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Delay in childhood vaccinations during the COVID-19 pandemic
Da In Diane Lee1,2, Shelley Vanderhout1,3, Mary Aglipay1,2
1Department of Paediatrics, St. Michael's Hospital, 61 Queen Street East, 2nd Floor, Toronto, ON, M5C 2T2, Canada.
Insights
Routine childhood vaccinations significantly decreased during the COVID-19 pandemic in Ontario, Canada. This delay in essential immunizations raises concerns about potential increases in vaccine-preventable diseases.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic led to widespread reductions in routine medical care.
- Assessing the impact on essential childhood immunizations is crucial for public health surveillance.
Purpose of the Study:
- To evaluate the frequency of on-time routine childhood vaccinations for children aged 0-2 years in Ontario, Canada.
- To compare vaccination rates before and after the COVID-19 declaration of emergency on March 17, 2020.
Main Methods:
- A longitudinal cohort study of 1277 children aged 0-2 years in Toronto, Canada.
- Logistic mixed effects regression and Cox proportional hazards models were used to analyze vaccination timing.
- Vaccination status was compared before and after the COVID-19 declaration of emergency.
Main Results:
- The proportion of on-time vaccinations dropped from 81.8% before the pandemic to 62.1% after (p < 0.001).
- The odds of delayed vaccination increased by 3.77 times (95% CI: 2.86-4.96).
- Median vaccination delay increased from 5 days to 17 days.
Conclusions:
- Routine childhood vaccination rates were significantly lower during the initial phase of the COVID-19 pandemic.
- Prolonged delays in childhood immunizations may increase the risk of vaccine-preventable diseases.
Objectives:
In many jurisdictions, routine medical care was reduced in response to the COVID-19 pandemic. The objective of this study was to determine whether the frequency of on-time routine childhood vaccinations among children age 0-2 years was lower following the COVID-19 declaration of emergency in Ontario, Canada, on March 17, 2020, compared to prior to the pandemic.
Methods:
We conducted a longitudinal cohort study of healthy children aged 0-2 years participating in the TARGet Kids! primary care research network in Toronto, Canada. A logistic mixed effects regression model was used to determine odds ratios (ORs) for delayed vaccination (> 30 days vs. ≤ 30 days from the recommended date) before and after the COVID-19 declaration of emergency, adjusted for confounding variables. A Cox proportional hazards model was used to explore the relationship between the declaration of emergency and time to vaccination.
Results:
Among 1277 children, the proportion of on-time vaccinations was 81.8% prior to the COVID-19 declaration of emergency and 62.1% after (p < 0.001). The odds of delayed vaccination increased (odds ratio = 3.77, 95% CI: 2.86-4.96), and the hazard of administration of recommended vaccinations decreased after the declaration of emergency (hazard ratio = 0.75, 95% CI: 0.60-0.92). The median vaccination delay time was 5 days (95% CI: 4-5 days) prior to the declaration of emergency and 17 days (95% CI: 12-22 days) after.
Conclusion:
The frequency of on-time routine childhood vaccinations was lower during the first wave of the COVID-19 pandemic. Sustained delays in routine vaccinations may lead to an increase in rates of vaccine-preventable diseases.
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