Challenges and barriers to immunization during COVID-19: An experience of parents/caregivers from a well-baby clinic of a tertiary care hospital of Eastern India

Mishra, Krishna; Mohapatra, Ipsa; Mohapatra, Partha Sarathi; Madhusikta, Smriti; Parimita, Pragyan

doi:10.1016/j.cegh.2022.101200

Cited by 3 publications

(9 citation statements)

References 8 publications

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“…The second, conducted in Brazil, also found no significant differences, but did find that infants were less likely to experience immunisation disruptions or delays compared to one-year old children [32]. This finding was similar two studies, conducted in Eastern India and in China, where increasing age of the child was found to be associated with immunisation delays [59,60]. A study conducted in South-East Asia and the Western Pacific found similar results, in which early-infancy was less disrupted than infancy, school-entry age, and adolescent immunisation [41].…”

Section: Demographic Heterogeneitysupporting

confidence: 65%

“…It was not only the total number of doses administered that was affected, but also when those doses were given. In China and India, the majority of interviewed caregivers delayed vaccination [58,59,60,47,52] and in Ecuador and Sierra Leone this delay was worse for last doses [31,26].…”

Section: Routine Immunisationmentioning

confidence: 99%

“…Only two studies stratified results by maternal or caregiver age; one finding that increasing maternal age was associated with delayed vaccination [59], the other finding no association [38].…”

Section: Demographic Heterogeneitymentioning

confidence: 99%

“…One study, conducted in South East Asia and the Western Pacific, reported that while affordability issues contributed to immunisation service utilisation, it was among the lowest ranked reasons [41]. Some caregivers additionally reported low or no awareness of the availability of immunisation services, often believing clinics and hospitals were closed for routine immunisation services [67,44,22,59].…”

Section: Vaccine Demand and Acceptancementioning

confidence: 99%

“…Declines in vaccine demand due to fears of contracting COVID-19 at clinics or hospitals was pervasive, and one of the most reported causes across several studies [46,52,41,48,68,44,40,13,22,45,38,9,59,67,25]. Many others reported additional fear or stigma against healthcare providers, including fears that staff might be infected by the virus [22,48,45,25,68].…”

Section: Vaccine Demand and Acceptancementioning

confidence: 99%

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COVID-19-related disruption and resiliency in immunisation activities in LMICs: a rapid review

Hartner,

Li,

Gaythorpe

2023

Preprint

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Objectives Rapid review to determine the extent that immunisation services in LMICs were disrupted by the COVID-19 pandemic and what factors can be considered to build resilience in future. Setting We searched PubMed on 28th Feb 2023 for studies published after 1st December 2019 in English that focused on LMICs. Participants Screening and data extraction were conducted by two experienced reviewers with one reviewer vote minimum per study per stage. Of 3801 identified studies, 66 met the eligibility criteria. Outcomes Routine vaccine coverage achieved; Supplementary immunisation activity timing; Vaccine doses given; Timing of vaccination; Supply chain changes; factors contributing to disruption or resilience. Results Included studies showed evidence of notable declines in immunisation activities across LMICs related to the COVID-19 pandemic. These have included reductions in achieved routine coverage, cancellation or postponement of campaigns, and underimmunised cohorts. Immunisation was most disrupted in the early months of the pandemic, particularly March to May 2020; however, the amount of recovery seen varied by country, age-group, and vaccine. Though many countries observed partial recovery beginning after lockdown policies were lifted in 2020, disruption in many countries has also continued into 2021. It has also been noted that clinician staff shortages and vaccine stock outs caused by supply chain disruptions contributed to immunisation delays but that concern over COVID transmission was a leading factor. Key resiliency factors included community outreach and healthcare worker support. Finally, whilst our search took place in February 2023, the latest dataset used across all studies was from November 2022 and many focused on 2020; as a result some of the study conclusions do not take recovery into account. Conclusions There is limited information on whether reductions in vaccination coverage or delays have persisted beyond 2021. Further research is needed to assess ongoing disruptions and identify missed vaccine cohorts.

