Keeping childhood immunisation rates stable during the COVID-19 pandemic

Abstract

During the first wave of the COVID-19 pandemic in spring, 2020, 22% of infants in the WHO European Region had their vaccination courses interrupted. 3 A drop in vaccination rates of almost 20% during the first UK lockdown was reported in England. 4 However, in Lothian, attendance at childhood immunisation clinics remained stable in the weeks during lockdown (appendix).When the Scottish Vaccination Transformation Programme was designed in 2018, a strong emphasis was placed on the needs of children and adults who require vaccinations. 5 This programme provided the foundation for local adaptations to immunisation efforts by the childhood immunisation team in Lothian during the first wave of the COVID-19 pandemic. Several adaptations had an important role in keeping attendance rates stable.First, vaccinations were delivered via fixed-point clinics at various locations that were accessible by public transport. Children who could not attend clinics owing to shielding could be vaccinated by mobile teams. All vaccinations were delivered with appropriate personal protective equipment in place, in line with guidance at the time.Second, changes were made to how data were collected. All vaccination data are held centrally in the Scottish Immunisation Recall System. Public Health Scotland collects and publishes vaccination uptake data for Scotland. 2 Data published in previous years began with vaccinations completed when children reached 12 months of age. By contrast, during the pandemic, much shorter periods of time were required to monitor immunisation clinic attendance (appendix) and uptake of vaccinations.Third, efforts were made to establish trust and ensure that children and their families felt looked after. All families received a personal reminder via telephone from a trained operator on Methodology.

Delivering routine immunisations in London during the COVID-19 pandemic: lessons for future vaccine delivery. A mixed-methods study

“…Similar adaptations have been reported to have helped to keep uptake rates stable in an area of Scotland during the COVID-19 pandemic. 30 …”

COVID-19 and missed or delayed vaccination in 26 middle- and high-income countries: An observational survey

“…Enhancing the accessibility of vaccines may include establishing vaccination centers at locations that are convenient to reach using public transport or by establishing mobile vaccination teams and using interpreters as required. [30] Approaches for emphasizing the importance of routine vaccination and COVID-19 safety measures may also include highlighting recommendations that those with symptoms of COVID-19 should delay attending routine vaccination clinics. [30] …”

“… [30] Approaches for emphasizing the importance of routine vaccination and COVID-19 safety measures may also include highlighting recommendations that those with symptoms of COVID-19 should delay attending routine vaccination clinics. [30] …”

“…[12] , [35] , [36] Using shorter time periods to monitor vaccination uptake during the pandemic is advantageous. [30] The pandemic has also emphasized the importance of strong public health surveillance to track missed vaccination. [21] Not all countries have national immunization registries, and for these countries detecting individuals who have missed vaccination may be a particular challenge, [36] especially given how many individuals this study found to be “unsure” if they have missed a vaccine during COVID-19.…”

Childhood Immunisation Coverage during the COVID-19 Epidemic in Italy

“…Other countries reported a slight decrease in VC rates against paediatric infectious diseases [24] and a reduced overall incidence of VPD [25][26][27], while some countries experienced a marked decrease in VC rates [28][29][30][31][32][33], slow resumption of immunisation services [34][35][36][37], or an overall negative pandemic impact on their immunisation services [38]. Indeed, the pandemic has led to global disruptions in essential health services.…”