the second dose is much lower, at 67 per cent. WHO recommends a threshold of 95 per cent immunisation coverage to achieve “herd immunity”.

In high income countries, while coverage with the first dose is 94 per cent, coverage for the second dose drops to 91 per cent, according to the latest data.

The United States (U.S) tops the list of high-income countries with the most children not receiving the first dose of the vaccine between 2010 and 2017, at more than 2.5 million.

It is followed by France and the United Kingdom (UK), with over 600,000 and 500,000 unvaccinated infants during the same period.

Worldwide coverage levels of the second dose of the measles vaccines are even more alarming. Of the top 20 countries with the largest number of unvaccinated children in 2017, nine have not introduced the second dose.

Twenty countries in sub-Saharan Africa have not introduced the necessary second dose in the national vaccination schedule, putting over 17 million infants a year at higher risk of measles during their childhood.

Speaking on the development, UNICEF’s Executive Director Henrietta Fore said: “The measles virus will always find unvaccinated children. If we are serious about averting the spread of this dangerous but preventable disease, we need to vaccinate every child in rich and poor countries alike.

“Measles is far too contagious.

“It is critical not only to increase coverage but also to sustain vaccination rates at the right doses to create an umbrella of immunity for everyone.”