Shet Anita, Carr Kelly, Danovaro-Holliday M Carolina, Sodha Samir V, Prosperi Christine, Wunderlich Joshua, Wonodi Chizoba, Reynolds Heidi W, Mirza Imran, Gacic-Dobo Marta, O'Brien Katherine L, Lindstrand Ann
International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Lancet Glob Health. 2022 Feb;10(2):e186-e194. doi: 10.1016/S2214-109X(21)00512-X. Epub 2021 Dec 21.
The SARS-CoV-2 pandemic has revealed the vulnerability of immunisation systems worldwide, although the scale of these disruptions has not been described at a global level. This study aims to assess the impact of COVID-19 on routine immunisation using triangulated data from global, country-based, and individual-reported sources obtained during the pandemic period.
This report synthesised data from 170 countries and territories. Data sources included administered vaccine-dose data from January to December, 2019, and January to December, 2020, WHO regional office reports, and a WHO-led pulse survey administered in April, 2020, and June, 2020. Results were expressed as frequencies and proportions of respondents or reporting countries. Data on vaccine doses administered were weighted by the population of surviving infants per country.
A decline in the number of administered doses of diphtheria-pertussis-tetanus-containing vaccine (DTP3) and first dose of measles-containing vaccine (MCV1) in the first half of 2020 was noted. The lowest number of vaccine doses administered was observed in April, 2020, when 33% fewer DTP3 doses were administered globally, ranging from 9% in the WHO African region to 57% in the South-East Asia region. Recovery of vaccinations began by June, 2020, and continued into late 2020. WHO regional offices reported substantial disruption to routine vaccination sessions in April, 2020, related to interrupted vaccination demand and supply, including reduced availability of the health workforce. Pulse survey analysis revealed that 45 (69%) of 65 countries showed disruption in outreach services compared with 27 (44%) of 62 countries with disrupted fixed-post immunisation services.
The marked magnitude and global scale of immunisation disruption evokes the dangers of vaccine-preventable disease outbreaks in the future. Trends indicating partial resumption of services highlight the urgent need for ongoing assessment of recovery, catch-up vaccination strategy implementation for vulnerable populations, and ensuring vaccine coverage equity and health system resilience.
US Agency for International Development.
尽管全球范围内这些免疫接种系统中断的规模尚未得到描述，但严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）大流行暴露了全球免疫接种系统的脆弱性。本研究旨在利用大流行期间从全球、国家层面和个人报告来源获取的三角测量数据，评估2019冠状病毒病（COVID-19）对常规免疫接种的影响。
本报告综合了170个国家和地区的数据。数据来源包括2019年1月至12月以及2020年1月至12月的疫苗接种剂量数据、世界卫生组织（WHO）区域办事处报告，以及WHO在2020年4月和2020年6月开展的一项脉冲调查。结果以受访者或报告国家的频率和比例表示。已接种疫苗剂量的数据按每个国家存活婴儿的人口进行加权。
2020年上半年，含白喉-百日咳-破伤风疫苗（DTP3）和首剂含麻疹疫苗（MCV1）的接种剂量有所下降。2020年4月观察到的疫苗接种剂量最低，当时全球DTP3接种剂量减少了33%，范围从WHO非洲区域的9%到东南亚区域的57%。疫苗接种工作于2020年6月开始恢复，并持续到2020年末。WHO区域办事处报告称，2020年4月常规疫苗接种工作受到严重干扰，这与疫苗接种需求和供应中断有关，包括卫生人力可用性降低。脉冲调查分析显示，65个国家中有45个（69%）的外展服务受到干扰，而62个固定接种点免疫服务受到干扰的国家中有27个（44%）。
免疫接种中断的显著程度和全球范围引发了未来疫苗可预防疾病爆发的危险。表明服务部分恢复的趋势凸显了持续评估恢复情况、为弱势群体实施补种疫苗策略以及确保疫苗接种覆盖率公平性和卫生系统恢复力的迫切需求。
美国国际开发署。
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