Impact of COVID-19-related disruptions to measles, meningococcal A, and yellow fever vaccination in 10 countries

Gaythorpe, Katy A. M.; Abbas, Kaja; Huber, John H.; Karachaliou, Andromachi; Thakkar, Niket; Woodruff, Kim; Li, Xiang; Echeverría-Londoño, Susy; Ferrari, Matthew J.; Jackson, Michael L.; McCarthy, Kevin; Perkins, T. Alex; Trotter, Caroline; Jit, Mark

doi:10.7554/elife.67023

Cited by 67 publications

(60 citation statements)

References 33 publications

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“…Consequently, the focus in children in low-and middle-income countries (LMICs) including Bangladesh has typically been addressing key concerns including poor vaccination rates as a result of lockdown and other activities [51][52][53] . In Bangladesh, this includes organising immunisation outreach services, tracking children who had missed their vaccinations as well as increasing home visits by health workers 53,54 .…”

Section: Introductionmentioning

confidence: 99%

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Nusrat

Haque

Chowdhury

et al. 2021

Bangladesh J Med Sci

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Objective: The focus on COVID-19 in children in low- and middle-income countries including Bangladesh has been on addressing key issues including poor vaccination rates as well as mental health issues, domestic violence and child labour. However, the focus on optimally managing children in hospitals is changing with new variants and concerns with the development of hyperinflammatory syndromes. There are also concerns with the overuse of antimicrobials to treat patients with COVID-19 in hospitals enhancing resistance rates. The Bangladesh Paediatric Association have developed guidelines to improve patient care building on national guidance. Consequently, there is a need to document the current management of children with COVID-19 in Bangladesh and use the findings for future guidance. Methods: Rapid analysis of the management of children with COVID-19 among eight private and public hospitals in Bangladesh with varying numbers of in-patient beds using purposely developed case report forms (CRFs). The CRFs were piloted before full roll-out. Results: Overall low numbers of children in hospital with COVID-19 (4.3% of in-patient beds). The majority were male (59.6%) and aged 5 years or under (63.5%). Reasons for admission included respiratory distress/ breathing difficulties with 94.2% of COVID-19 cases confirmed. All children were prescribed antibiotics empirically, typically those on the Watch list of antibiotics and administered parenterally, with only a small minority switched to oral therapy before discharge. There was appreciable prescribing of Vitamins (C and D) and zinc and encouragingly limited prescribing of other antimicrobials (antivirals, antimalarials and antiparasitic medicines). Length of stay was typically 5 to 10 days. Conclusion: Encouraging to see low hospitalisation rates and limited use of antimicrobials apart from antibiotics. Concerns with high empiric use of antibiotics and limited switching to oral formulations can be addressed by instigating antimicrobial stewardship programmes. We will be monitoring this. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.188-198

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Section: Introductionmentioning

confidence: 99%

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Nusrat

Haque

Chowdhury

et al. 2021

Bangladesh J Med Sci

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“…They found the benefits outweighed the costs with 84 (95% uncertainty interval 14-267) child deaths averted by sustained childhood immunisation per 1 excess COVID-19 death even with the risks associated with vaccination clinic visits. The VIMC Working Group on COVID-19 Impact on VPDs analysed the effect of COVID-19 disruption on measles, MenA and YF through modelling scenarios of routine immunisation service disruptions and mass vaccination campaign suspensions in a subset of countries ( Gaythorpe et al, 2021b ). They found that the nature of the disease affects the impact of vaccination activity disruption; for example, YF and measles affect younger age groups and are prone to outbreaks, thus short-term disruption will likely increase burden.…”

Section: Discussionmentioning

confidence: 99%

“…Whilst the effect of COVID-19 is not the focus of the current study, we acknowledge the huge influence the global pandemic has had and will have for years to come. Preliminary work has begun on quantifying the effect of disruption on vaccination activities and on assessing the benefit of continuing routine infant immunisation in times of COVID-19 ( Abbas et al, 2020a ; Gaythorpe et al, 2021b ). There is also evidence that the rise in non-pharmaceutical interventions (NPIs, e.g.…”

Section: Introductionmentioning

confidence: 99%

Lives saved with vaccination for 10 pathogens across 112 countries in a pre-COVID-19 world

