Routine immunizations fell to 2005 levels in 2020 due to COVID: Gates Foundation report
Globally, children missed out on crucial routine immunization due to the pandemic, which greatly reduced access to healthcare. Now, these children face the risk of getting infected with diseases that are preventable.
- In 2020, more than 30 million children worldwide missed their routine vaccination.
- India had highest number of unvaccinated children worldwide at 3.5 million.
- Many of these children may never catch up on lost doses.
- Some vaccines can be given at a later date but some become ineffective after a certain age.
- Need to ramp up healthcare workforce to increase the pace of immunizations.
- Lifting COVID restrictions without bridging vaccination gap may lead to future disease outbreaks.
Global routine childhood vaccination rates in 2020 fell to 2005 levels, the 2021 Goalkeepers report has found. According to the report, which is an initiative of the Gates Foundation, between the start of the pandemic and when health services began to recover in the second half of 2020, more than 30 million children around the world missed their vaccinations — 10 million more because of the pandemic. And, possibly, many of these children will never catch up on doses.
The Institute for Health Metrics and Evaluation had estimated that the global vaccine coverage would drop 14 percentage points in 2020. However, recent data suggests that the actual drop in vaccine coverage was only half of that.
Earlier this year, UNICEF AND WHO data showed that the COVID-19 pandemic led to major reductions in childhood vaccinations in South Asia, with coverage of basic vaccination dropping by 6 percentage points from 2019 to 2020. India, which was hit hard by the COVID-19 pandemic, had the highest number of unprotected children worldwide at 3.5 million, an increase of 1.4 million from 2019.
What happens when a child misses out on some vaccinations? Can she get them later? News9 spoke to experts to find out the answer.
Certain vaccinations are not age bound, said Mumbai-based paediatrician Dr Manisha Mukhija. “Children who have missed the doses can take them at any age. This is true for most vaccines. The challenge is that certain vaccines are not useful or have very limited use beyond a certain age,” she said.
For example, the Rotavirus vaccine. “Although Rota viral diarrhoea can happen at any age, it is known to be severe or causing a disease that might need admission or sometimes may even cause death, only at a very young age. We do not administer the vaccine to babies above six months and if missed this cannot be taken later,” Dr Mukhija said.
However, all is not lost. Most of the diseases these vaccines are used for are communicable diseases. “What this means is that if you are living in isolation, eating home-cooked food, and drinking purified water, then the chances of you getting these diseases at the time are low. The incidence of [children contracting communicable diseases] has been low during the lockdown,” added Dr Mukhija.
However, the child must be given all routine immunization vaccines if they are given later than mandates. “Don’t delay it any further and complete the missed doses as soon as possible.”
The healthcare workers who vaccinate children are the same healthcare workers who are involved in contact tracing, COVID-19 testing and are now engaged in COVID-19 vaccinations, said Dr Giridhar Babu, professor and head of life-course epidemiology at the Public Health Foundation of India.
“There have to be more numbers of health workers in the field like ANMs or a greater number of volunteers who help in social mobilization in the form of ASHAs. Having additional ANMs for each sub-center, having additional workforce is one of the prerequisites because of the growing burden of non-communicable diseases and zoonotic (which spread from animals to humans) diseases,” he said.
“At least 85 per cent of all the future outbreaks will be related to some form of zoonotic disease. We need to build resilient systems to fight that and that comes from the strength of the workforce. Strength both in number and in the capacity building of the trained workforce. This is the time when investments in health have to go up and most of it has to be from the state level because health is a state subject,” he added.
However, Babu said he has full faith in the immunization programmes in India. “The immunization systems are so strong in India, even if there is a decrease in vaccination coverage over one year, the Mission Indradhanush which catches all left out children and vaccinates them is robust. Once the left-out children are identified, then they can be reached through Mission Indradhanush and other supplementary immunization programmes,” he said.
A special round of Mission Indradhanush in February and March 2021 was held to vaccinate the missed children under which 9.6 lakh children and 2.2 lakh pregnant women were vaccinated. To ensure that the COVID-19 vaccine drive does not impact Routine Immunization (RI), the Ministry of Health and Family Welfare guidelines categorically defined that ‘No COVID-19 vaccination will be done on RI days’.
Mukhija cautioned that lifting COVID restrictions without bridging the gap created by lack of vaccinations may lead to sudden increases in vaccine-preventable diseases and put us back epidemiologically by a few decades as well.
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