Trends in DTP3 Vaccination in Asia (2012-2023)

DTP3 (diphtheria-tetanus-pertussis vaccine, third dose) coverage is a key indicator of the strength and continuity of routine immunization programs, which demonstrably reduces the burden of infectious diseases globally. This study aimed to assess trends in DTP3 vac-cination coverage across Asian regions and countries from 2012 to 2023, with a particular focus on changes associated with the COVID-19 pandemic. Methods: DTP3 vaccination data were obtained from official WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) and analyzed using Joinpoint regression to detect statistically sig-nificant changes in vaccination trends. Data were grouped by five Asian subregions based on the UN geoscheme (Central, Eastern, South-eastern, Southern, and Western Asia), and trends were weighted using birth cohort sizes. The presence of joinpoints and annual per-centage changes (APCs) was calculated, and potential pandemic-related disruptions were contextualized. Results: At the continental level, Asia experienced a modest 0.4% increase in DTP3 coverage between 2012 and 2023, with a significant joinpoint detected in 2018. Southeast and South Asia experienced declines in coverage after 2018, followed by partial recoveries. East and West Asia also exhibited trend changes overlapping with the pan-demic years. Central Asia remained stable with no detected joinpoint. Country-level anal-ysis revealed heterogeneity, with some nations experiencing persistent declines (e.g., Af-ghanistan, Yemen), while others maintained high or improving coverage (e.g., Bangla-desh, Iraq, Israel). The pandemic, systemic weaknesses, and emerging vaccine hesitancy and misinformation were identified as key influences. Conclusions: There is progress in DTP3 coverage across Asia. There were pandemic-related disruptions, particularly in re-gions with fragile health systems. Strategies to address zero-dose and dropout children, improve service continuity, and counter misinformation are essential to meet immuniza-tion targets under the Immunization Agenda 2030