Impact of the COVID-19 pandemic on routine childhood immunisation in Colombia

Moreno‐Montoya, José; Ballesteros, Silvia Marcela; Sotelo, Jaid Constanza Rojas; Cervera, Clara Lucia Bocanegra; Barrera-López, Pedro; Hoz-Valle, José A. De la

doi:10.1136/archdischild-2021-321792

Cited by 41 publications

(54 citation statements)

References 27 publications

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“…The leading causes of under 5-year-old children morbidity in Ethiopia,25 including acute respiratory illness, fever and diarrhoea, may have decreased due to school closures (older siblings less exposed), limited interactions with peers in the community, spending more time indoors, mask-wearing at community gatherings, hand washing, physical distancing, and other PPE and practices. Despite a marked reduction in supply chain distribution of vaccines in Ethiopia during COVID-19,26 we found that RI remained stable during the initial 6 months of the pandemic, which was different from the findings in Colombia, India, and Brazil where RI declined during the pandemic 27–29. The MOH of Ethiopia prioritised RI, especially measles, during COVID-19.…”

Section: Discussioncontrasting

confidence: 92%

Impact of the COVID-19 pandemic on utilisation of facility-based essential maternal and child health services from March to August 2020 compared with pre-pandemic March–August 2019: a mixed-methods study in North Shewa Zone, Ethiopia

Bekele

Hunegnaw

et al. 2022

BMJ Open

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IntroductionHealth systems are often weakened by public health emergencies that make it harder to access health services. We aimed to assess maternal, newborn and child health (MNCH) service utilisation during the first 6 months of the COVID-19 pandemic compared with prior to the pandemic.MethodsWe conducted a mixed study design in eight health facilities that are part of the Birhan field site in Amhara, Ethiopia and compared the trend of service utilisation in the first 6 months of COVID-19 with the corresponding time and data points of the preceding year.ResultNew family planning visits (43.2 to 28.5/month, p=0.014) and sick under 5 child visits (225.0 to 139.8/month, p=0.007) declined over the first 6 months of the pandemic compared with the same period in the preceding year. Antenatal (208.9 to 181.7/month, p=0.433) and postnatal care (26.6 to 19.8/month, p=0.155) visits, facility delivery rates (90.7 to 84.2/month, p=0.776), and family planning visits (313.3 to 273.4/month, p=0.415) declined, although this did not reach statistical significance. Routine immunisation visits (37.0 to 36.8/month, p=0.982) for children were maintained. Interviews with healthcare providers and clients highlighted several barriers to service utilisation during COVID-19, including fear of disease transmission, economic hardship, and transport service disruptions and restrictions. Enablers of service utilisation included communities’ decreased fear of COVID-19 and awareness-raising activities.ConclusionWe observed a decline in essential MNCH services particularly in sick children and new family planning visits. To improve the resiliency of fragile health systems, resources are needed to continuously monitor service utilisation and clients’ evolving concerns during public health emergencies.

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Section: Discussioncontrasting

confidence: 92%

Impact of the COVID-19 pandemic on utilisation of facility-based essential maternal and child health services from March to August 2020 compared with pre-pandemic March–August 2019: a mixed-methods study in North Shewa Zone, Ethiopia

Bekele

Hunegnaw

et al. 2022

BMJ Open

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“…In summary, although two moderate risk-of-bias studies [20,22] failed to show evidence of increasing inequity during the pandemic, three low-risk-of-bias studies [14,21,23] report moderately strong evidence of increasing inequity, with additional, but weak, supporting evidence from Bramer et al [24].…”

Section: Outcome 1: Change In Routine Childhood Vaccination Coverage ...mentioning

confidence: 83%

The Impact of COVID-19 Pandemic on Inequity in Routine Childhood Vaccination Coverage: A Systematic Review

et al. 2022

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Background: Routine childhood vaccination coverage rates fell in many countries during the COVID-19 pandemic, but the impact of inequity on coverage is unknown. Methods: We synthesised evidence on inequities in routine childhood vaccination coverage (PROSPERO, CRD 42021257431). Studies reporting empirical data on routine vaccination coverage in children 0–18 years old during the COVID-19 pandemic by equity stratifiers were systematically reviewed. Nine electronic databases were searched between 1 January 2020 and 18 January 2022. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Tool for Cohort Studies. Overall, 91 of 1453 studies were selected for full paper review, and thirteen met the inclusion criteria. Results: The narrative synthesis found moderate evidence for inequity in reducing the vaccination coverage of children during COVID-19 lockdowns and moderately strong evidence for an increase in inequity compared with pre-pandemic months (before March 2020). Two studies reported higher rates of inequity among children aged less than one year, and one showed higher inequity rates in middle- compared with high-income countries. Conclusions: Evidence from a limited number of studies shows the effect of the pandemic on vaccine coverage inequity. Research from more countries is required to assess the global effect on inequity in coverage.

