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Hussain I, Umer M, Khan A, Sajid M, Ahmed I, Begum K, Iqbal J, Alam MM, Safdar RM, Baig S, Voorman A, Partridge J, Soofi S. Exploring the path to polio eradication: insights from consecutive seroprevalence surveys among Pakistani children. Front Public Health 2024; 12:1384410. [PMID: 38601488 PMCID: PMC11004230 DOI: 10.3389/fpubh.2024.1384410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/14/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction After trivalent oral poliovirus vaccine (tOPV) cessation, Pakistan has maintained immunity to type 2 poliovirus by administering inactivated polio vaccine (IPV) in routine immunization, alongside monovalent OPV type 2 (mOPV2) and IPV in supplementary immunization activities (SIAs). This study assesses the change in poliovirus type 2 immunity after tOPV withdrawal and due to SIAs with mOPV2 and IPV among children aged 6-11 months. Methods Three cross-sectional sequential serological surveys were conducted in 12 polio high-risk areas of Pakistan. 25 clusters from each geographical stratum were selected utilizing probability proportional to size. Results Seroprevalence of type 2 poliovirus was 49%, with significant variation observed among surveyed areas; <30% in Pishin, >80% in Killa Abdullah, Mardan & Swabi, and Rawalpindi. SIAs with IPV improved immunity from 38 to 57% in Karachi and 60 to 88% in Khyber. SIAs with IPV following mOPV2 improved immunity from 62 to 65% in Killa Abdullah, and combined mOPV2 and IPV SIAs in Pishin improved immunity from 28 to 89%. Results also reflected that immunity rates for serotypes 1 and 3 were consistently above 90% during all three phases and across all geographical areas. Conclusion The study findings highlight the importance of implementing effective vaccination strategies to prevent the re-emergence of poliovirus. Moreover, the results provide crucial information for policymakers working toward achieving global polio eradication.
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Affiliation(s)
- Imtiaz Hussain
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Muhammad Umer
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Ahmad Khan
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Muhammad Sajid
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Imran Ahmed
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Kehkashan Begum
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Junaid Iqbal
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Rana M. Safdar
- Polio National Emergency Operations Center, Islamabad, Pakistan
| | - Shahzad Baig
- Polio National Emergency Operations Center, Islamabad, Pakistan
| | - Arie Voorman
- Bill and Melinda Gates Foundation, Seattle, WA, United States
| | | | - Sajid Soofi
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
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da Silva TMR, Sá ACMGND, Prates EJS, Freitas Saldanha RD, da Silva TPR, Silva Teixeira AMD, Beinner MA, de Oliveira SR, de Sá ATN, Matozinhos FP, Vieira EWR. Temporal and spatial distribution trends of polio vaccine coverage in less than one-year old children in Brazil, 2011-2021. BMC Public Health 2023; 23:1359. [PMID: 37452296 PMCID: PMC10349464 DOI: 10.1186/s12889-023-16192-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Low polio vaccine coverage can result in the spread of Poliovirus to areas free from viral circulation. This study analyzed the temporal trends and spatial distribution of polio vaccine coverage in one year-old children in Brazil, between 2011 and 2021. METHODS This was an ecological, time-series study (2011 to 2021) with annual vaccine coverages against poliomyelitis, extracted from the Information System of the National Immunization Program from the 26 States and the Distrito Federal (DF). The percentage reductions in vaccination coverage in Brazil and in the Regions were calculated. Prais-Winsten regression models were used to analyze time series for the Regions and States, and spatial analysis identified the distribution of clusters (high-high; low-low; high-low and low-high) of vaccination coverages across Brazilian municipalities, using a 5% significance level. RESULTS From 2011 to 2021, the coverage of polio vaccines decreased by 29,9%. There was a progressive increase observed in clusters resulting in low vaccination coverages (140 low-low Brazilian municipalities in 2011 vs. 403 in 2021), mostly reported in the North and Northeast regions of the country. There was a downward trend in vaccination coverages in 24 of the 26 States and DF (p ≤ 0.05). CONCLUSIONS The reduction in polio vaccine coverage, as observed in the North and Northeast regions of Brazil, may favor the spread of Poliovirus. Therefore, vaccination strategies should be prioritized for children residing in areas with sharp and recurrent declines in vaccination coverages, including travelers, migrants, and refugees.
