Vaccination is one way to protect infants and children from certain diseases. But the ongoing COVID-19 pandemic has crippled immunization programs worldwide. Recently, major organizations warned that at least 80 million children are at risk due to disrupted vaccination efforts. These children are at risk of disability or death from vaccine-preventable diseases.
The estimated number of affected children from disrupted vaccination efforts was unveiled by UNICEF, GAVI, the Sabin Vaccine Institute, and the World Health Organization (WHO), a specialized agency of the United Nations. Their joint warning stated that at least 80 million children are at risk of vaccine-preventable diseases, such as diphtheria, measles, and rubella. While the reasons for the disruptions varied among individual cases, all of them centered around COVID-19. Donors are expected to pledge their support on June 4, at the Global Vaccine Summit, to accelerate vaccination efforts worldwide.
Millions of Children Threatened by Disrupted Vaccine Programs
Despite the potential side effects of vaccines, these drugs remain the best method in gaining immunity from a preventable disease. One does not have to suffer from the illness just to become immune. This is because a vaccine can prevent patients from experiencing certain scenarios. First, the person no longer needs to endure pain and severe symptoms of the disease. Second, the person does not have to risk their health to immune amnesia, wherein the immune system forgets how to fight infections. And third, the person can avoid health complications like permanent disability or organ damage.
However, the ongoing pandemic makes it difficult to sustain vaccination programs in different parts of the world. Since COVID-19 is highly contagious, strict quarantine measures have been enforced in various cities and overridden medical fieldwork unassociated with the pandemic. As such, major health organizations are very concerned about the long-term impacts of disrupted vaccination programs. The disruption may let millions of children worldwide die from vaccine-preventable diseases or from coinfection.
"Immunization is one of the most powerful and fundamental disease prevention tools in the history of public health. Disruption to immunization programs from the COVID-19 pandemic threatens to unwind decades of progress against vaccine-preventable diseases like measles," said Dr. Tedros Adhanom Ghebreyesus, Director-General at the WHO.
In a joint effort between the WHO, UNICEF, GAVI, and the Sabin Institute, experts determined that immunization efforts in 68 countries have stalled. The impact of COVID-19 in these efforts threatens the lives of at least 80 million children under one year of age in those nations. Since March 2020, the pandemic effectively impaired the global vaccination programs, which were expanded in the 1970s. To make sense of it, the data showed that 53% of countries reporting to the WHO confirmed moderate to severe disruptions in the said programs. Some of these countries confirmed the complete suspension of the programs between March and April 2020.
Furthermore, the data showed the main causes of disruptions. Aside from manpower issues, certain communities were found to be reluctant to receive the vaccinations. The combination of movement restrictions, lack of knowledge of COVID-19, and fear of contracting the novel disease made parents reluctant to leave their homes and have their children vaccinated. The shortage of personal protective equipment also prevented the deployment of healthcare workers in communities to distribute vaccines. Most of these workers were reassigned to health facilities to help patients with COVID-19.
When it comes to supplies, UNICEF established the severed supply lines of vaccines. A significant delay in the supply of different vaccines for various territories was identified. Lockdown measures and limited flights cut the deliveries of vaccines. At the same time, freight costs surged due to the economic problems in the airline industry. So, an agreement between UNICEF and GAVI was signed to fund and cover the freight costs applied to vaccine deliveries.
Severely Affected Immunization Programs
In terms of the vaccine program types, several countries temporarily suspended mass vaccination programs with justifiable reasons. Immunization programs like for cholera, measles, meningitis, polio, tetanus, typhoid fever, and yellow fever have been suspended to maintain social distancing and reduce the risk of COVID-19 transmission. But the suspension severely affected specific programs in low-income territories.
In 27 countries, measles vaccine programs have been put on hold while in 38 countries, polio vaccine programs have been postponed until the situation improves. In the low-income countries supported by GAVI, about 24 million individuals are at risk of several vaccine-preventable diseases due to COVID-19. Though, some nations are persistent in pushing vaccine campaigns, in spite of the pandemic. One example is Uganda, which has continuously provided immunization services, along with other essential health services the country can offer.
According to the Universal Immunization Coverage report by the WHO, as of July 2019, 9 out of 10 children in the world reached the third dose of diphtheria, tetanus, and pertussis vaccine (DTP3) in 2018. That represented 86% of vaccinated children worldwide. Although the percentage was considered high, it still indicated as inefficient as 19.4 million children were not fully vaccinated in 2018. Moreover, the 86% rating in 2018 was similar to 2016.
For the coverage of DTP3 in 2018, 116 million children were estimated to be fully vaccinated from diphtheria, tetanus, and pertussis, while 5.9 million children were estimated to be partially vaccinated from those diseases. But 13.5 million children were not given the first dose of the vaccine, which placed them at the highest risk. In 2017, a total of 117 million children were fully vaccinated, 6.3 million were partially vaccinated, and 12.4 million were not vaccinated. The numbers in 2017 were better than in 2018.
In the preliminary survey included in the report, 10 countries accounted for 60% of children unprotected from the three diseases. Nigeria had the highest estimated number of unprotected children at 3 million. It was followed by India at 2.6 million, Pakistan at 1.4 million, Indonesia at 1 million, Ethiopia at 950,000, the Philippines at 750,000, the Democratic Republic of the Congo at 620,000, Brazil at 490,000, Angola at 480,000, and Vietnam at 390,000.
Immunization campaigns cannot be put on hold until the availability of the COVID-19 vaccine. The longer these campaigns are suspended, the greater the chances of infants and younger children becoming sick from certain diseases. The suspension may even increase their risk of coinfection of COVID-19 and a vaccine-preventable illness.