Routine childhood vaccinations disrupted by the 2020 global pandemic

1. Approximately 8.5 million children were estimated to have missed DTP3 and MCV1 vaccinations in 2020 due to the global pandemic.

2. The largest disruptions were seen in April and May 2020, with some countries recovering to annual targets by the end of 2020.

Evidence Rating Level: 3 (Average)

Study Rundown: The full burden of COVID-19 on the healthcare system is continually being revealed. With many healthcare systems limiting visits to strictly urgent care, routine appointments such as child and adolescent vaccinations may have been disrupted. Modeling studies, such as this one, show the estimated indirect impact of COVID-19 on other areas of healthcare. Using electronic and administrative records, this study estimated the number of children who did not receive their routine third-dose diphtheria-tetanus-pertussis (DTP3) and first-dose measles-containing vaccine (MCV1) due to the pandemic-related disruptions in 2020. The results of this modeling study showed that over eight million children were estimated to have missed vaccinations with DTP3 and MCV1, due to the COVID-19 pandemic. The most severe impact was seen in April and May of 2020. However, during the second half of 2020, many regions, such as southeast Asia, east Asia, and Oceania, had recovered and were vaccinated at an expected annual rate. Yet, globally there remained a relative reduction in vaccination coverage compared to expected vaccination rates in the absence of the pandemic. Limitations of this study include gaps in vaccination data for certain countries in 2020. Nevertheless, these modelling studies help inform catch-up vaccination programs which will begin to be implemented in the future.

Click to read the study in the Lancet

Click to read an accompanying editorial in the Lancet

Relevant Reading: Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study

In-Depth [retrospective cohort]: This modelling study was done following the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) statement. The expected vaccination rates in 2020 in the absence of the global pandemic were estimated using data from the Global Burden of Disease (GBD) on vaccine coverage from 1980-2019. The estimated actual vaccine coverage was 7.7% (6.0-10.1) and 7.9% (5.2-11.7) less than expected for DTP3 and MCV1, respectively. Due to the pandemic, an estimated additional 8.5 (6.5-11.6) and 8.9 (5.7-13.7) million children were not routinely vaccinated with DTP3 and MCV1, respectively. Total vaccine coverage for DTP3 and MCV1 was 76.7% and 78.9%, respectively. Generally, the months with the largest disruptions were April and May 2020. The most severe impact was seen in the regions of north Africa, the Middle East, south Asia, Latin America and the Caribbean. During the 2^nd half of 2020, recovery was seen in certain regions, such as southeast Asia, east Asia, and Oceania.

Image: PD

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