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Affiliation(s)
- Tércia Moreira Ribeiro da Silva
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil.
| | | | - Elton Junio Sady Prates
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | | | - Thales Philipe Rodrigues da Silva
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | | | - Mark Anthony Beinner
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | - Suelen Rosa de Oliveira
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | | | - Fernanda Penido Matozinhos
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
| | - Ed Wilson Rodrigues Vieira
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, 30190 000, Minas Gerais, Brazil
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Elbert B, Zainumi CM, Pujiastuti RAD, Yaznil MR, Yanni GN, Alona I, Lubis IND. Mothers' knowledge, attitude, and behavior regarding child immunization, and the association with child immunization status in Medan City during the COVID-19 pandemic. IJID REGIONS 2023:S2772-7076(23)00040-1. [PMID: 37363195 PMCID: PMC10157388 DOI: 10.1016/j.ijregi.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 06/28/2023]
Abstract
Background The COVID-19 pandemic has caused disruption to healthcare access worldwide and has impacted basic childhood immunization services. A decline in immunization coverage can cause immunity gaps and lead to outbreaks of vaccine-preventable diseases. Our study evaluated the association between mothers' knowledge, attitude, and behavior regarding immunization and child immunization status during the COVID-19 pandemic in Medan, Indonesia. Methods An analytical cross-sectional study was conducted from April to November 2021. Mothers with children aged 0-12 months were interviewed about their knowledge, attitude, and behavior regarding immunization, and their child's immunization status. Results Of 196 participants, 46.5% had low knowledge on immunization, 41.3% had a negative attitude, and 20.4% had negative behavior. Only 62.8% of participants had children with a complete vaccination status, and mothers with moderate knowledge (OR 2.65, 95% CI 1.08-6.61), negative attitude (OR 5.33, 95% CI 2.71-10.59), and negative behavior (OR 7.88, 95% CI 3.36-19.47) were more likely to not vaccinate their children. Conclusion Mothers' attitude, behavior, and educational background were associated with child immunization status. Recovery efforts to improve immunization coverage are urgently needed, and should include efforts to reduce mothers' hesitancy regarding child vaccination during the pandemic.
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Affiliation(s)
- Bryant Elbert
- Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Cut Meliza Zainumi
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | | | - Muhammad Rizki Yaznil
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Gema Nazri Yanni
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Ivana Alona
- Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Inke Nadia D Lubis
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Menzies School of Health Research, Darwin, Australia
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The impact of the COVID-19 pandemic on vaccine coverage in Kilifi, Kenya: A retrospective cohort study. Vaccine 2023; 41:666-675. [PMID: 36543684 PMCID: PMC9622384 DOI: 10.1016/j.vaccine.2022.10.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic caused unprecedented disruption in health service delivery, globally. This study sought to provide evidence on the impact of the pandemic on vaccine coverage in Kilifi County, Kenya. We conducted a vaccine coverage survey between April and June 2021 within the Kilifi Health and Demographic Surveillance System (KHDSS). Simple random sampling was used to identify 1500 children aged 6 weeks-59 months. Participants were grouped into three retrospective cohorts based on when they became age-eligible for vaccination: before the pandemic, during the first year, or during the second year of the pandemic. Survival analysis with Cox regression was used to evaluate the association between the time-period at which participants became age-eligible for vaccination and the rate of vaccination within a month of age-eligibility for the third dose of pentavalent vaccine (Pentavalent-3) and within three months of age-eligibility for the first dose of Measles vaccine (MCV-1). A total of 1,341 participants were included in the survey. Compared to the pre-COVID-19 baseline period, the rate of vaccination within a month of age-eligibility for Pentavalent-3 was not significantly different in the first year of the pandemic (adjusted hazard ratio [aHR] 1.03, 95 % confidence interval [CI] 0.90-1.18) and was significantly higher during the second year of the pandemic (aHR 1.33, 95 % CI 1.07-1.65). The rate of vaccination with MCV-1 within three months of age-eligibility was not significantly different among those age-eligible for vaccination during the first year of the pandemic (aHR 1.04, 95 % CI 0.88-1.21) and was 35 % higher during the second year of the pandemic (95 % CI 1.11-1.64), compared to those age-eligible pre-COVID-19. After adjusting for known determinants of vaccination, the COVID-19 pandemic did not adversely affect the rate of vaccination within the KHDSS.