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Section: Demographic Heterogeneitysupporting

confidence: 65%

Section: Routine Immunisationmentioning

confidence: 99%

Section: Demographic Heterogeneitymentioning

confidence: 99%

Section: Vaccine Demand and Acceptancementioning

confidence: 99%

Section: Vaccine Demand and Acceptancementioning

confidence: 99%

See 3 more Smart Citations

COVID-19-related disruption and resiliency in immunisation activities in LMICs: a rapid review

Hartner,

Li,

Gaythorpe

2023

Preprint

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COVID-19 related disruption and resilience in immunisation activities in LMICs: a rapid review

Hartner,

Li,

Gaythorpe

2024

BMJ Open

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ObjectivesWe conducted a rapid review to determine the extent that immunisation services in low-income and middle-income countries (LMICs) were disrupted by the COVID-19 pandemic and synthesised the factors that can be used to build resilience in future.DesignRapid review reported in accordance with the Preferred reporting for Systematic reviews and Meta-Analyses (PRISMA) guidelines.Data sourcesPubMed and Web of Science were searched through 6 October 2023.Eligibility criteria for selecting studiesWe included studies that focused on disruption to immunisation activities due to the COVID-19 pandemic in LMICs. Outcomes included routine vaccine coverage, supplementary immunisation activities, vaccine doses, timing of vaccination, supply chain changes, and factors contributing to disruption or resilience.Data extraction and synthesisTwo independent reviewers used standardised methods to search, screen and code studies. Quality assessment was performed using a modified version of the Critical Appraisal Skills Programme for qualitative research. Findings were summarised qualitatively.ResultsOf 4978 identified studies, 85 met the eligibility criteria. Included studies showed declines in immunisation activities across LMICs related to the COVID-19 pandemic. These included reductions in achieved routine coverage, cancellation or postponement of campaigns and underimmunised cohorts. Immunisation was most disrupted in the early months of the pandemic; however, recovery varied by country, age-group and vaccine. Though many countries observed partial recovery in 2020, disruption in many countries continued into 2021. It has also been noted that clinician staff shortages and vaccine stock-outs caused by supply chain disruptions contributed to immunisation delays, but that concern over COVID-19 transmission was a leading factor. Key resiliency factors included community outreach and healthcare worker support.ConclusionsThere is limited information on whether reductions in vaccination coverage or delays have persisted beyond 2021. Further research is needed to assess ongoing disruptions and identify missed vaccine cohorts.

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Routine immunization experience and practices during the COVID-19 pandemic of caregivers attending a tertiary hospital in Cape Town

Manan,

Wessels,

Finlayson

2023

Front. Health Serv.

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IntroductionImmunizations are successful, cost-effective interventions for the control of infectious diseases and preventing mortality. Lockdown restrictions during the COVID-19 pandemic had adverse effects on child-health including access to immunizations. Our study aimed to document immunization status, describe caregiver experiences around accessing immunizations during the COVID-19 pandemic and identify any significant factors associated with immunization status.MethodsCaregivers, with children between the ages of 10 to 33 months, attending Tygerberg Hospital Paediatric Department were invited to complete an anonymous survey from 15th September–15th December 2022. Data was captured using a REDCap questionnaire and analysed using Stata Version 17.Results171 caregivers completed the survey. Immunizations were up to date in 81%. Most (155, 88%) agreed it was important to immunize their child. A third of caregivers (55) felt it was unsafe to attend the clinic and 37% (62) agreed it was difficult to attend. Caregivers receiving a social grant (p = 0.023) or who felt safe attending clinic (p = 0.053) were more likely to be up to date with immunizations. Three-quarters (128, 78%) were aware of recommendations to continue immunization. These caregivers were more likely to think it was important to immunize on time (p = 0.003) and to receive family encouragement (p = 0.001). Caregivers were more likely to attend clinic if they felt it was important to vaccinate on time (p < 0.001) or felt safe attending clinic (p = 0.036).ConclusionImmunization rates were higher than expected but below global targets. Although caregivers feel immunizations are important, unknowns still instilled fear of attending clinics. Social factors such as family support and social grants improve vaccine seeking behaviour.

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Challenges and barriers to immunization during COVID-19: An experience of parents/caregivers from a well-baby clinic of a tertiary care hospital of Eastern India

Cited by 3 publications

References 8 publications

COVID-19-related disruption and resiliency in immunisation activities in LMICs: a rapid review

COVID-19-related disruption and resiliency in immunisation activities in LMICs: a rapid review

COVID-19 related disruption and resilience in immunisation activities in LMICs: a rapid review

Routine immunization experience and practices during the COVID-19 pandemic of caregivers attending a tertiary hospital in Cape Town

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