The Impact of COVID-19 Restrictions on Childhood Vaccination Uptake: A Rapid Review

Abstract

Abstract: Background Vaccines are highly effective for preventing a range of childhood infections. However, there have been concerns about an alarming decline in vaccinations in 2020 due to the COVID-19 pandemic. Methods We performed a rapid review for studies that assessed childhood vaccination uptake during restrictive phases of the covid-19 pandemic. Results We found 35 published studies that compared changes in the pattern of childhood vaccinations before and during the pandemic. Thirteen were surveys; two mixed-methods surveys and interviews, three modelling studies and 17 retrospective cohort studies with historical controls. We also included ten reports by national or international agencies that had original data on vaccination uptake. Significant global disruptions to vaccine services were reported in Africa, Asia, America (including Latin America and the Caribbean) and Europe. We also found evidence of significant disruption to vaccine uptake for diphtheria tetanus pertussis, BCG, measles and polio. Countries, where vaccination rates were already suboptimal, had greater drops in uptake and there was evidence of smaller declines in younger children compared to older children. Children born to women who could not read and write were more likely to have an incompletely immunized child. Various initiatives were used to drive up vaccination rates post restrictions. Conclusions Obstacles to the delivery of vaccination services during the COVID-19 pandemic drove down immunisation rates, especially in disadvantaged people and poorer countries.