469 Preventive health care of children in Croatia during COVID-19 EPIdemic

Abstract

<h3></h3> To determine the impact of the COVID-19 epidemic on preventive health care visits and vacciantions in pediatrician practises in primary health care in Croatia. Data about preventive health care visits and vacciantions of infants and preschool children in pediatrician practises in primary health care in Croatia were extracted from the Central Health Information System of the Republic of Croatia and comparison of 2019 and 2020 data was made, respectively month by month. We analized data only for infants and preschool children, from 0 to 6 years old. In total, during 2019, 268,556 preventive health care visits of infants and preschool children were recorded compared to 252,690 during the 2020, which is decline of 5.9%. The biggest decline, 42.6%, was recorded during the March 2020, but with notable increase in the following months which almost overturned the impact of the initial decline. New decline in the visits was seen during the November, but far smaller than during the begining of epidemic. Regarding vacciantions, during the 2019, 238,799 vaccinations were recorded to be administred, compared to 262,157 during the 2020, which is increase of 9,8%. The biggest decline was also seen during the March, 26.1%. Begining of COVID-19 epidemic in Croatia caused a major decline in the number of preventive health care visits and vaccinations already during March 2020. It was probably direct consequence of ‘lockdown‘and parental fear of going to a health facility. Negligible is also the earthquake that hit Zagreb and surroundings in mid-March. Joint and rapid response of together primary pediatricians and Croatian Institute of Public Health with the thrust of the parents, manage to stop the decline of the numbers and even to increase the numbers in the following months. A second round of the decline in preventivne health care visits, during the late autumn and the begining of winter, was probably result of increase in the number of SARS-CoV- 2 positive people, including children, self-isolations and possible delay of vaccination after child is recovered from COVID-19. However, this favorable situation with frequency of preventive health care visits and vaccinations in Croatia during the COVID-19 epidemic gives us hope that in the future Croatia will not face vaccine-preventable communicable diseases outbreak, as some countries expect and once more emphasizes the importance of the pediatricians in the primary health care for the well-being of infants and preschool children.