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.
Background Asia has been at the forefront of leveraging big data and digital technologies to strengthen measures against SARS-CoV-2 spread. Understanding strengths and challenges of these new approaches is important to inform improvements and implementation. In this review, we aimed to explore how these tools were utilized in four countries in Asia to facilitate COVID-19 preventative control measures. Methods We conducted a pragmatic review of English-language literature and web-based information in Pubmed, MedRxiv, national and international public health institution websites and media sources between 1st January-3rd August 2020 to identify examples of big data and digital technologies to facilitate COVID-19 preventative control measures in Taiwan, South Korea, Hong Kong, and Singapore. Results were summarized narratively by common technological themes, and examples of integration highlighted. Results Digital tools implemented included real-time epidemiological dashboards, interactive maps of case location, mobile apps for tracing patients’ contacts and geofencing to monitor quarantine compliance. Examples of integration of tools included linkage of national health and immigration databases to identify high-risk individuals in Taiwan, and the use of multiple digital surveillance sources to map patients’ movements in South Korea. Challenges in balancing privacy and public good were identified. Conclusions Digital technologies have facilitated and strengthened traditional public health measures for prevention of SARS-CoV-2 spread in Asia. Resolving issues around privacy concerns would improve future preparedness, implementation speed and uptake of digital measures. The significant technological advances and lessons learned can be adopted or adapted by other countries to ensure public health preparedness for future waves of COVID-19 and other pandemics.
Background
With no vaccines or specific treatments, non-pharmaceutical interventions are the only tools for controlling the human-to-human transmission of the COVID-19 disease, which appeared in Wuhan, China last December and has spread globally since. Here we describe and compare the first-wave mitigation strategies and epidemiology of five Asia-Pacific countries that responded rapidly to the epidemic.
Methods
From January to April 2020, mitigation measures and epidemiological data for Singapore, South Korea, Japan, Taiwan, Hong Kong were screened from official local government websites and a review of investigational studies was conducted. Daily case reports and mitigation measures information were extracted. Epidemiological estimates were calculated and compared between countries.
Results
All five countries combined measures, focusing on contact tracing, testing, isolation efforts and healthcare management. Epidemiological data varied temporally and geographically: incubation period ranged 3.9–7.1 days, effective reproduction number at time t (Rt) ranged 0.48–1.5, with intensive care admissions 1–3% of hospitalised patients, and case fatality rates were 0.1–3%. Extrinsic estimates to the virus were lower than global estimates.
Conclusion
Implemented mitigation strategies in these countries allowed a rapid and successful control or delay of the first COVID-19 pandemic wave. These are valuable examples to inform subsequent waves.
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