新冠疫情对美洲地区的百白破三联疫苗（DTP3）接种有影响吗？

Has COVID-19 Affected DTP3 Vaccination in the Americas?

作者信息

Aguinaga-Ontoso Ines, Guillén-Aguinaga Sara, Guillén-Aguinaga Laura, Alas-Brun Rosa, Aguinaga-Ontoso Enrique, Rayón-Valpuesta Esperanza, Guillén-Grima Francisco

机构信息

Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain.

Healthcare Research Institute of Navarra (IdiSNA), 31008 Pamplona, Spain.

出版信息

Vaccines (Basel). 2024 Feb 25;12(3):238. doi: 10.3390/vaccines12030238.

DOI:10.3390/vaccines12030238

PMID:38543872

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10975091/

Abstract

BACKGROUND

In the Americas, deaths by diseases avoidable with vaccines are a significant contributor to child mortality. An essential means of reducing this is through broad vaccine coverage. The COVID-19 pandemic has posed a potential disruption to vaccine coverage due to its effects on the healthcare system.

OBJECTIVES

this study aims to evaluate the impact of the COVID-19 pandemic on DTP3 vaccination coverage in the Americas, investigating trends from 2012 to 2022 to identify significant changes, regional disparities, and the overall effect of the pandemic on progress towards global immunization targets.

METHODS

This study used the coverage data for the third dose of the diphtheria, tetanus, and pertussis vaccine (DTP3) pulled from UNICEF databases spanning 2012 to 2022. We conducted a Joinpoint regression to identify points of significant trend changes. The annual percentage change (APC) and 95% confidence intervals (95% CIs) were calculated for America and its regions. We also used segmented regression analysis. Using the Chi-square test, we compared DTP3 vaccination coverage for each country between 2019 and 2022.

RESULTS

Overall, America saw a decrease in vaccine coverage during this period, with an APC of -1.4 (95% CI -1.8; -1.0). This trend varied across regions. In North America, the decrease was negligible (-0.1% APC). South America showed the steepest decrease, with an APC of -2.5%. Central America also declined, with an APC of -1.3%. Our findings suggest a concerning trend of declining DTP-vaccination rates in the Americas, exacerbated in certain regions, in the wake of the COVID-19 pandemic. The absolute decrease in vaccine coverage in the Americas was -4% between 2019 and 2022, with the most important drop being in Central America (-7%). However, six countries reported increased vaccination rates post-COVID-19, led by Brazil, with a 7% increase. Conversely, twenty-two countries registered a decline in DTP3 vaccine coverage, with the average decrease being -7.37%. This decline poses an important challenge to achieving the WHO's target of 90% coverage for the third dose of DTP by 2030, as evidenced by the reduction in the number of countries meeting this target from 2019 to 2022.

CONCLUSIONS

The COVID-19 pandemic has impacted vaccine coverage in America, leading to a decrease, especially across Central America.

摘要

背景

在美洲，可通过疫苗预防的疾病导致的死亡是儿童死亡率的一个重要因素。减少这一情况的一个重要手段是实现广泛的疫苗接种覆盖。由于新冠疫情对医疗系统的影响，其可能会对疫苗接种覆盖造成干扰。

目的

本研究旨在评估新冠疫情对美洲白喉、破伤风和百日咳三联疫苗（DTP3）接种覆盖率的影响，研究2012年至2022年的趋势，以确定显著变化、地区差异以及疫情对实现全球免疫目标进展的总体影响。

方法

本研究使用了从联合国儿童基金会数据库中提取的2012年至2022年白喉、破伤风和百日咳三联疫苗第三剂（DTP3）的接种覆盖数据。我们进行了Joinpoint回归以确定显著趋势变化点。计算了美洲及其各地区的年度百分比变化（APC）和95%置信区间（95%CI）。我们还使用了分段回归分析。通过卡方检验，比较了2019年至2022年每个国家的DTP3疫苗接种覆盖率。

结果

总体而言，在此期间美洲的疫苗接种覆盖率有所下降，APC为-1.4（95%CI -1.8；-1.0）。这一趋势在各地区有所不同。在北美，下降幅度可忽略不计（APC为-0.1%）。南美洲下降最为明显，APC为-2.5%。中美洲也有所下降，APC为-1.3%。我们的研究结果表明，在新冠疫情之后，美洲的DTP疫苗接种率出现了令人担忧的下降趋势，在某些地区更为严重。2019年至2022年期间，美洲的疫苗接种覆盖率绝对下降了4%，其中下降最为严重的是中美洲（-7%）。然而，有六个国家报告称在新冠疫情后接种率有所上升，以巴西为首，上升了7%。相反，有二十二个国家的DTP3疫苗接种覆盖率出现下降，平均下降幅度为-7.37%。这一下降对实现世界卫生组织到2030年DTP第三剂接种覆盖率达到90%的目标构成了重大挑战，从2019年到2022年达到这一目标的国家数量减少就证明了这一点。