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.
The PHiD-CV 2 + 1 UMV program is projected to be cost-effective, compared with no vaccination, and would provide substantial savings with higher quality-adjusted life-year gains as compared with the PCV13 2 + 1 strategy in the context of the Philippines.
Purpose
Meningococcal disease is a major global health concern due to its severe and sudden clinical manifestations, devastating long‐term sequelae, and predominance in younger age groups. This study evaluated the safety of a quadrivalent meningococcal polysaccharide diphtheria toxoid conjugate vaccine (MenACWY‐D; Menactra) in participants aged 9 months to 55 years in Vietnam.
Methods
This was an open‐label, single‐arm study conducted between June and December 2016. Participants received one 0.5‐mL dose of the vaccine, and those aged 9 to 23 months received a second 0.5‐mL dose 3 months later. Participants (or their parents or legal guardians) reported adverse events during the 28 days after each dose.
Results
The study included 112 participants aged 9 to 23 months and 112 participants aged 2 to 55 years. Of these 224 participants, 100 (44.6%) had one or more solicited reactions within 7 days following any MenACWY‐D dose, mostly injection site pain, lost appetite (in 9 to 23‐month‐olds), and malaise (in 2 to 55‐year‐olds). Most solicited reactions were of mild or moderate intensity and resolved within 3 days. Five participants had unsolicited adverse reactions (ARs), two of which (tonsillitis and febrile convulsion), in 9 to 23‐month‐olds, were considered by the investigator as serious adverse events related to the vaccine. No immediate unsolicited ARs, severe unsolicited nonserious ARs, or unsolicited injection site reactions were reported, and both participants who experienced vaccine‐related serious adverse events recovered.
Conclusion
Consistent with studies in other countries, MenACWY‐D had an acceptable safety profile in individuals from Vietnam aged 9 months to 55 years (WHO Universal Trial Number: U1111‐1143‐9207).
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