The world is facing an unprecedented challenge since the onset of the COVID-19 pandemic. Healthcare services have been disrupted across the globe to a considerable extent, with the immunization services being one of them.

A recent report from the World Health Organization (WHO) suggests that although immunization services have started a slow recovery from disruptions due to the pandemic, over one-third of the countries (37%) responding to a WHO survey still report disruptions to their routine immunization services.¹

A report published in Morbidity and Mortality Weekly Report (MMWR), in May 2020, evaluated two data sources to determine the impact of the pandemic on vaccination in children in the United States. These included the Vaccines for Children Program (VFC) provider order data from CDC’s Vaccine Tracking System and Vaccine Safety Datalink (VSD) vaccine administration data. There was a considerable reduction in orders for VFC-funded, Advisory Committee on Immunization Practices (ACIP)-recommended noninfluenza childhood vaccines and for measles-containing vaccines during the period from January 6–April 19, 2020 (period 2) compared with the period from January 7–April 21, 2019 (period 1). The dip started during the week after the national emergency was declared in the country in response to the pandemic. There were similar declines in orders for other vaccines as well. VSD data also demonstrated a corresponding reduction in measles-containing vaccine administrations starting the week of March 16, 2020.²

The situation has been similar back home in India as well. Jain et al conducted a retrospective observational study in Rajasthan to assess immunization disruptions during the March-May 2020 lockdown in the country. Phone surveys were done to collect data on immunization for 2,144 children who turned one year old from January through October 2020. Investigators compared the differences in vaccination timeliness and completed first-year vaccination status among children who were due for immunizations just prior to (unexposed), during (heavily exposed), and after (post-exposure) lockdown. In comparison with the unexposed children, the heavily exposed ones had significantly lesser odds of being vaccinated at or before 9 months (OR 0.550; 95%CI 0.367-0.824), but they were more likely to be vaccinated at 10-12 months (OR 1.761; 95% CI 1.196-2.591). Furthermore, they had a lesser likelihood of completing their first-year immunizations (OR 0.624; 95%CI 0.478-0.816) by the time of survey. Post-exposure children had no difference in timelines or completed first-year immunizations in comparison with unexposed children. So, children missed their vaccinations due to disruptions to immunization services during the lockdown. After the lockdown was lifted, catch-up efforts made sure that many children were reached at later ages.³

The COVID-19 pandemic emphasizes the significance of immunization. It is important to remind parents at this time that it is crucial to protect their children against serious vaccine-preventable diseases, even during the COVID-19 pandemic. With relaxation of social distancing measures, children who are not protected against serious diseases by vaccines will be susceptible to these diseases.²

References

1. Immunization services begin slow recovery from COVID-19 disruptions, though millions of children remain at risk from deadly diseases – WHO, UNICEF, Gavi. Available from: https://www.who.int/news/item/26-04-2021-immunization-services-begin-slow-recovery-from-covid-19-disruptions-though-millions-of-children-remain-at-risk-from-deadly-diseases-who-unicef-gavi. Accessed on April 28, 2021.
2. Santoli JM, Lindley MC, DeSilva MB, et al. Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration — United States, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(19);591–593.
3. Jain R, Chopra A, Falézan C, et al.COVID-19 related immunization disruptions in Rajasthan, India: A retrospective observational study. Available from: https://www.medrxiv.org/content/10.1101/2020.12.04.20244327v1.full.