Dadari Ibrahim, Belt Rachel V, Iyengar Ananya, Ray Arindam, Hossain Iqbal, Ali Daniel, Danielsson Niklas, Sodha Samir V
Coverage & Equity Unit, Immunization Section, PG-Health, UNICEF Headquarters, 3 UN Plaza, New York, NY 10017, USA.
College of Public Health, University of South Florida, Tampa, FL 33612, USA.
Vaccines (Basel). 2023 Apr 6;11(4):809. doi: 10.3390/vaccines11040809.
The 2021 WHO and UNICEF Estimates of National Immunization Coverage (WUENIC) reported approximately 25 million under-vaccinated children in 2021, out of which 18 million were zero-dose children who did not receive even the first dose of a diphtheria-tetanus-pertussis-(DPT) containing vaccine. The number of zero-dose children increased by six million between 2019, the pre-pandemic year, and 2021. A total of 20 countries with the highest number of zero-dose children and home to over 75% of these children in 2021 were prioritized for this review. Several of these countries have substantial urbanization with accompanying challenges. This review paper summarizes routine immunization backsliding following the COVID-19 pandemic and predictors of coverage and identifies pro-equity strategies in urban and peri-urban settings through a systematic search of the published literature. Two databases, PubMed and Web of Science, were exhaustively searched using search terms and synonyms, resulting in 608 identified peer-reviewed papers. Based on the inclusion criteria, 15 papers were included in the final review. The inclusion criteria included papers published between March 2020 and January 2023 and references to urban settings and COVID-19 in the papers. Several studies clearly documented a backsliding of coverage in urban and peri-urban settings, with some predictors or challenges to optimum coverage as well as some pro-equity strategies deployed or recommended in these studies. This emphasizes the need to focus on context-specific routine immunization catch-up and recovery strategies to suit the peculiarities of urban areas to get countries back on track toward achieving the targets of the IA2030. While more evidence is needed around the impact of the pandemic in urban areas, utilizing tools and platforms created to support advancing the equity agenda is pivotal. We posit that a renewed focus on urban immunization is critical if we are to achieve the IA2030 targets.
2021年世界卫生组织和联合国儿童基金会发布的《全球国家免疫规划覆盖率评估报告》显示，2021年约有2500万儿童疫苗接种不足，其中1800万儿童一剂未种，即未接种过任何含白喉-破伤风-百日咳（DPT）疫苗的第一剂。与疫情前的2019年相比，一剂未种儿童数量增加了600万。2021年，20个一剂未种儿童数量最多、占此类儿童总数超75%的国家被列为本次综述的重点对象。其中一些国家城市化程度高，面临诸多挑战。本综述论文总结了新冠疫情后常规免疫接种工作的倒退情况以及覆盖率的预测因素，并通过系统检索已发表文献，确定了城市和城郊地区的公平促进策略。使用检索词及其同义词对PubMed和Web of Science这两个数据库进行了全面检索，共识别出608篇经同行评审的论文。根据纳入标准，最终综述纳入了15篇论文。纳入标准包括2020年3月至2023年1月期间发表的论文，以及论文中提及城市环境和新冠疫情的内容。多项研究明确记录了城市和城郊地区覆盖率的倒退情况，以及一些影响最佳覆盖率的预测因素或挑战，还有这些研究中采用或推荐的一些公平促进策略。这凸显了有必要关注因地制宜的常规免疫接种追赶和恢复策略，以适应城市地区的特点，使各国重回实现《2030年免疫议程》目标的正轨。虽然关于疫情对城市地区影响的更多证据仍有待获取，但利用为支持推进公平议程而创建的工具和平台至关重要。我们认为，若要实现《2030年免疫议程》目标，重新聚焦城市免疫接种至关重要。
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