The outbreak of the new coronavirus has seen fewer parents taking their children for vaccination for fear of contamination (WHO, 2020a). As a result, children have become more vulnerable to preventable diseases. Globally, there have been moderate to severe disruptions, or total suspension of routine immunization services in March and April (WHO, 2020b). If this situation is not properly handled, it may lead to another catastrophic health issue (UN, 2020a).

Before the outbreak of COVID-19, 116 million infants (approximately 86%) were vaccinated annually (UN, 2020b). According to recent data, since the crisis routine immunization has been hampered in at least 68 lower-income countries where the availability of vaccines is limited. This will affect about 80 million children under the age of one (GAVI, 2020).

The first guidelines for immunization activities during the pandemic were published on 26th March 2020 by the WHO (WHO 2020c). According to the guideline principles, there is a risk of disruption to routine immunisation. Due to the burden of COVID-19 on the health system, there has been a reduction in demand for vaccinations due to physical distancing requirements or reluctance of families to visit health facilities are reasons. This increases the risk of children contracting other communicable diseases like measles (Unicef, 2020a). According to the WHO, over 117 million children in 37 countries are at risk of missing out on the life-saving measles vaccine. Measles immunization campaigns in 24 countries have already been delayed (Unicef, 2020b). In some countries, the spread of infectious diseases like measles has been stalled due to measures like school closures. However, this is not the case in settings where physical distancing is not possible due to factors like living arrangements and poor hygiene.

The present management of immunisation is complex. The United Nations Children’s Fund (UNICEF) and WHO have advised that routine child immunisation programs be continued to prevent future outbreaks and ensure healthcare systems are sustainable (Unicef, 2020c). However, mass preventive campaigns should be suspended if they put health providers, caregivers and the community at risk of infection. Additionally, alternative immunisation-delivery strategies may be adopted to prevent undue exposure to risk. If the current vaccine-delivery system is impacted, strategies for catchup vaccination must be designed in the COVID-19 response plan. Also, healthcare facilities must ensure patients are not at risk of infection by implementing schedules that ensure fewer children per day are vaccinated to accommodate physical distancing while increasing service availability (WHO, 2020c).

The COVID-19 pandemic highlights the importance of resolving practical, delivery concerns to reassure and also educate parents on the importance of vaccinating their children.

By Nkengfua Blaise

Contributor and member of the Public Health Pathways team

3 June 2020

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