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Lai YA, Chen X, Kunasekaran M, Rahman B, MacIntyre CR. Global epidemiology of vaccine-derived poliovirus 2016-2021: A descriptive analysis and retrospective case-control study. EClinicalMedicine 2022; 50:101508. [PMID: 35784443 PMCID: PMC9240990 DOI: 10.1016/j.eclinm.2022.101508] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Vaccine derived poliovirus (VDPV) remains a major barrier to polio eradication, and recent growing emergences are concerning. This paper presents the global epidemiology of circulating VDPV (cVDPV) by exploring associations between demographic and socioeconomic factors with its recent rise. METHODS Data on reported cVDPV cases and isolates between January 1 2016 and June 30 2021 were compiled from EPIWATCH, an open-source observatory for outbreak scanning and analysis, the World Health Organisation (WHO) and ProMed, and analysed descriptively. Reports containing cVDPV case information were included while duplicates and defective links were excluded. Data collection occurred from April 5 2021 to July 16 2021. To identify factors associated with cVDPV, a retrospective case-control study comparing socioeconomic profiles of countries which reported cVDPV with those that did not was undertaken with weighted logistic regression analysis. FINDINGS cVDPV caused by serotype 2 poliovirus was the predominant strain (95%) of 1818 total human cVDPV cases reported. Of 40 countries reporting cVDPV cases or isolates, 22 (55%) had polio vaccination coverages below 80%. Low vaccination coverage (Adjusted OR = 83·41, 95% CI: [5·01, 1387·71], p = 0·0020) was found to be associated with increased odds of reporting cVDPV after adjusting for confounding effects of GDP per capita, female adult literacy rates, maternal mortality rate, and Global Peace Index. INTERPRETATION Our findings reinforce the importance of maintaining high levels of vaccination, as risk of re-emergence rises when immunity wanes. Interventions to increase vaccination and standards of living in developing countries, coupled with robust surveillance are required if humanity hopes to eradicate polio in the near future. FUNDING This research was supported by the MRFF 2021 Frontier Health and Medical Research Grant (ID RFRHPI000280), Department of Health, the Australian Government.
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Affiliation(s)
- Yi An Lai
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Corresponding author at: Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
| | - Xin Chen
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Bayzidur Rahman
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Chandini Raina MacIntyre
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
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Azizatunnisa' L, Cintyamena U, Bura V, Surya A, Wibisono H, Ahmad RA, Mahendradhata Y. Maintaining Polio-Free Status in Indonesia During the COVID-19 Pandemic. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00310. [PMID: 35294381 PMCID: PMC8885360 DOI: 10.9745/ghsp-d-21-00310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/16/2021] [Indexed: 11/15/2022]
Abstract
Despite the negative impact that the COVID-19 pandemic has had on polio eradication efforts, ensuring the high coverage of polio immunization and high performance of surveillance are essential to maintaining Indonesia’s polio-free status and the reaching the 2023 global polio eradication target.
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Affiliation(s)
- Luthfi Azizatunnisa'
- Department of Health Behavior, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Utsamani Cintyamena
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Vinod Bura
- World Health Organization, Country Office for Indonesia
| | - Asik Surya
- Sub-directorate of Immunization, Directorate of Surveillance and Health Quarantine, Ministry of Health of The Republic of Indonesia
| | - Hariadi Wibisono
- National Certification Committee for Polio Eradication (NCCPE) Indonesia
| | - Riris Andono Ahmad
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yodi Mahendradhata
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Rahim S, Ahmad Z, Abdul-Ghafar J. The polio vaccination story of Pakistan. Vaccine 2021; 40:397-402. [DOI: 10.1016/j.vaccine.2021.11.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/12/2021] [Accepted: 11/30/2021] [Indexed: 11/29/2022]
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Rana MS, Ikram A, Salman M, Usman M, Umair M. Negative impact of the COVID-19 pandemic on routine childhood immunization: experience from Pakistan. Nat Rev Immunol 2021; 21:689-690. [PMID: 34522031 PMCID: PMC8439171 DOI: 10.1038/s41577-021-00627-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic has disrupted routine childhood immunization coverage for many vaccine-preventable diseases at the global, regional and national levels. In Pakistan, more than 40 million children were unable to receive measles vaccination and around 50 million children missed polio vaccination in 2020. Moreover, more than 36 million children did not receive vitamin A supplementation in 2020. Implementing catch-up vaccination services to prevent outbreaks of vaccine-preventable diseases, particularly polio and measles, in malnourished children is urgently required to prevent a global resurgence of these deadly diseases. Muhammad Suleman Rana and colleagues from the National Institute of Health in Pakistan discuss the urgent need to implement catch-up vaccination programmes for measles and polio to prevent resurgence of these deadly diseases.
