Impact of COVID-19 on routine immunisation in South-East Asia and Western Pacific: Disruptions and solutions

Rebecca C Harris; Yutao Chen; Pierre Côte; Antoine Ardillon; Maria Carmen Nievera; Anna Ong-Lim; Somasundaram Aiyamperumal; Chan Poh Chong; Kiruthika Velan Kandasamy; Kuharaj Mahenthiran; Ta-Wen Yu; Changshu Huang; Clotilde El Guerche-Séblain; Juan C Vargas-Zambrano; Ayman Chit; Gopinath Nageshwaran

doi:10.1016/j.lanwpc.2021.100140

Impact of COVID-19 on routine immunisation in South-East Asia and Western Pacific: Disruptions and solutions

Lancet Reg Health West Pac. 2021 May:10:100140. doi: 10.1016/j.lanwpc.2021.100140. Epub 2021 Apr 21.

Authors

Rebecca C Harris^{1

2}, Yutao Chen³, Pierre Côte⁴, Antoine Ardillon^{4

5}, Maria Carmen Nievera¹, Anna Ong-Lim⁶, Somasundaram Aiyamperumal⁷, Chan Poh Chong⁸, Kiruthika Velan Kandasamy⁹, Kuharaj Mahenthiran¹, Ta-Wen Yu¹, Changshu Huang¹⁰, Clotilde El Guerche-Séblain¹, Juan C Vargas-Zambrano⁴, Ayman Chit^{11

12}, Gopinath Nageshwaran¹

Affiliations

¹ Sanofi Pasteur, 38 Beach Road, #18-11 South Beach Tower, Singapore 189767, Singapore.
² London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
³ Sanofi Pasteur China, 7F HP Plaza, 112 Jianguo Rd, ChaoYang District, Beijing 100022, China.
⁴ Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France.
⁵ Current affiliation: Institute of Pharmaceutical and Biological Sciences, Claude Bernard Lyon University, 8 avenue Rockefeller, 69373 Lyon, France.
⁶ Division of Infectious and Tropical Disease, Department of Pediatrics, University of the Philippines - Philippine General Hospital, Manila 1000, Philippines.
⁷ Department of Developmental and Behavioural Pediatrics, D'Soul Child Development Centre and Kanchi Kamakoti Childs Trust Hospital, Chennai 600034, India.
⁸ Division of General Ambulatory Paediatrics and Adolescent Medicine, Department of Paediatrics, National University Children's Medical Institute, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Singapore 119228, Singapore.
⁹ Sanofi Pasteur, Rain Tree Place, Mc Nichols Road, Chetpet, Chennai 600031, India.
¹⁰ Sanofi Pasteur, New World International Trade, No.568, Jianshe Avenue, Jianghan District, Wuhan City 430000, China.
¹¹ Sanofi Pasteur, Discovery Drive Swiftwater, PA 18370, USA.
¹² Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada.

Abstract

Background: Data on COVID-19-induced disruption to routine vaccinations in the South-East Asia and Western Pacific regions (SEAR/WPR) have been sparse. This study aimed to quantify the impact of COVID-19 on routine vaccinations by country, antigen, and sector (public or private), up to 1 June 2020, and to identify the reasons for disruption and possible solutions.

Methods: Sanofi Pasteur teams from 19 countries in SEAR/WPR completed a structured questionnaire reporting on COVID-19 disruptions for 13-19 routinely delivered antigens per country, based on sales data, government reports, and regular physician interactions. Data were analysed descriptively, disruption causes ranked, and solutions evaluated using a modified public health best practices framework.

Findings: 95% (18/19) of countries reported vaccination disruption. When stratified by country, a median of 91% (interquartile range 77-94) of antigens were impacted. Infancy and school-entry age vaccinations were most impacted. Both public and private sector healthcare providers experienced disruptions. Vaccination rates had not recovered for 39% of impacted antigens by 1 June 2020. Fear of infection, movement/travel restrictions, and limited healthcare access were the highest-ranked reasons for disruption. Highest-scoring solutions were separating vaccination groups from unwell patients, non-traditional vaccination venues, virtual engagement, and social media campaigns. Many of these solutions were under-utilised.

Interpretation: COVID-19-induced disruption of routine vaccination was more widespread than previously reported. Adaptable solutions were identified which could be implemented in SEAR/WPR and elsewhere. Governments and private providers need to act urgently to improve coverage rates and plan for future waves of the pandemic, to avoid a resurgence of vaccine-preventable diseases.

Funding: Sanofi Pasteur.

Keywords: Asia; COVID-19; Disruption; Immunisation; Preventive care; Public health; Routine vaccination; Vaccination coverage rates; Vaccines.