Routine child immunizations in India during the COVID-19 pandemic

Chakrabarti, Averi; Bair, Elizabeth F.; Thirumurthy, Harsha

doi:10.1016/j.ssmph.2023.101383

Cited by 10 publications

(11 citation statements)

References 30 publications

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“…A likely explanation for this finding is that these children were in health facilities and within the reach of routine health services and the subsequent visits were more affected [ 22 ]. Similar trends where administration of BCG and Hepatitis B declined less than later vaccines [ 12 ]. On the contrary, Pakistan’s Sindh province reported BCG vaccination as more disrupted than follow-up vaccines due to enrollment services getting more affected [ 11 ].…”

Section: Discussionmentioning

confidence: 70%

“…Several barriers during the pandemic including parental and health care worker’s concerns regarding exposure to COVID infection, transport restrictions due to lockdown, economic hardships, reallocation of resources, disruptions in supply chains acted as an add-on to the existing inequities in routine immunization [ 1 , 11 ]. Studies from India have reported major decline in vaccination coverage during the pandemic period [ 12 , 13 ]. However, no study has been conducted in the post-COVID period to assess the extent of recovery from the impact of the pandemic.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Covid pandemic on immunization status of children in tertiary care Hospital of North India: reason for partial and non-immunization a cross-sectional study

Kumar,

Allyhan,

Aggarwal

2024

J Health Popul Nutr

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Background Low immunization coverage in India attributes to many factors including sociodemographic factors and people’s behavior. COVID-19 pandemic resulted in disruptions in achieving optimum availability and utilization of immunization services. This study was carried out to find out the immunization status of children in the post COVID era and various factors responsible for non-immunization during the pandemic. Methods This cross-sectional study included parents of 225 admitted children aged 1–6 years were interviewed using a semi-structured open-ended questionnaire. Children were classified as completely immunized, partially immunized and unimmunized on the basis of vaccines missed given under first year of life. Reasons for non-immunization and delay/missed vaccination during COVID-19 pandemic were recorded. Results Of the 225 children, 162 (72%; 95% CI 66–78%) were completely immunized, 55 (24.4%; 95% CI 19–30%) were partially immunized and 8 (3.6%; 95% CI 1–6%) were unimmunized. Parents with hospital deliveries, higher education level and lesser birth order were more likely to have children with better immunization status (p < 0.05). First dose of measles scheduled at 9 months and 3rd dose of pentavalent vaccine/OPV/Rotavirus vaccine scheduled at 14 weeks were most commonly missed vaccines among partially immunized. Lack of awareness (n = 36, 57.1%; 95% CI 45–70%) was the common reason for partial and non-immunization followed by illness of child (n = 21, 33.3%; 95% CI 21–45%) and COVID-19 pandemic (n = 11, 17.4%; 95% CI 8–27%). Pandemic was reason for delay in 50 (22.2%; 95% CI 17–28%) children. Restrictions of movement (64%; 95% CI 50–78%), fear of being exposed to COVID-19 (52%; 95% CI 38–66%) were the most common reasons for delay during the pandemic. Of the 50 children who had delay due to pandemic, 39 children (17.3%; 95% CI 12–22%) received their catch-up immunization after the pandemic. No child remained completely unimmunized due to COVID-19 pandemic. Conclusions Although COVID-19 pandemic resulted in disruptions in routine immunization services, sociodemographic factors such as awareness for immunization, parental education and various beliefs for immunization were responsible for the children remaining unimmunized or partially immunized after the pandemic.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Effect of Covid pandemic on immunization status of children in tertiary care Hospital of North India: reason for partial and non-immunization a cross-sectional study

Kumar,

Allyhan,

Aggarwal

2024

J Health Popul Nutr

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“…However, on must consider that non pharmaceutical interventions can be associated with numerous harms (including, but not restricted to : loss of civil liberties, rise in global hunger FAO et al [2023], medical care and routine child immunization disruption Chakrabarti et al [2023], WHO and UNICEF [2020], rise in mental health issues Léon et al [2023] and economic disruption), we emphasize that overestimation of epidemic spread by models is not devoid of harms. Therefore, accuracy is critical for modelling, and overestimation should be viewed as a failure of modelling to the same extent as underestimation is.…”