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“…This could be attributed to the probably higher caregivers' concerns about exposing their vulnerable newborns and other children under the age of 12 months to the risk of COVID-19. This age-related difference in vaccination coverage during the pandemic was also documented in Colombia where the highest decline in vaccination coverage during March-October 2020 was observed in children under the age of 12 months, in particular those living in rural areas [ 20 ]. Similarly, in Michigan, around 17% reduction in the percentage of vaccinated children at the age of 5 months was documented in May 2020 as compared to around 10% and 5% reduction at ages of 19 months and 24 months, respectively [ 4 ].…”

Section: Discussionmentioning

confidence: 67%

Nationwide Routine Childhood Vaccination Coverage During the COVID-19 Pandemic in Jordan: Current Situation, Reasons, and Predictors of Vaccination

Abu-rish

Bustanji

Abusal

2022

International Journal of Clinical Practice

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Background. The healthcare system in Jordan faced substantial burden during the 2020 COVID-19 pandemic including disruption of routine childhood vaccination services. Aims. We sought, for the first time, to describe the impact of the 2020 pandemic on vaccination coverage of Jordanian children in Jordan and to identify the key contributing factors. Methods. Nationwide vaccination rates were retrieved from the electronic records at the Ministry of Health (2018–2020) enrolling crude births of 220,057 Jordanian children during 2020. Records of doses administered were compared for each month of 2020 with the baseline of 2018–2019. A cross-sectional survey (March–August 2021) was also conducted enrolling a convenient sample of adults aged ≥18 who were Jordanian caregivers for vaccine-eligible children (0–23 months) between 1 January 2020 and the date of the interview. The survey aimed to address caregivers’ adherence to routine vaccination during 2020–2021 and to describe the determinants of the current and future adherence to vaccination where multiple logistic regression model was utilized. Results. The electronic records revealed a significant decline in vaccination coverage during 2020. The greatest decline was observed during the lockdown period from 21 March 2020 to 21 April 2020 (32.4%–46.8%) followed by the decline observed by the entry of the first wave during September-October 2020 (18.4%–22.8%). A drop of 14–16% was observed for the vaccines recommended under the age of 12 months and of 6–7% for those recommended in 1-2-year-old children. The yearly coverage rates for measles-1 (at 9 months), 2 (at 12 months as part of measles-mumps-rubella (MMR) vaccine), and 3 (at 18 months as part of MMR) were 76%, 90%, and 87%, respectively, and for hexavalent-1, 2, and 3 were 78%, 78%, and 77%, respectively. The results of the survey revealed that the main reason for vaccination delay for at least 1 month from the recommended administration time was the lockdown, followed by child illness and smart lockdowns (regional lockdown/health center closure). Vaccination delay was less likely to be observed in children aged ≥12 months ( P value < 0.001; OR: 0.18; CI: 0.11–0.29) or children with chronic diseases ( P value < 0.05; OR: 0.5; CI: 0.33–0.88). Conclusion. The current study demonstrates a decline in vaccination coverage of Jordanian children during the 2020 COVID-19 pandemic. It is important to formulate future strategies to promote catch-up vaccination and to avoid future backsliding of vaccination rates during further waves of the COVID-19 pandemic or other pandemics. These include improving health services, allaying caregivers’ concerns about contracting COVID-19, and arranging vaccination campaigns outside health centers.

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Impact of the COVID-19 pandemic on routine childhood immunisation in Colombia

Cited by 41 publications

References 27 publications

Impact of the COVID-19 pandemic on utilisation of facility-based essential maternal and child health services from March to August 2020 compared with pre-pandemic March–August 2019: a mixed-methods study in North Shewa Zone, Ethiopia

Impact of the COVID-19 pandemic on utilisation of facility-based essential maternal and child health services from March to August 2020 compared with pre-pandemic March–August 2019: a mixed-methods study in North Shewa Zone, Ethiopia

The Impact of COVID-19 Pandemic on Inequity in Routine Childhood Vaccination Coverage: A Systematic Review

Nationwide Routine Childhood Vaccination Coverage During the COVID-19 Pandemic in Jordan: Current Situation, Reasons, and Predictors of Vaccination

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