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Affiliation(s)
| | - Aamer Ikram
- National Institute of Health, Islamabad, Pakistan
| | | | | | - Massab Umair
- National Institute of Health, Islamabad, Pakistan
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Chiappini E, Parigi S, Galli L, Licari A, Brambilla I, Angela Tosca M, Ciprandi G, Marseglia G. Impact that the COVID-19 pandemic on routine childhood vaccinations and challenges ahead: A narrative review. Acta Paediatr 2021; 110:2529-2535. [PMID: 34028088 PMCID: PMC8222862 DOI: 10.1111/apa.15949] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 12/23/2022]
Abstract
Aim To document the decline in vaccination coverage in the first months of 2020 as an indirect effect of the COVID‐19 pandemic. Methods We performed a literature review in medical databases. Overall, 143 articles were initially retrieved, out of which 48 were selected and included in the review. Results Our review retrieved similar data in many countries worldwide, and, globally, preliminary data from the first 4 months of 2020 indicate a decline in diphtheria‐tetanus‐pertussis coverage, generally considered the marker of vaccination coverage across countries. World Health Organization recommends maintaining vaccination services, prioritising primary series vaccinations especially for measles‐rubella or poliomyelitis, but it also lets each country decide whether to maintain the immunisation services evaluating the current epidemiology of vaccine‐preventable diseases and the COVID‐19 local transmission scenario. Successively, recovering of vaccinations should be planned. Moreover, during the pandemic, influenza vaccination should be promoted as a central public health measure. Conclusion Future challenges will be to maintain the vaccination programmes, especially in children younger than 2 years old and adolescents, to plan the recovery of vaccinations for subjects who postponed them during the lockdown, and to early identify any vaccine‐preventable disease outbreak.
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Affiliation(s)
- Elena Chiappini
- Paediatric Infectious Diseases Unit Department of Health Sciences Anna Meyer Children University Hospital Florence Italy
| | - Sara Parigi
- Paediatric Infectious Diseases Unit Department of Health Sciences Anna Meyer Children University Hospital Florence Italy
| | - Luisa Galli
- Paediatric Infectious Diseases Unit Department of Health Sciences Anna Meyer Children University Hospital Florence Italy
| | - Amelia Licari
- Department of Pediatrics Foundation IRCCS Policlinico San Matteo University of Pavia Pavia Italy
| | - Ilaria Brambilla
- Department of Pediatrics Foundation IRCCS Policlinico San Matteo University of Pavia Pavia Italy
| | | | | | - Gianluigi Marseglia
- Department of Pediatrics Foundation IRCCS Policlinico San Matteo University of Pavia Pavia Italy
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Harris RC, Chen Y, Côte P, Ardillon A, Nievera MC, Ong-Lim A, Aiyamperumal S, Chong CP, Kandasamy KV, Mahenthiran K, Yu TW, Huang C, El Guerche-Séblain C, Vargas-Zambrano JC, Chit A, Nageshwaran G. Impact of COVID-19 on routine immunisation in South-East Asia and Western Pacific: Disruptions and solutions. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 10:100140. [PMID: 33899040 PMCID: PMC8057868 DOI: 10.1016/j.lanwpc.2021.100140] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/08/2021] [Accepted: 03/18/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Data on COVID-19-induced disruption to routine vaccinations in the South-East Asia and Western Pacific regions (SEAR/WPR) have been sparse. This study aimed to quantify the impact of COVID-19 on routine vaccinations by country, antigen, and sector (public or private), up to 1 June 2020, and to identify the reasons for disruption and possible solutions. METHODS Sanofi Pasteur teams from 19 countries in SEAR/WPR completed a structured questionnaire reporting on COVID-19 disruptions for 13-19 routinely delivered antigens per country, based on sales data, government reports, and regular physician interactions. Data were analysed descriptively, disruption causes ranked, and solutions evaluated using a modified public health best practices framework. FINDINGS 95% (18/19) of countries reported vaccination disruption. When stratified by country, a median of 91% (interquartile range 77-94) of antigens were impacted. Infancy and school-entry age vaccinations were most impacted. Both public and private sector healthcare providers experienced disruptions. Vaccination rates had not recovered for 39% of impacted antigens by 1 June 2020. Fear of infection, movement/travel restrictions, and limited healthcare access were the highest-ranked reasons for disruption. Highest-scoring solutions were separating vaccination groups from unwell patients, non-traditional vaccination venues, virtual engagement, and social media campaigns. Many of these solutions were under-utilised. INTERPRETATION COVID-19-induced disruption of routine vaccination was more widespread than previously reported. Adaptable solutions were identified which could be implemented in SEAR/WPR and elsewhere. Governments and private providers need to act urgently to improve coverage rates and plan for future waves of the pandemic, to avoid a resurgence of vaccine-preventable diseases. FUNDING Sanofi Pasteur.
