Essoh Tene-Alima, Adeyanju Gbadebo Collins, Adamu Abdu A, Ahawo Alain Komi, Aka Desquith, Tall Haoua, Aplogan Aristide, Wiysonge Charles S
Regional Directorate, Agence de Médecine Préventive (AMP) Afrique, Abidjan 08 BP 660, Côte d'Ivoire.
Psychology and Infectious Disease Lab (PIDI), University of Erfurt, 99089 Erfurt, Germany.
Vaccines (Basel). 2022 Jul 11;10(7):1107. doi: 10.3390/vaccines10071107.
By 11 March 2022, there were 450,229,635 coronavirus disease (COVID-19) cases and 6,019,085 deaths globally, with Nigeria reporting 254,637 cases and 3142 deaths. One of the essential healthcare services that have been impacted by the pandemic is routine childhood immunization. According to the 2018 National Demographic and Health Survey, only 31% of children aged 12-23 months were fully vaccinated in Nigeria, and 19% of eligible children in the country had not received any vaccination. A further decline in coverage due to the pandemic can significantly increase the risk of vaccine-preventable-disease outbreaks among children in Nigeria. To mitigate such an occurrence, it is imperative to urgently identify how the pandemic and the response strategies have affected vaccination services, hence, the goal of the study.
The research method was qualitative, including in-depth interviews of healthcare workers and focus group discussions (FGDs) with caregivers of children aged 0-23 months. We selected one state from each of the three zones of Nigeria: northern, central, and southern. Within each state, 10 local government areas and 20 healthcare facilities were purposively selected. In each facility, 10 healthcare workers were invited for interviews. Overall, 517 healthcare workers were interviewed. For the focus group discussion, 30 communities were selected. Within each selected community, six consenting caregivers were included. Overall, 180 caregivers participated. The data were analyzed using thematic inductive content analysis.
Three significant impacts that were observed are: difficulties in accessibility to immunization services, declining immunization demand and uptake among caregivers due to varying factors, and erosion of vaccine confidence among both caregivers and healthcare workers. Movement restriction and lockdown had numerous major impacts, such as decreased general healthcare service delivery, increased transportation costs, fewer engagements that promote vaccine uptake, and cessation of mobile vaccination campaigns that target hard-to-reach communities. Moreover, misinformation, conspiracy beliefs about the pandemic and COVID-19 vaccines, and risk perception negatively influenced general vaccine confidence.
The results of this early impact study show that immunization was directly affected by the pandemic and provide insights into areas where interventions are needed for recovery.
截至2022年3月11日，全球新冠病毒病（COVID-19）病例达450,229,635例，死亡6,019,085例，尼日利亚报告了254,637例病例和3,142例死亡。受疫情影响的基本医疗服务之一是儿童常规免疫接种。根据2018年全国人口与健康调查，在尼日利亚，12至23个月大的儿童中只有31% 完全接种了疫苗，该国19% 符合条件的儿童未接种任何疫苗。疫情导致的覆盖率进一步下降会显著增加尼日利亚儿童中疫苗可预防疾病爆发的风险。为减轻此类情况的发生，迫切需要确定疫情及应对策略如何影响疫苗接种服务，因此，这就是本研究的目标。
研究方法为定性研究，包括对医护人员进行深入访谈以及与0至23个月大儿童的看护人进行焦点小组讨论（FGD）。我们从尼日利亚的三个地区各选了一个州：北部、中部和南部。在每个州内，有目的地选择了10个地方政府辖区和20个医疗机构。在每个机构中，邀请10名医护人员接受访谈。总共访谈了517名医护人员。对于焦点小组讨论，选择了30个社区。在每个选定的社区中，纳入了六名同意参与的看护人。总共180名看护人参与。使用主题归纳性内容分析法对数据进行了分析。
观察到的三个重大影响是：免疫接种服务获取困难、由于各种因素看护人对免疫接种的需求和接种率下降，以及看护人和医护人员对疫苗的信心受到侵蚀。行动限制和封锁产生了许多重大影响，如一般医疗服务提供减少、交通成本增加、促进疫苗接种的活动减少，以及针对难以到达社区的流动疫苗接种活动停止。此外，错误信息、关于疫情和新冠疫苗的阴谋论以及风险认知对总体疫苗信心产生了负面影响。
这项早期影响研究的结果表明，免疫接种受到了疫情的直接影响，并为恢复所需干预措施的领域提供了见解。
