Addressing disruptions in childhood routine immunisation services during the COVID-19 pandemic: perspectives from Nepal, Senegal and Liberia (original) (raw)
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Assessment of Disruption of Routine Childhood Immunization in Developing Countries Due to Pandemic
Cureus
The COVID-19 pandemic, also known as the coronavirus pandemic, began in March 2020 and was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pandemic impacted the global healthcare system. It caused the biggest threat to the global routine immunization system. Routine childhood immunization was disrupted globally, particularly in the early pandemic period. This review discusses the severity of disruptions to routine immunization, their root causes, and remedial measures to lessen these disruptions. It is essential to maintain routine medical care, especially routine immunization, to avert morbidity and death from several diseases that vaccines can prevent, including a pandemic. The healthcare system's reaction to a pandemic must include catch-up vaccinations because missed vaccines increase the population's and children's health risks.
Bulletin of the World Health Organization, 2022
Objective To examine changes in vaccination of children younger than 1 year during the coronavirus disease 2019 (COVID-19) pandemic (March 2020-August 2021) in Haiti, Lesotho, Liberia and Malawi. Methods We used data from health management information systems on vaccination of children aged 12 months or younger in districts supported by Partners In Health. We used data from January 2016 to February 2020 and a linear model with negative binomial distribution to estimate the expected immunization counts for March 2020-August 2021 with 95% prediction intervals, assuming no pandemic. We compared these expected levels with observed values and estimated the immunization deficits or excesses during the pandemic months. Findings Baseline vaccination counts varied substantially by country, with Lesotho having the lowest count and Haiti the highest. We observed declines in vaccination administration early in the COVID-19 pandemic in Haiti, Lesotho and Liberia. Continued declines largely corresponded to high rates of COVID-19 infection and discrete stock-outs. By August 2021, vaccination levels had returned to close to or above expected levels in Haiti, Liberia and Lesotho; in Malawi levels remained below expected. Conclusion Patterns of childhood immunization coverage varied by country over the course of the pandemic, with significantly lower than expected vaccination levels seen in one country during subsequent COVID-19 waves. Governments and health-care stakeholders should monitor vaccine coverage closely and consider interventions, such as community outreach, to avoid or combat the disruptions in childhood vaccination.
Current Tropical Medicine Reports
Purpose of Review The COVID-19 pandemic, since 2020, has affected health care services and access globally. Although the entire impact of COVID-19 pandemic on existing global public health is yet to be fully seen, the impact of COVID-19 pandemic on global childhood immunization programs is of particular importance. Recent Findings Disruptions to service delivery due to lockdowns, challenges in vaccination programs, vaccine misinformation and hesitancy, and political and social economic inequalities all posed a threat to existing childhood immunization programs. These potential threats were especially critical in LMIC where childhood immunization programs tend to experience suboptimal implementation. Summary This review provides an overview of childhood immunizations and discusses past pandemics particularly in LMIC, factors contributing to disparities in childhood immunizations, and reviews potential lessons to be learned from past pandemics. Vaccine hesitancy, social determinants of health, and best practices to help lessen the pandemic's influence are also further elaborated. To address current challenges that hindered the progress made in prevention of childhood illnesses through vaccination campaigns and increased vaccine availability, lessons learned through best practices explored from past pandemics must be examined to mitigate impact of COVID-19 on childhood immunization and in turn conserve health and improve economic well-being of children especially in LMIC.
Journal of Pharmaceutical Policy and Practice
Background The COVID-19 pandemic has disproportionately affected all essential healthcare services delivery in low-resource settings. This study aimed to explore the challenges and experiences of providers and users of childhood immunisation services in Nepal during the COVID-19 pandemic. Methods Semi-structured qualitative interviews were conducted with childhood immunisation service providers and users (i.e., parents of children) from Kathmandu valley, Nepal. All interviews were conducted through phone or internet-based tools, such as Zoom, WhatsApp, and messenger. All interviews were audio-recorded, transcribed verbatim, and analysed using theme-based content analysis in an Excel spreadsheet. Results A total of 15 participants (n = 7 service providers and n = 8 service users) participated. Six themes were identified, namely: (1) impact of COVID-19 and lockdown on childhood immunisation services; (2) motivation and resilience for childhood immunisation; (3) Biosafety practices and...
Childhood immunization services accessibility and utilization during the COVID-19 pandemic in Africa
Journal of Infection, 2022
According to the WHO, more than 30 million children under five years of age still suffer from vaccine-preventable diseases (VPDs) every year in Africa.1 Of these, over half a million die from VPDs annually, representing approximately 58% of global VPD-related deaths.1 Pre-COVID-19, the immunization programs in most African countries were gaining traction with diseases such as polio and maternal and neonatal tetanus nearing eradication and elimination respectively.1 As such, the consequences of COVID-19 related disruptions in childhood immunization service delivery will be catastrophic. Granted, most countries in Africa are anticipating an increased risk of a resurgence of VPDs that were controlled or eliminated. To anticipate the consequences related to suboptimal control of VPDs in children following the COVID-19 pandemic, there is a need to assess the extent of these disruptions in the region. In this letter, we present preliminary findings of a review aimed at synthesizing the available evidence on the accessibility and utilization of child immunization services (CIS) in Africa during the COVID-19 pandemic period.
