At the peak of the SARS-CoV-2 (COVID-19) pandemic, the medical field understandably shifted its efforts to treating patients with COVID-19 and developing vaccines. As people quarantined, other routine medical treatments became less common. One such treatment was routine immunization.

April 24-30, 2022 is World Immunization Week, as the World Health Organization (WHO) seeks to promote vaccinations for protection against disease around the world.¹ Routine immunization against conditions like measles, diphtheria, and tetanus were commonplace worldwide long before the COVID-19 pandemic. But as the pandemic grew, routine immunization was disrupted. How can this disruption be addressed?

How COVID-19 Affected Routine Immunization


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Though we may not know the entire scope, it is clear that the beginning of the pandemic significantly disrupted routine immunization around the world. A recent study in The Lancet Global Health used WHO data to get a sense of routine immunization disruption in 2020.² In April of 2020, over 50% of WHO member states or countries in the African region, the Americas, the Eastern Mediterranean region, and the South-East Asian region reported disruption to routine immunization sessions. The Americas saw reduced demand for vaccination services in 80% of countries, while 50% had difficulty getting vaccination supplies and 67% had limited workforce availability.

The result of these disruptions was a significant drop-off in administered vaccination doses for much of 2020 compared to similar months in 2019. Globally, there was a decrease of greater than 30% in administered doses of the diphtheria-pertussis-tetanus-containing vaccine (DTP) and the measles-containing vaccine (MCV1) in April 2020 compared to April 2019. In the WHO South-East Asian region, it was over 50%. The Americas saw a 30% year-over-year decrease in MCV1 doses in April 2020, with numbers increasing in May and June before falling again in July.

The researchers concluded that the data showed a large disruption, and that while there was in time a partial resumption, more was needed for an effective catch-up.

Addressing and Mitigating Disruption

How can these disruptions be addressed and mitigated now following the peak of the COVID-19 pandemic? A 2021 study in BMJ Global Health looked into how Nepal, Senegal, and Liberia worked to address its effects, and found potential solutions for the rest of the world.³ Routine immunization efforts suffered at the beginning of the pandemic in these countries for a number of reasons; delayed shipments of vaccination supplies, fear of COVID-19 exposure, and difficulty accessing vaccination, among others.

Some of the ways these countries addressed those concerns and tried to mitigate disruption included:

  • Implementing more communication and outreach programs
  • Increasing alternative delivery options for vaccination, including additional hours and home visits
  • Leveraging current records to track which patients are missing doses
  • Conducting catch-up services and campaigns once COVID-19 risks could be mitigated

These attempts at mitigation, the researchers concluded, were important components of addressing disruption. However, they also stressed that one-size-fits-all strategies to get patients caught up should be avoided.

References

1. World Immunization Week 2022. World Health Organization. https://www.who.int/campaigns/world-immunization-week/world-immunization-week-2022. Accessed April 22, 2022.

2. Shet A, Carr K, Danovaro-Holliday MC, et al. Impact of the SARS-CoV-2 pandemic on routine immunisation services: evidence of disruption and recovery from 170 countries and territories. Lancet Glob Health. 2022;10(2):e186-e194. doi:10.1016/S2214-109X(21)00512-X

3. Dixit SM, Sarr M, Gueye DM, et al. Addressing disruptions in childhood routine immunisation services during the COVID-19 pandemic: perspectives from Nepal, Senegal and Liberia. BMJ Glob Health. 2021;6(7):e005031. doi:10.1136/bmjgh-2021-005031

This article originally appeared on Clinical Advisor