Abstract
The COVID-19 pandemic has had an impact on health service delivery, including immunization programs, and this review assesses the impact on vaccine coverage across the globe and identifies the potential underlying factors. A systematic search strategy was employed on PubMed, Embase, MedRxiv, BioRxiv, and WHO COVID-19 databases from December 2019 till 15 September 2020. Two review authors independently assessed studies for inclusion, assessed quality, and extracted the data (PROSPERO registration #CRD42020182363). A total of 17 observational studies were included. The findings suggest that there was a reduction in the vaccination coverage and decline in total number of vaccines administered, which led to children missing out on their vaccine doses. An approximately fourfold increase was also observed in polio cases in polio endemic countries. Factors contributing to low vaccine coverage included fear of being exposed to the virus at health care facilities, restriction on city-wide movements, shortage of workers, and diversion of resources from child health to address the pandemic. As the world re-strategizes for the post-2020 era, we should not let a crisis go to waste as they provide an opportunity to establish guidelines and allocate resources for future instances. High-quality supplementary immunization activities and catch-up programs need to be established to address gaps during the pandemic era.
Highlights
The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) led the world into a crisis of unprecedented scale and scope [1]
Our search was designed to include all populations from both high-income countries and low- and middle-income countries impacted by COVID-19
Of the studies from high income countries (HICs), five were conducted in the United States [30,32,36,39,42], two in the United Kingdom [37,40], and one each in France [44], Italy [29], and Spain [38]. Of those from low- and middle-income countries (LMIC), four were from Pakistan [28,33,35,43], one study was conducted across two countries namely, Afghanistan and Pakistan [34], and one each was from South
Summary
The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) led the world into a crisis of unprecedented scale and scope [1]. As governments across the world attempted to regulate the outbreak by implementing population-wide lockdowns, closing borders and halting mass gatherings, experts started worrying about the indirect health impacts. These disruptions are very likely to threaten the progress of various programs, including immunization campaigns, which have proven to be a valuable and cost-effective public health intervention to date [3]. While global vaccination programs were sliding backward even before this era [6], the related disruption is occurring at a scale larger than any since the advent of immunization programs in the 1970s Consequences of such a falling through can be extensive, and could possibly even impact the future delivery of a COVID-19 vaccine
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