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Affiliation(s)
- Rebecca C. Harris
- Sanofi Pasteur, 38 Beach Road, #18-11 South Beach Tower, Singapore 189767, Singapore
- London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Yutao Chen
- Sanofi Pasteur China, 7F HP Plaza, 112 Jianguo Rd, ChaoYang District, Beijing 100022, China
| | - Pierre Côte
- Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France
| | - Antoine Ardillon
- Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France
- Current affiliation: Institute of Pharmaceutical and Biological Sciences, Claude Bernard Lyon University, 8 avenue Rockefeller, 69373 Lyon, France
| | - Maria Carmen Nievera
- Sanofi Pasteur, 38 Beach Road, #18-11 South Beach Tower, Singapore 189767, Singapore
| | - Anna Ong-Lim
- Division of Infectious and Tropical Disease, Department of Pediatrics, University of the Philippines – Philippine General Hospital, Manila 1000, Philippines
| | - Somasundaram Aiyamperumal
- Department of Developmental and Behavioural Pediatrics, D'Soul Child Development Centre and Kanchi Kamakoti Childs Trust Hospital, Chennai 600034, India
| | - Chan Poh Chong
- Division of General Ambulatory Paediatrics and Adolescent Medicine, Department of Paediatrics, National University Children's Medical Institute, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Singapore 119228, Singapore
| | | | - Kuharaj Mahenthiran
- Sanofi Pasteur, 38 Beach Road, #18-11 South Beach Tower, Singapore 189767, Singapore
| | - Ta-Wen Yu
- Sanofi Pasteur, 38 Beach Road, #18-11 South Beach Tower, Singapore 189767, Singapore
| | - Changshu Huang
- Sanofi Pasteur, New World International Trade, No.568, Jianshe Avenue, Jianghan District, Wuhan City 430000, China
| | | | | | - Ayman Chit
- Sanofi Pasteur, Discovery Drive Swiftwater, PA 18370, USA
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
| | - Gopinath Nageshwaran
- Sanofi Pasteur, 38 Beach Road, #18-11 South Beach Tower, Singapore 189767, Singapore
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The Impact of the COVID-19 Pandemic on Immunization Campaigns and Programs: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030988. [PMID: 33499422 PMCID: PMC7908591 DOI: 10.3390/ijerph18030988] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/07/2021] [Accepted: 01/20/2021] [Indexed: 02/08/2023]
Abstract
The COVID-19 pandemic has had an impact on health service delivery, including immunization programs, and this review assesses the impact on vaccine coverage across the globe and identifies the potential underlying factors. A systematic search strategy was employed on PubMed, Embase, MedRxiv, BioRxiv, and WHO COVID-19 databases from December 2019 till 15 September 2020. Two review authors independently assessed studies for inclusion, assessed quality, and extracted the data (PROSPERO registration #CRD42020182363). A total of 17 observational studies were included. The findings suggest that there was a reduction in the vaccination coverage and decline in total number of vaccines administered, which led to children missing out on their vaccine doses. An approximately fourfold increase was also observed in polio cases in polio endemic countries. Factors contributing to low vaccine coverage included fear of being exposed to the virus at health care facilities, restriction on city-wide movements, shortage of workers, and diversion of resources from child health to address the pandemic. As the world re-strategizes for the post-2020 era, we should not let a crisis go to waste as they provide an opportunity to establish guidelines and allocate resources for future instances. High-quality supplementary immunization activities and catch-up programs need to be established to address gaps during the pandemic era.
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