Changes in childhood vaccination during the coronavirus disease 2019 pandemic in Japan

Abstract

Background The coronavirus disease 2019 (COVID-19) pandemic has greatly affected daily life. COVID-19 often causes asymptomatic or mild disease In children; however, delayed routine childhood immunization is a concern, as it could increase the risk of vaccine-preventable disease. No study has evaluated the status of childhood vaccinations in Japan during the COVID-19 pandemic. Methods This retrospective observational study evaluated the number of vaccine doses administered to children in 4 Japanese cities (2 cities in the Tokyo metropolitan area and 2 cities far from Tokyo) during the period from 2016 to 2020. Vaccine doses administered between January and September 2020 during the COVID-19 pandemic were compared, by month, with those given during 2016-2019. Age-stratified demographic data were collected to determine whether factors other than change in the child population over time affected vaccination trends. Results In all cities the decrease in vaccine doses administered was most apparent in March and April 2020, i.e., just before or coincident with the declaration of a nationwide COVID-19 emergency on April 7, 2020. The decrease started as early as February in the Tokyo metropolitan area. As child age increased, the decrease became more apparent. Before the lift of national emergency on May 25, catch-up of the vaccination was observed in all age groups in all cities. Vaccine doses persistently increased in older age groups but not in infants. The overall vaccination trends did not differ significantly among the 4 cities. Conclusions The COVID-19 pandemic significantly affected routine childhood immunization in Japan. Thus, a nationwide electronic surveillance system and announcements for guardians to encourage timely routine immunization are warranted.

Impact of the COVID-19 pandemic on routine immunization coverage in children under 2 years old in Ontario, Canada: A retrospective cohort study

“…Similar to reports from other countries, we found that the impact of the pandemic and stay-at-home orders on immunization coverage rates was the most significant in the early period of the pandemic and only partially recovered subsequently [9] , [10] , [11] , [14] , [40] . Some of this recovery may have been prompted by public messaging from official organizations that routine childhood immunization is an essential health service [9] , [10] .…”

“…Similar to reports from other countries, we found that the impact of the pandemic and stay-at-home orders on immunization coverage rates was the most significant in the early period of the pandemic and only partially recovered subsequently [9] , [10] , [11] , [14] , [40] . Some of this recovery may have been prompted by public messaging from official organizations that routine childhood immunization is an essential health service [9] , [10] . In May 2020, Canada’s National Advisory Committee on Immunization recommended prioritizing primary immunization series up to 18-months old during the pandemic [20] , which may have encouraged the increase in coverage rates seen in our results starting in June 2020.…”

“…Our finding that older (15- and 18-month-old) children have experienced a more significant drop in immunization coverage than younger children in the early pandemic period has been noted in other parts of the world [9] , [10] , [11] . Our study also found that the baseline on-time immunization coverage rate fell from around 88% for 2-month-old children to 51% at 18-months old.…”

“…The coronavirus disease 2019 (COVID-19) pandemic and associated public health measures aiming to limit its transmission have had an unprecedented impact on healthcare services at all levels, including on routine childhood immunizations [1] , [2] , [3] . Multiple jurisdictions worldwide have reported significant declines in childhood vaccines administered and immunization coverage in the months following the pandemic declaration [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] . Disruptions to routine childhood immunization services leading to decreased coverage are concerning for possible resurgence of vaccine-preventable diseases (VPDs), including measles [15] , [16] , [17] .…”

Changes in Exanthema Subitum Incidence and Patient Age Distribution During the COVID-19 Pandemic in Japan

“…Indeed, the number of vaccine doses administered was also lower in March and April 2020 in Japan because parents avoided leaving their homes to decrease the risk of COVID-19 exposure. 9 …”