With Covid-19 vaccinations in full swing in many parts of the world, childhood inoculation should not be put on the back burner.
The warning is based on findings by public health researchers who worry that a drop in vaccination during the pandemic could give rise to preventable childhood infections and deaths.
According to the University of Washington study, the decline in the measles (MCV1) and diphtheria-tetanus-pertussis (DTP3) vaccines — which protect against deadly infectious diseases in childhood — could increase disease outbreaks once Covid-19 prevention measures subside. Vaccine mop-up campaigns should be intensified, the experts urged.
The study, which appears in the Lancet, shows that in 2020 the global coverage of DTP3 fell by about 8% to 76%, a level that has not been seen in 13 years. On the other hand the measles vaccines dropped by 7.7% to 79%, a level not seen in 15 years.
While these disruptions in vaccinations were severe in the earlier months of the pandemic, and countries have since started mopping up in the second half of 2020, experts said such efforts were far from completion, with about 17 million children still missing doses of those two vaccines.
“Covid-19 remains a formidable threat in 2021, with new variants emerging and transmission continuing even as countries are rapidly rolling out Covid-19 vaccines. In the absence of concerted routine immunisation catch-up and expansion efforts, especially as populations return to pre-pandemic interactions, the world will face heightened risks of vaccine-preventable diseases in 2021 and beyond,” researchers warned.
“As evidenced by past epidemics and modelling exercises, substantive gaps in vaccine coverage increase the risk of vaccine-preventable disease outbreaks once Covid-19 prevention measures subside and individuals resume pre-pandemic social contact patterns,” lead researcher Kate Causey and her colleagues argued.
“Recovery efforts should not only accelerate and monitor catch-up vaccination initiatives but also expand services to children historically missed or underserved by routine immunisation programmes, so that pre-existing gaps in vaccine coverage do not become more entrenched.”
But local health experts said while SA was not out of the woods yet, the slight drop in vaccine coverage was manageable.
“We have been keeping a close eye on this issue during the pandemic. A drop was noted during March and April 2020, but various strategies were devised to increase awareness and demand to ensure ongoing vaccination. Through these interventions, we managed to sufficiently close the gaps,” said Sonia Botha, coordinator of the Western Cape expanded programme on immunisations.
Botha said the province only experienced a 2% drop in vaccine coverage from 85% in 2019 to 83% in 2020, and this was largely a result of the hard lockdown that saw certain clinics closing and patients’ fear of being infected with Covid-19.
Health department spokesperson Popo Maja said the country’s mop-up campaign had already paid off, with statistics showing an improvement of 3% for children under the age of one. Both measles and DTP3 vaccine coverage measure above 80% coverage.
Maja said apart from temporary clinic closures during the lockdown, some health facilities “prioritised Covid-19 screening over other health services, including child immunisation”. He described the possible re-emergence of preventable childhood infections as a concern. “However, there is slight improvement on coverage in 2021 as compared to 2020 due to a number of interventions to address immunisation backlogs.”
Prof Mark Cotton, head of paediatrics and the infectious disease unit at Stellenbosch University and Tygerberg Hospital, expressed concern at SA’s vaccination rate of less than 90%, which he said made the country vulnerable to disease outbreaks.
“For measles prevention, coverage should be above 90%. Anything less is ineffective, but 70% is better than 50%.”
He said the provincial health departments should strive for this figure too for all other vaccines and mass communication campaigns would help achieve that.
“For example, there are isolated cases of diphtheria occurring. One can consider linking standard vaccinations to Covid-19 vaccination and adding the influenza vaccine to the Covid-19 vaccines.”
Prof Heather Zar, head of paediatrics at Red Cross Children’s Hospital, said while immunisation gaps in SA had been negligible, a lack of immunisation “places children at increased risk for vaccine preventable diseases such as measles, pneumonia or whooping cough and associated mortality, so it’s imperative to catch up on missed vaccinations”.
“Infants are the most susceptible to developing severe infections from these vaccine-preventable illnesses. Also specific groups of older children have an increased risk of severe disease such as children with malnutrition or those with HIV and who are immunocompromised.”
Would you like to comment on this article?
Sign up (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.