Section: Discussionmentioning

confidence: 99%

“…While intended to slow virus spread, the policies influenced by these models can also have harmful consequences such as global hunger FAO et al [2023], routine child immunization disruption Chakrabarti et al [2023], WHO and UNICEF [2020] and mental health issues Léon et al [2023], disproportionately affecting the most vulnerable groups Li et al [2023] and the young UNICEF [2021]. It is therefore essential that models correctly anticipate epidemic spread and accurately assess non pharmaceutical interventions effectiveness in order not to bias the political trade-offs: overestimating epidemic spread is not devoid of harms.…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of Covid-19 hospitalization modelling scenarios which guided policy response in France

Starck,

Langevin

2023

Preprint

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Epidemiological modelling has played a key role in proposing, analyzing and justifying non-pharmaceuticals interventions in response to the COVID-19 pandemic. Despite its importance, evaluations of models’ ability to accurately anticipate the evolution of the disease remain scarce. Thus, robust, systematic, and pre-specified evaluation criteria are needed to assess the relevance of modelling scenarios that guided policy response during the pandemic. We conduct a retrospective assessment of modelling reports which guided policy response in France from April 2020 to April 2022. After systematically verifying the scenarios hypotheses (e.g., exclusion of no-lockdown scenarios when a lockdown was effectively in place), we find that epidemiological models were (a) uncertain, (b) unaccurate, and (c) biased towards an overestimation of predicted COVID-19 related hospitalizations. In more than half of the reports, reality is below or equal to even the best-case scenario. To our knowledge, this is the only national systematic retrospective assessment of COVID-19 pandemic scenarios; such an approach should be reproduced in other countries whenever possible.Abstract FigureGraphical Abstract: Comparison of Pasteur Institute’s scenarios to reality. Forecasting errors of scenarios (colors) compared to reality (black line) are expressed as a percentage of the maximum Intensive Care Units occupancy reached during the covid-19 pandemic in France (horizontal dashed line).

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“…In 2021, the pandemic at its peak disrupted essential services (SDG 3.8.1) in 92% of countries, and in 2022 the disruptions were still reported in 82% of countries [ 5 , 6 , 7 , 8 ]. The pandemic’s emergence and subsequent lockdowns, particularly in urban areas, led to mass migrations, with individuals in informal settlements and slums returning to rural hometowns [ 9 , 10 , 11 ]. This was compounded by a shortage of healthcare workers as they were diverted to patient care services along with low vaccine uptake as parents avoided routine immunization (RI) sessions due to fear of their children getting infected.…”

Section: Introductionmentioning

confidence: 99%

Balancing Routine and Pandemic: The Synergy of India’s Universal Immunization Program and COVID-19 Vaccination Program

Kumar,

Chakraborty,

Dhandore

et al. 2023

Vaccines

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The COVID-19 pandemic posed substantial challenges to healthcare systems globally and severely disrupted essential health services, including routine immunization programs. In India, these disruptions were exacerbated due to the sudden emergence of the pandemic and lockdown measures, leading to mass migrations and a shortage of healthcare workers. Caregivers’ concerns about routine immunization sessions further compounded the problem, resulting in a sharp increase in zero-dose children. This review paper examines India’s strategies for conducting one of the world’s largest COVID-19 vaccination programs while effectively restoring and perpetuating its Universal Immunization Program (UIP). The UIP played a pivotal role in sustaining immunization services during the pandemic, ultimately improving immunization coverage compared to pre-pandemic levels. India’s accomplishments in this regard are highlighted through key performance indicators, the reach of immunization services, a reduction in zero-dose children, and antigen-wise coverage. The paper also discusses the successful integration of COVID-19 vaccination within the UIP framework, underscoring the significance of existing infrastructure, technology, and capacity building. India’s dedication to concurrently managing routine immunization and COVID-19 vaccination showcases the adaptability and resilience of its healthcare system. India’s journey serves as a global example of efficient mass immunization during challenging times, emphasizing the importance of political will, healthcare infrastructure investment, skilled healthcare workforces, and comprehensive vaccination programs. In a world grappling with the dual challenge of COVID-19 and routine immunization, India’s experience provides a roadmap for strengthening healthcare systems and promoting public health as the critical agenda in challenging times.

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Routine child immunizations in India during the COVID-19 pandemic

Cited by 10 publications

References 30 publications

Effect of Covid pandemic on immunization status of children in tertiary care Hospital of North India: reason for partial and non-immunization a cross-sectional study

Effect of Covid pandemic on immunization status of children in tertiary care Hospital of North India: reason for partial and non-immunization a cross-sectional study

Retrospective analysis of Covid-19 hospitalization modelling scenarios which guided policy response in France

Balancing Routine and Pandemic: The Synergy of India’s Universal Immunization Program and COVID-19 Vaccination Program

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