Toor

Echeverría-Londoño

et al. 2021

eLife

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Background:Vaccination is one of the most effective public health interventions. We investigate the impact of vaccination activities for Haemophilus influenzae type b, hepatitis B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, rotavirus, rubella, Streptococcus pneumoniae, and yellow fever over the years 2000–2030 across 112 countries.Methods:Twenty-one mathematical models estimated disease burden using standardised demographic and immunisation data. Impact was attributed to the year of vaccination through vaccine-activity-stratified impact ratios.Results:We estimate 97 (95%CrI[80, 120]) million deaths would be averted due to vaccination activities over 2000–2030, with 50 (95%CrI[41, 62]) million deaths averted by activities between 2000 and 2019. For children under-5 born between 2000 and 2030, we estimate 52 (95%CrI[41, 69]) million more deaths would occur over their lifetimes without vaccination against these diseases.Conclusions:This study represents the largest assessment of vaccine impact before COVID-19-related disruptions and provides motivation for sustaining and improving global vaccination coverage in the future.Funding:VIMC is jointly funded by Gavi, the Vaccine Alliance, and the Bill and Melinda Gates Foundation (BMGF) (BMGF grant number: OPP1157270 / INV-009125). Funding from Gavi is channelled via VIMC to the Consortium’s modelling groups (VIMC-funded institutions represented in this paper: Imperial College London, London School of Hygiene and Tropical Medicine, Oxford University Clinical Research Unit, Public Health England, Johns Hopkins University, The Pennsylvania State University, Center for Disease Analysis Foundation, Kaiser Permanente Washington, University of Cambridge, University of Notre Dame, Harvard University, Conservatoire National des Arts et Métiers, Emory University, National University of Singapore). Funding from BMGF was used for salaries of the Consortium secretariat (authors represented here: TBH, MJ, XL, SE-L, JT, KW, NMF, KAMG); and channelled via VIMC for travel and subsistence costs of all Consortium members (all authors). We also acknowledge funding from the UK Medical Research Council and Department for International Development, which supported aspects of VIMC's work (MRC grant number: MR/R015600/1).JHH acknowledges funding from National Science Foundation Graduate Research Fellowship; Richard and Peggy Notebaert Premier Fellowship from the University of Notre Dame. BAL acknowledges funding from NIH/NIGMS (grant number R01 GM124280) and NIH/NIAID (grant number R01 AI112970). The Lives Saved Tool (LiST) receives funding support from the Bill and Melinda Gates Foundation.This paper was compiled by all coauthors, including two coauthors from Gavi. Other funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.

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“…Routine childhood vaccines should not be interrupted, since the risk of children dying as a result of not receiving these vaccines far outweighs the risk of dying from COVID-19 as a result of attending a vaccine clinic [10]. For vaccine campaigns, the risk of outbreaks as a result of postponing campaigns varies across settings and pathogens [11]. For some vaccines (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Previous modelling studies have demonstrated that the benefits of continuing routine immunisation likely outweigh the excess risk from COVID-19 but did not examine campaign delivery [10]. A recent study has examined the risks of vaccine-preventable disease outbreaks (measles, meningococcal A, and yellow fever) associated with delaying immunisation campaigns, which varied across countries [11]. Another study assessed the risk of measles outbreaks in Kenya and found that although COVID-19 interventions also temporarily reduced the risk of an outbreak from measles immunity gaps, this risk rises rapidly once these restrictions are lifted highlighting the need to implement catch-up campaigns [12].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 infection risk during delivery of childhood vaccination campaigns: a modelling study

Procter

Abbas

Griffiths

et al. 2021

BMC Med

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Background The COVID-19 pandemic has disrupted the delivery of immunisation services globally. Many countries have postponed vaccination campaigns out of concern about infection risks to the staff delivering vaccination, the children being vaccinated, and their families. The World Health Organization recommends considering both the benefit of preventive campaigns and the risk of SARS-CoV-2 transmission when making decisions about campaigns during COVID-19 outbreaks, but there has been little quantification of the risks. Methods We modelled excess SARS-CoV-2 infection risk to vaccinators, vaccinees, and their caregivers resulting from vaccination campaigns delivered during a COVID-19 epidemic. Our model used population age structure and contact patterns from three exemplar countries (Burkina Faso, Ethiopia, and Brazil). It combined an existing compartmental transmission model of an underlying COVID-19 epidemic with a Reed-Frost model of SARS-CoV-2 infection risk to vaccinators and vaccinees. We explored how excess risk depends on key parameters governing SARS-CoV-2 transmissibility, and aspects of campaign delivery such as campaign duration, number of vaccinations, and effectiveness of personal protective equipment (PPE) and symptomatic screening. Results Infection risks differ considerably depending on the circumstances in which vaccination campaigns are conducted. A campaign conducted at the peak of a SARS-CoV-2 epidemic with high prevalence and without special infection mitigation measures could increase absolute infection risk by 32 to 45% for vaccinators and 0.3 to 0.5% for vaccinees and caregivers. However, these risks could be reduced to 3.6 to 5.3% and 0.1 to 0.2% respectively by use of PPE that reduces transmission by 90% (as might be achieved with N95 respirators or high-quality surgical masks) and symptomatic screening. Conclusions SARS-CoV-2 infection risks to vaccinators, vaccinees, and caregivers during vaccination campaigns can be greatly reduced by adequate PPE, symptomatic screening, and appropriate campaign timing. Our results support the use of adequate risk mitigation measures for vaccination campaigns held during SARS-CoV-2 epidemics, rather than cancelling them entirely.

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Impact of COVID-19-related disruptions to measles, meningococcal A, and yellow fever vaccination in 10 countries

Cited by 67 publications

References 33 publications

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Lives saved with vaccination for 10 pathogens across 112 countries in a pre-COVID-19 world

SARS-CoV-2 infection risk during delivery of childhood vaccination campaigns: a modelling study

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