The measures in place to help slow and control the COVID-19 pandemic, including lockdowns, social distancing, and mask wearing are triggering repercussions in other areas of public health. One of these is a steep decline in routine immunization. Recent surveys by the World Health Organization (WHO) showed an estimated 80 million children under the age of one are likely at risk of preventable childhood diseases due to delayed or halted routine immunization programs in nearly 70 countries worldwide.1
While health experts hope the dip is only temporary, its steepness is cause for concern. The WHO reported that countries in Africa, the Americas, and the eastern Mediterranean were showing around 75% less demand for vaccination services in May versus February 2020.2
The situation in South America is particularly worrisome for Dr. Lucia Bricks, Sanofi Pasteur’s medical director in that region and a former professor of pediatric medicine at São Paulo University. She explains: “I’m troubled by the public’s attention, which is focused on the one dramatic infectious outbreak of the moment, forgetting that the other diseases we’ve been fighting for decades are still there, lurking in the background. Past outbreaks such as pertussis and measles, both of which are preventable infections, have resurged and caused deaths within the last decade. We cannot become complacent about seeking necessary, life-protecting vaccines.”
"It's not because an infectious disease isn't visible today that it has effectively disappeared."
Dr Lucia Bricks, Medical Director based in Brazil
“Catch up” vaccinations for herd immunity
While a vaccine helps protect an individual from getting an infection, a high vaccine coverage rate, i.e. ensuring nearly everyone in a population has their recommended vaccines, provides “herd immunity”, which helps to stop diseases from spreading.
Dr. Bricks notes that the key to keeping diseases under control is retaining high vaccine coverage rates, which should hover around 90% of the population.
When there are large dips in routine vaccination coverage, as has been the case during the recent COVID-19 pandemic, health authorities often turn to “catch-up” vaccination schedules to help maintain herd immunity.
“Catch-up schedules are designed to help doctors and families know how and when to have vaccinations following unexpected delays or diversions from regularly scheduled vaccine routines,” Dr. Bricks explains.3 Catch up programs typically provide a condensed schedule using shorter intervals between doses or types of vaccines in order to safely and effectively bring a person up to date as quickly as possible, and decrease their risks of acquiring or spreading preventable infectious diseases.
Most governments and the WHO recommend that maintaining and/or catching up on routine vaccination remains an essential health service that should be prioritized and continued during the COVID-19 pandemic wherever possible.4,5
Catch up is catching on
There is good news: 75% of the countries in the WHO surveys reported that plans are in place to catch-up people who have missed vaccine doses. And 18% noted that vaccination levels had already started to improve by June versus levels documented in April; since not all countries had seen their highest peak of COVID-19 infections by June, this is likely a promising start. Finally, 85% of reporting countries indicated that they would help boost uptake of vaccination services using mass media and door-to-door community engagement.6
The upcoming change in seasons is a timely reminder for families to double check vaccination schedules and ensure children are up to date on routine vaccinations or can “catch up” as needed. Life may not be “back to normal” just yet, but the restart of routine immunizations can help better protect society for when it is.
1 https://www.who.int/news-room/detail/22-05-2020-at-least-80-million-children-under-one-at-risk-of-diseases-such-as-diphtheria-measles-and-polio-as-covid-19-disrupts-routine-vaccination-efforts-warn-gavi-who-and-unicef last accessed last accessed September 3, 2020
2 https://www.who.int/immunization/monitoring_surveillance/immunization-and-covid-19/en/ last accessed September 3, 2020
3 Australian Technical Advisory Group on Immunisation (ATAGI). Catch up Vaccination. The Australian immunisation handbook September 20, 2019 ed. Canberra: Australian Government Department of Health; 2018. Date of approval: May 2020 | MAT-GLB-2000243 Page7
4 World Health Organization. Guiding Principles for Immunization Activities During the COVID-19 Pandemic. Geneva, Switzerland: March 26, 2020. WHO/2019-nCoV/immunization_services/2020.1. Available at: https://www.who.int/publications-detail/guiding-principles-for-immunization-activities-during-the-covid-19-pandemic-interim-guidance . Accessed September 3, 2020.
5 Kaja Abbas et al, Routine childhood immunisation during the COVID-19 pandemic in Africa: a benefit–risk analysis of health benefits versus excess risk of SARS-CoV-2 infection. The Lancet Global Health Published:July 17, 2020 DOI:https://doi.org/10.1016/S2214-109X(20)30308-9
6 https://www.who.int/immunization/monitoring_surveillance/immunization-and-covid-19/en/ last accessed September 3, 2020