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Impact of the SARS-CoV-2 Pandemic on Routine Immunization Services: Evidence of Disruption and Recovery From 169 Countries and Territories

24 Pages Posted: 26 May 2021

See all articles by Anita Shet

Anita Shet

Johns Hopkins University - International Vaccine Access Center

Kelly Carr

Johns Hopkins University - International Vaccine Access Center

Carolina M. Danovaro-Holliday

World Health Organization

Samir V. Sodha

World Health Organization

Christine Prosperi

Johns Hopkins University - International Vaccine Access Center

Joshua Wunderlich

GAVI Alliance (Vaccine Alliance)

Chizoba Wonodi

Johns Hopkins University - International Vaccine Access Center

Heidi W. Reynolds

GAVI Alliance (Vaccine Alliance)

Imran Mizra

United Nations Children’s Fund (UNICEF)

Marta Gacic-Dobo

World Health Organization

Katherine O'Brien

World Health Organization; Johns Hopkins Bloomberg School of Public Health - Department of International Health, International Vaccine Access Center

Ann Lindstrand

World Health Organization

More...

Abstract

Background: The SARS-CoV-2 pandemic has revealed the vulnerability of immunization systems worldwide, although the scale of these disruptions has not been described at a global level.

Methods: This report synthesized data representing 169 countries and territories. Data sources included administered vaccine dose data from January-December 2019 and 2020, WHO Regional office reports, and the WHO-led pulse survey administered in April and June 2020. Results were expressed as frequencies and proportions of respondents or reporting countries. Vaccine doses administered data were weighted by the population of surviving infants per country.

Findings: A decline in the number of DTP3 and MCV1 doses administered in the first half of 2020 was noted. The nadir was observed in April 2020, when 35% fewer DTP3 doses were administered globally, ranging from 10% in Africa to 58% in South East Asia. Recovery of vaccinations began by June 2020 and continued into late 2020. WHO regional offices reported significant disruption to routine vaccination sessions in April 2020, related to interrupted vaccination demand, and supply, including reduced availability of the health workforce. Pulse survey analysis revealed that 69% of countries experienced disruption in outreach services compared to 44% countries with disrupted fixed-post immunization services.  

Interpretation: The marked magnitude and global scale of immunization disruption evokes the dangers of vaccine-preventable disease outbreaks in the future. Trends indicating partial resumption of services highlight the urgent need for ongoing assessment of recovery, catch-up vaccination strategy implementation for vulnerable populations, and ensuring vaccine coverage equity and health system resilience.

Funding: World Health Organization and U.S. Agency for International Development (USAID).

Conflict of Interest: We declare no competing interests.

Keywords: SARS-CoV-2 pandemic, routine immunization, disruption of essential services, vaccination, global

Suggested Citation

Shet, Anita and Carr, Kelly and Danovaro-Holliday, Carolina M. and Sodha, Samir V. and Prosperi, Christine and Wunderlich, Joshua and Wonodi, Chizoba and Reynolds, Heidi W. and Mizra, Imran and Gacic-Dobo, Marta and O'Brien, Katherine and Lindstrand, Ann, Impact of the SARS-CoV-2 Pandemic on Routine Immunization Services: Evidence of Disruption and Recovery From 169 Countries and Territories. Available at SSRN: https://ssrn.com/abstract=3850009 or http://dx.doi.org/10.2139/ssrn.3850009

Anita Shet (Contact Author)

Johns Hopkins University - International Vaccine Access Center ( email )

Baltimore, MD
United States

Kelly Carr

Johns Hopkins University - International Vaccine Access Center ( email )

Baltimore, MD
United States

Carolina M. Danovaro-Holliday

World Health Organization ( email )

20 Avenue Appia
Geneva 27, CH-1211
Switzerland

Samir V. Sodha

World Health Organization ( email )

20 Avenue Appia
Geneva 27, CH-1211
Switzerland

Christine Prosperi

Johns Hopkins University - International Vaccine Access Center ( email )

Baltimore, MD
United States

Joshua Wunderlich

GAVI Alliance (Vaccine Alliance) ( email )

Global Health Campus
Le Grand-Saconnex
Switzerland

Chizoba Wonodi

Johns Hopkins University - International Vaccine Access Center ( email )

Baltimore, MD
United States

Heidi W. Reynolds

GAVI Alliance (Vaccine Alliance) ( email )

Global Health Campus
Le Grand-Saconnex
Switzerland

Imran Mizra

United Nations Children’s Fund (UNICEF) ( email )

New York City, NY
United States

Marta Gacic-Dobo

World Health Organization ( email )

20 Avenue Appia
Geneva 27, CH-1211
Switzerland

Katherine O'Brien

World Health Organization

20 Avenue Appia
Geneva 27, CH-1211
Switzerland

Johns Hopkins Bloomberg School of Public Health - Department of International Health, International Vaccine Access Center ( email )

United States

Ann Lindstrand

World Health Organization ( email )

20 Avenue Appia
Geneva 27, CH-1211
Switzerland

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