Routine child immunizations in India during the COVID-19 pandemic

Area of Science:

• Public Health
• Epidemiology
• Global Health

Background:

• COVID-19 pandemic disrupted global health services, impacting essential child healthcare.
• India's immunization program, the world's largest, faced unprecedented challenges.
• Preventative health services, including routine vaccinations, were likely affected worldwide.

Purpose of the Study:

• To investigate the impact of the COVID-19 pandemic on routine childhood vaccinations in India.
• To quantify changes in vaccination rates during the pandemic compared to pre-pandemic levels.
• To identify factors associated with vaccination declines.

Main Methods:

• Utilized data from India's health management information system.
• Employed interrupted time series analyses to assess changes in vaccination.
• Examined district-level vaccination data to understand pandemic effects.

Main Results:

• Significant reductions in routine childhood vaccinations observed during the pandemic.
• Drastic declines, particularly in April 2020 during the national lockdown (e.g., 60% drop in polio doses).
• Vaccinations remained below pre-pandemic levels even after initial increases, with further declines during the 2021 COVID-19 second wave.

Conclusions:

• The COVID-19 pandemic severely impacted childhood immunizations in India.
• Districts with stricter lockdowns and lower health system capacity experienced greater vaccination declines.
• Urgent need for corrective actions, including catch-up vaccination programs, to mitigate long-term health consequences for unvaccinated children.