Childhood immunisations in India during the COVID-19 pandemic

Shet, Anita; Dhaliwal, Baldeep; Banerjee, Preetika; DeLuca, Andrea; Carr, Kelly; Britto, Carl; Seth, Rajeev; Parekh, Bakul Jayant; Basavaraj, G; Shastri, Digant; Gupta, Piyush

doi:10.1136/bmjpo-2021-001061

Cited by 14 publications

(18 citation statements)

References 14 publications

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“…The immunisation services had to bear the brunt of unprecedented circumstances arisen because of COVID-19 pandemic. Interrupted routine childhood vaccination leads to outbreaks of preventable infections [4,5]. In April 2020, the health management and information system data of India reported a drastic decrease in the number of routine immunisation sessions relative to the previous year.…”

Section: Discussionmentioning

confidence: 99%

“…Identifying these children and offering them the missed vaccinations can decrease their risk of common childhood diseases. House to house campaigns to increase awareness about the dangers of delaying vaccine-preventable diseases must be promoted to caregivers, as well as the promotion of home vaccinations services [4,5]. Vaccination catch-up sessions with innovative strategies such as implementing appointment-only visits, minimising overcrowding, separating immunisation visits from sick children visits, prioritising robust communication efforts which address caregivers' fears of contracting COVID-19, and reminders to caregivers of the importance of routine vaccinations [14].…”

Section: Discussionmentioning

confidence: 99%

“…Vaccination catch-up sessions with innovative strategies such as implementing appointment-only visits, minimising overcrowding, separating immunisation visits from sick children visits, prioritising robust communication efforts which address caregivers' fears of contracting COVID-19, and reminders to caregivers of the importance of routine vaccinations [14]. The way forward should include an increased focus on catch-up campaigns, strong government engagement, effective surveillance and clear public health messaging to ensure restoration of immunisation and essential services for children [5].…”

Section: Discussionmentioning

confidence: 99%

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Childhood Immunization Coverage at a Tertiary Care Centre in South India Pre and Post COVID Lockdown - A Retrospective Study

Devadas

Puttaswamy

Kaniyala

et al. 2022

AJPR

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Introduction: Childhood immunisation is the most cost effective method to prevent vaccine preventable diseases and decrease childhood morbidity and mortality. COVID-19 pandemic has affected routine immunisation of children due to various reasons. We aimed to study the attendance to immunisation clinic at our tertiary care hospital prior and during COVID-19 pandemic. Methods: Retrospective data of monthly attendance to the immunisation clinic at our tertiary care hospital was collected for a study period of 30months, sub-grouped into - January 2019 to March 2020 (pre-COVID) and April 2020 to June 2021 (during COVID). The clinic caters to children from first day of life till 18 years, as per National Immunisation Schedule (NIS). Trends in attendance across the months were studied. Statistical analysis were employed to test whether there was a significant reduction in immunisation clinic attendance. Results: Attendance to the immunisation clinic during the 30 month study period was 37418 children. Among these, 29879 children received birth dose vaccines. This cohort was excluded from further analysis as deliveries continued at our maternity centre in both periods of study. Comparing vaccine recipients above the age of 6weeks till 18years across the months, 6222 and 1502 children received immunisation in the pre-COVID and during COVID pandemic respectively. No child received immunisation from April 2020 to July 2020 during national lockdown. Unpaired t-test showed highly significant reduction in attendance to immunisation clinic during the COVID pandemic in comparison to pre-COVID period (p<0.001). The reduction in immunisation attendance had greatest affection among recipients of pentavalent vaccine at our centre. Conclusion: Immunisation among children is significantly hampered during this COVID-19 pandemic as highlighted by our study findings. Vaccination delay leaves young children vulnerable and there is an acute need to increase awareness and catch-up drives to prevent resurgence of vaccine preventable diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Childhood Immunization Coverage at a Tertiary Care Centre in South India Pre and Post COVID Lockdown - A Retrospective Study