Nepal Medical College Journal
This study aimed to evaluate the utilization and quality of routine immunization (RI) services at a tertiary hospital during the second wave of the COVID-19 pandemic period. An observational analytical study was carried out in the Immunization Clinic of a tertiary hospital in Kathmandu, Nepal. The infant cohort was enrolled over a period of 4 months and followed up for a year (April 2021 to August 2022). Up-to-date immunization (UTD) status, overall and vaccine specific drop-out rates were quantified and reasons for missed or delayed doses were elicited from caregivers. An infant who received BCG, 3 doses of Pentavalent (DPT-HEPB-HIB) and OPV containing vaccine, one dose of fractional IPV, 2 doses of Rotavirus vaccine, 3 doses of PCV and first dose of Measles-Rubella (MR1) vaccine prior to their first birthday was categorized as UTD. Dropout rates between early and later vaccine doses were defined as the percentage of children that started their immunization series, but did not comp...
2022
Background: Globally, national immunization programs are at risk of disruption due to severe health system constraints caused by the ongoing Corona Virus Disease 2019 (COVID-19) pandemic. Objective: To assess the impact of COVID-19 on the availability of supplies of routine childhood immunization in the Oromia Regional State in Ethiopia. Methods: A health facility-based mixed-methods of study design was conducted. Both quantitative and qualitative data were collected using pre-tested questionnaires and key informant interview question guides, respectively. Descriptive statistics such as frequencies, means, and standard deviations were performed. Binary logistic regression analysis was employed to assess the associations between the COVID-19 pandemic and the availability of vaccine-related supplies at health facilities in study area. The qualitative data were analyzed using a thematic content analysis approach. Results: Of the total 448 study participants, 214 (47.8%) reported that COVID-19 has disrupted childhood vaccines availability. A significant proportion of participants agreed with the disruption of BCG (62.1%), OPV (48%), IPV (40.4%), and PENTA (36.9%) vaccine availabilities. These findings were also supported with key informant interviews. Fear of not maintaining physical distance (71.4%) followed by government lockdown (68.1%) and inadequate supply by local providers/suppliers (62.4%) were the most frequently reported likely causes for the observed disruptions. A large proportion of participants (87.7% and 81.7%) reported disruptions in the supply of face masks and hand gloves, respectively. As to the binary logistic regression analysis, the study participants from hospitals were 1.72 (1.01, 2.68; 95% CI) times more likely to report the impacts of COVID-19. Conclusion: Corona Virus Disease −19 significantly disrupted the availability of supplies of childhood immunization in the Oromia region. The most disrupted vaccines and related supplies were BCG, OPV, IPV, PENTA, facemasks, and hand gloves. An effective vaccine supply management is crucial to prevent disruptions during pandemics such as COVID-19.
Pan African Medical Journal, 2020
Introduction: following the declaration of the COVID-19 pandemic on 11 March 2020, countries started implementing strict control measures, health workers were redeployed and health facilities re-purposed to assist COVID-19 control efforts. These measures, along with the public concerns of getting COVID-19, led to a decline in the utilization of regular health services including immunization. Methods: we reviewed the administrative routine immunization data from 15 African countries for the period from January 2018 to June 2020 to analyze the trends in the monthly number of children vaccinated with specific antigens, and compare the changes in the first three months of the COVID-19 pandemic. Results: thirteen of the 15 countries showed a decline in the monthly average number of vaccine doses provided, with 6 countries having more than 10% decline. Nine countries had a lower monthly mean of recipients of first dose measles vaccination in the second quarter of 2020 as compared to the first quarter. Guinea, Nigeria, Ghana, Angola, Gabon, and South Sudan experienced a drop in the monthly number of children vaccinated for DPT3 and/or MCV1 of greater than 2 standard deviations at some point in the second quarter of 2020 as compared to the mean for the months January-June of 2018 and 2019. Conclusion: countries with lower immunization coverage in the pre-COVID period experienced larger declines in the number of children vaccinated immediately after the COVID-19 pandemic was declared. Prolonged and significant reduction in the number of children vaccinated poses a serious risk for outbreaks such as measles. Countries should monitor coverage trends at national and subnational levels, and undertake catch-up vaccination activities to ensure that children who have missed scheduled vaccines receive them at the earliest possible time.
Routine immunization services in the light of COVID-19 pandemic
International Journal Of Community Medicine And Public Health, 2020
World immunisation week is observed every year in the last week of 24th April to 30th April. Many parts of the world are still reeling under the threats of vaccine-preventable diseases (VPDs) and the importance of vaccination cannot be understated even in times of any other crisis. Worldwide, millions of children are saved from the grip of infectious diseases like polio and measles, and annually, around 2 to 3 million deaths are being averted. Routine immunization services, mass vaccination campaigns, catch up, and mop up sessions through outreach activities form part of the vaccine delivery strategies.