Achieving the IA2030 Coverage and Equity Goals through a Renewed Focus on Urban Immunization

Area of Science:

• Global Health
• Immunization Programs
• Public Health Policy

Background:

• The COVID-19 pandemic caused a significant increase in under-vaccinated children, with 18 million receiving no diphtheria-tetanus-pertussis (DTP) vaccine doses in 2021.
• This rise in zero-dose children, an increase of six million since 2019, disproportionately affects 20 countries with substantial urbanization.
• Urban and peri-urban settings present unique challenges to maintaining and recovering routine immunization coverage.

Purpose of the Study:

• To review routine immunization backsliding post-COVID-19 pandemic in urban and peri-urban areas.
• To identify predictors of immunization coverage and pro-equity strategies in these settings.
• To inform context-specific recovery strategies for achieving the Immunization Agenda 2030 (IA2030) targets.

Main Methods:

• Systematic literature search of PubMed and Web of Science databases for papers published between March 2020 and January 2023.
• Inclusion criteria focused on routine immunization, urban/peri-urban settings, and the impact of COVID-19.
• Analysis of 15 selected peer-reviewed papers to synthesize findings on coverage trends, challenges, and strategies.

Main Results:

• Multiple studies confirm a decline in routine immunization coverage in urban and peri-urban areas following the pandemic.
• Key challenges and predictors impacting coverage in these settings were identified.
• Various pro-equity strategies, both implemented and recommended, were documented in the reviewed literature.

Conclusions:

• A significant backsliding in routine immunization occurred in urban and peri-urban settings due to the COVID-19 pandemic.
• Context-specific strategies are essential to address the unique challenges of urban immunization and drive recovery.
• Renewed focus on urban immunization is critical for achieving global vaccination goals, such as the IA2030 targets.