Devadas

Puttaswamy

Kaniyala

et al. 2022

AJPR

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“…COVID-19-related disruptions to the provision of child health service and outcomes, including the impact on immunizations and primary health care, have been well documented [ 39 , 43 ]. This study is among few reporting impact to essential maternal/newborn care including access to safe delivery and transfer to neonatal inpatient care [ 8 , 11 – 14 , 32 , 40 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of the early COVID-19 pandemic on outcomes in a rural Ugandan neonatal unit: A retrospective cohort study

et al. 2021

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Background During the early COVID-19 pandemic travel in Uganda was tightly restricted which affected demand for and access to care for pregnant women and small and sick newborns. In this study we describe changes to neonatal outcomes in one rural central Ugandan newborn unit before and during the early phase of the COVID-19 pandemic. Methods We report outcomes from admissions captured in an electronic dataset of a well-established newborn unit before (September 2019 to March 2020) and during the early COVID-19 period (April–September 2020) as well as two seasonally matched periods one year prior. We report excess mortality as the percent change in mortality over what was expected based on seasonal trends. Findings The study included 2,494 patients, 567 of whom were admitted during the early COVID-19 period. During the pandemic admissions decreased by 14%. Patients born outside the facility were older on admission than previously (median 1 day of age vs. admission on the day of birth). There was an increase in admissions with birth asphyxia (22% vs. 15% of patients). Mortality was higher during COVID-19 than previously [16% vs. 11%, p = 0.017]. Patients born outside the facility had a relative increase of 55% above seasonal expected mortality (21% vs. 14%, p = 0.028). During this period patients had decreased antenatal care, restricted transport and difficulty with expenses and support. The hospital had difficulty with maternity staffing and supplies. There was significant community and staff fear of COVID-19. Interpretation Increased newborn mortality during the early COVID-19 pandemic at this facility was likely attributed to disruptions affecting maternal and newborn demand for, access to and quality of perinatal healthcare. Lockdown conditions and restrictions to public transit were significant barriers to maternal and newborn wellbeing, and require further focus by national and regional health officials.

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“…Researchers have identified the shortfalls in the provision and utilization of routine MCH services during the current pandemic. A drop in utilization of antenatal care (ANC) and post-natal care (PNC) [ 5 , 6 ], institutional delivery [ 7 ], routine immunization services [ 8 , 9 ], and family planning services [ 10 ] signifies the lapses in MCH care due to the COVID-19 pandemic. Prior to the onset of the pandemic, the state of Odisha was making great efforts to improve its maternal and child health indicators [ 11 ] to achieve the figures targeted under sustainable development goals (SDG).…”

Section: Introductionmentioning

confidence: 99%

Resolution of Resilience: Empirical Findings on the Challenges Faced and the Mitigation Strategies Adopted by Community Health Workers (CHWs) to Provide Maternal and Child Health (MCH) Services during the COVID-19 Pandemic in the Context of Odisha, India

et al. 2022

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Community health workers (CHW) faced increased challenges in delivering maternal and child health services during the current COVID-19 pandemic. In addition to routine services, they were also engaged in pandemic management. In view of a dearth of evidence, the current study explores the challenges faced by CHWs while rendering maternal and child health services. A qualitative study through in-depth interviews (IDI) and focus group discussions (FGD) in six districts of Odisha was conducted from February to April 2021. Data were analyzed using MAXQDA software. Personal-level challenges, like lack of family support, stress, and fear of contracting COVID-19; facility-level challenges, like transportation problems and inadequate personal protective measures; and community-level challenges, like stigma, resistance, and lack of community support were major hindrances in provisioning routine MCH services. Prevailing myths and misconceptions concerning COVID-19 were factors behind stigma and resistance. Sharing experiences with family, practicing yoga and pranayam, engaging ambulance bikes, financial assistance to mothers, counseling people, and involving community leaders were some effective strategies to address these challenges. Development and implementation of appropriate strategy guidelines for addressing the challenges of frontline warriors will improve their work performance and achieve uninterrupted MCH services during pandemics or similar health emergencies.

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Childhood immunisations in India during the COVID-19 pandemic

Cited by 14 publications

References 14 publications

Childhood Immunization Coverage at a Tertiary Care Centre in South India Pre and Post COVID Lockdown - A Retrospective Study

Childhood Immunization Coverage at a Tertiary Care Centre in South India Pre and Post COVID Lockdown - A Retrospective Study

Impact of the early COVID-19 pandemic on outcomes in a rural Ugandan neonatal unit: A retrospective cohort study

Resolution of Resilience: Empirical Findings on the Challenges Faced and the Mitigation Strategies Adopted by Community Health Workers (CHWs) to Provide Maternal and Child Health (MCH) Services during the COVID-19 Pandemic in the Context of Odisha, India

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