Vaccinating

VACCINE ACCESSIBILITY

The COVID-19 pandemic has threatened the ability of health care systems around the world to maintain childhood vaccinations. Due to the decreased uptake of routine childhood vaccines, outbreaks of Vaccine-Preventable Diseases have begun to appear in many countries.

 

The development of vaccines is said to be one of the greatest advancements in medical science (Roush, 2007). They harness the power of the immune system to protect the individual against different diseases or illnesses (Roush, 2007). According to one study completed in the US, after national vaccination recommendations were in place illnesses like diphtheria, measles, paralytic poliomyelitis, rubella, and smallpox decreased by more than 99% (Roush, 2007). In fact, smallpox has been eradicated worldwide (Roush, 2007). Many diseases that were once quite dangerous are now vaccine-preventable. This is why routine childhood vaccinations must continue even during the COVID-19 pandemic.

It is estimated that of 129 countries, almost 53% of them have experienced suspension or moderate/severe disturbance of vaccine services (World Health Organization, 2020). One study estimates that almost 9 million doses may have been missed in 2020 (Skolnik et al., 2021). One hospital in Saudi Arabia found that standard vaccines given at 2, 4, 6, 9, and 12-months of age declined by 72.9% (Alrabiaah et al., 2020). In England, vaccine coverage for measles, mumps, and rubella decreased by 20% during the first few weeks of lockdown (McDonald et al., 2020). Similarly, Singapore experienced a decrease in the level of measles vaccines administered, resulting in decreased immunity in the population (Zhong et al., 2021). Many studies within the United States are also showing decreased uptake of routine vaccines. In both Southern California and Michigan, there was a decrease in routine vaccines in all age groups, this effect was especially apparent for measles-containing vaccines (Ackerson et al., 2021; Bramer et al., 2020)

Unfortunately, the COVID-19 pandemic has threatened the ability of health care systems around the world to maintain childhood vaccinations. Many parents have canceled or postponed their child’s vaccination appointments due to the fear of contracting COVID-19 (Alrabiaah et al., 2020; Torner, 2020; Zhong et al., 2021). Many countries also implemented stay-at-home orders during the pandemic which also contributed to the decreased number of vaccinations (Alrabiaah et al., 2020; Coker et al., 2020; McDonald et al., 2020; Moraga-Llop et al., 2020; Skolnik et al., 2021).  

Due to the decreased uptake of routine childhood vaccines, outbreaks of Vaccine-Preventable Diseases have begun to appear in many countries. This has been the case most especially for measles. To prevent an outbreak of measles, there needs to be 95% herd immunity. If this number decreases, as it has in many countries, the possibility for an outbreak is present (Alrabiaah et al., 2020; Zhong et al., 2021). Almost 18 countries have reported an outbreak of measles due to the suspension of life-saving measles vaccination campaigns. There have been outbreaks in Afghanistan, Brazil, Cambodia, the Central African Republic, Iraq, Kazakhstan, Nepal, Nigeria, and Uzbekistan (Dinleyici et al., 2020). There have also been outbreaks of Diphtheria in Venezuela, Pakistan, Nepal, Bangladesh, and Yemen (Dinleyici et al., 2020). While some missed vaccines can be given at a later time, other vaccines need to be given within a certain time period. The Rotavirus vaccine for example cannot be administered after 8 months of age. Children who missed this vaccine are now permanently at a higher risk of gastroenteritis (Alrabiaah et al., 2020). Evidently, a consequence of decreased vaccine uptake during the pandemic is the increased risk of outbreaks of vaccine-preventable diseases. This is especially burdensome for an already taxed health system (Alrabiaah et al., 2020). 

Given the danger that outbreaks of vaccine-preventable diseases pose to a population, the priority should be to restore vaccination rates. Children who have missed or postponed vaccines should be contacted and encouraged to catch up with any required vaccines. This can be done using patient records or databases (Ackerson et al., 2021; Alrabiaah et al., 2020; Bramer et al., 2020; Chiappini et al., 2021; MacDonald et al., 2020; Saxena et al., 2020). The importance of receiving routine vaccines should also be communicated to the public. This can be accomplished via advertising or social media (Moraga-Llop et al., 2020).


Many parents postponed or canceled vaccine appointments due to safety concerns and the risk of contracting COVID-19. It should be communicated to parents that vaccines can be administered safely with minimal risk (Bramer et al., 2020; Zhong et al., 2021)

 Measures should be put in place to ensure that the vaccination of children can occur safely in clinics. These measures should include, enough space in waiting rooms to ensure social distancing, avoid crowding by booking appointments ahead of time, and having only one parent per child attend the visit (Bramer et al., 2020; Dinleyici et al., 2020; Moraga-Llop et al., 2020). Clinics should also ensure they have proper ventilation systems, easy access to hand hygiene facilities and masks must be worn (Dinleyici et al., 2020). Where possible parents should combine wellness checks with vaccine appointments to minimize the number of visits to the clinic (Dinleyici et al., 2020; Moraga-Llop et al., 2020). Vaccination should also be made more accessible, perhaps by using mobile clinics or drive-through vaccinations (Skolnik et al., 2021; Zhong et al., 2021). 

 

HOW YOU CAN HELP

On an individual level, parents should ensure their children are up to date with vaccines as soon as they are able to access the service. It is also important to spread awareness of the importance of receiving routine vaccines, to avoid outbreaks of vaccine-preventable diseases. There are also many organizations, like World Vision (https://donate.worldvision.ca/products/vaccines) and Unicef (https://help.unicef.org/donate-today-give-children-vaccines-and-future?language=en), that take monetary donations and use the funds to provide live-saving vaccines.