Addressing disruptions in childhood routine immunisation services during the COVID-19 pandemic: perspectives from Nepal, Senegal and Liberia

Learning from the COVID-19 pandemic to strengthen routine immunization systems

“…These findings stand in contrast to the documented experience of many other countries, where available data suggest historic disruptions in routine childhood vaccination coverage, particularly during the first months of pandemic-related lockdowns [ 5 , 6 ]. Supply side limitations such as delayed shipments of vaccines and supplies [ 7 ], inadequate personal protective equipment [ 8 ], staff shortages [ 9 ], and delayed or canceled campaigns and introductions [ 9 ] threatened vaccine delivery. Furthermore, fear of exposure to COVID-19 at vaccination centers [ 10 ], misinformation about vaccine safety [ 8 ], and lockdown-related limitations on travel to facilities [ 9 , 10 ] reduced demand.…”

“…Supply side limitations such as delayed shipments of vaccines and supplies [ 7 ], inadequate personal protective equipment [ 8 ], staff shortages [ 9 ], and delayed or canceled campaigns and introductions [ 9 ] threatened vaccine delivery. Furthermore, fear of exposure to COVID-19 at vaccination centers [ 10 ], misinformation about vaccine safety [ 8 ], and lockdown-related limitations on travel to facilities [ 9 , 10 ] reduced demand. In polls of country experts conducted by WHO, UNICEF, and Gavi, the Vaccine Alliance throughout the second quarter of 2020, 126 of 170 countries reported at least some disruption to routine immunization programs [ 10 , 11 ].…”

“…Similarly, immunization programs around the world have employed a broad range of strategies to maintain or increase vaccination during the pandemic. Leaders in Senegal, Paraguay, and Sri Lanka designed and conducted media campaigns to emphasize the importance of childhood immunization even during lockdown [ 8 , 14 , 15 ]. Although many programs delayed mass campaigns in the spring of 2020, multiple countries were able to implement campaigns by the summer of 2020 [ 8 , 16 – 20 ].…”

“…Leaders in Senegal, Paraguay, and Sri Lanka designed and conducted media campaigns to emphasize the importance of childhood immunization even during lockdown [ 8 , 14 , 15 ]. Although many programs delayed mass campaigns in the spring of 2020, multiple countries were able to implement campaigns by the summer of 2020 [ 8 , 16 – 20 ]. In each of these examples, leaders responded quickly to meet the unique challenges presented by the COVID-19 pandemic in their communities.…”

“…Vaccination data systems that track individual children and doses, such as the reminder system in Scotland, allow for highly targeted responses. Similarly, in Senegal, Ghana, and in Karachi, Pakistan, healthcare workers have relied on existing or newly implemented tracking systems to identify children who have missed doses and provide text message and/or phone call reminders [ 8 , 22 , 23 ]. Investing in robust routine data systems allows for rapid scale-up of data collection, targeted services to those who miss doses, and a more informed response when vaccine delivery challenges arise.…”