Imamura Tadatsugu, Mochida Keiji, Olukunmi Balogun, Tchicondingosse Lino, Sapalalo Pedro, Francisco Ketha Rubuz, Aoki Ai, Ishiguro Akira, Takehara Kenji
Center for Postgraduate Training and Education, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 〒157-8535, Japan.
Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
Trop Med Health. 2025 Jan 14;53(1):5. doi: 10.1186/s41182-024-00668-3.
The impact of public health measures against the coronavirus disease 2019 on the rate of childhood immunization has not yet been fully defined. Particularly, measures which directly affect health-seeking behaviors (e.g., the State of Emergency; SoE) drew public health attention. We aim to describe this impact in Benguela Province, Angola, by comparing the immunization rates between infants who had their immunizations before and after the SoE, which was declared on March 27, 2020.
We retrospectively reviewed the epidemiological data of infants born between November 2019 and February 2020 in Benguela Province, Angola. Immunization rates (i.e., the number of immunized infants divided by the number of infants in the group of same months of birth and residential areas) were calculated for 11 vaccines that infants received from at birth to the 4th month after birth. The rates for the 2nd month vaccines were compared between infants immunized before the SoE (post-SoE), and after the SoE (pre-SoE).
Among 9,595 infants, the overall immunization rates were higher in the post-SoE (71.9-77.8%) than in the pre-SoE groups (66.0-73.8%). The overall immunization rates were higher in the post-SoE group than in the pre-SoE group in both urban and rural municipalities, although the rates were > 20% higher in urban than in rural municipalities. The immunization rates in the recommended month showed a similar trend, except for the stratified analysis for rural municipalities, where the rates were 2.3-4.1% lower in the post-SoE than in the pre-SoE groups. The most common reason for missing immunization was vaccine unavailability at health units (19.9%, 684/3,440). Less than 10% of missed immunizations were due to the SoE, which occurred mostly in infants born in rural municipalities in February 2020 (9.8%, 52/532). Less than 2% of missed immunizations were due to health units not being open, and was highest in rural municipalities in January 2020 (1.6%, 27/1,673).
Our study suggested that the disruptive impacts of public health measures against pandemics on rates of childhood immunization can be mitigated, and support is needed for areas with vulnerable health systems, such as rural areas.
2019年冠状病毒病公共卫生措施对儿童免疫接种率的影响尚未完全明确。特别是，直接影响就医行为的措施（如紧急状态）引起了公共卫生领域的关注。我们旨在通过比较2020年3月27日宣布紧急状态前后婴儿的免疫接种率，来描述安哥拉本格拉省的这种影响。
我们回顾性分析了2019年11月至2020年2月在安哥拉本格拉省出生的婴儿的流行病学数据。计算了婴儿从出生到出生后第4个月接种的11种疫苗的免疫接种率（即接种疫苗的婴儿数量除以同月份出生且居住在同一地区的婴儿数量）。比较了紧急状态宣布前（紧急状态后）和宣布后（紧急状态前）接种第2个月疫苗的婴儿的接种率。
在9595名婴儿中，紧急状态后的总体免疫接种率（71.9 - 77.8%）高于紧急状态前的组（66.0 - 73.8%）。在城市和农村市镇，紧急状态后组的总体免疫接种率均高于紧急状态前组，不过城市的接种率比农村市镇高20%以上。除了对农村市镇的分层分析外，推荐月份的免疫接种率呈现类似趋势，在农村市镇中，紧急状态后的接种率比紧急状态前的组低2.3 - 4.1%。错过免疫接种的最常见原因是卫生单位没有疫苗（19.9%，684/3440）。不到10%的错过免疫接种是由于紧急状态，主要发生在2020年2月出生在农村市镇的婴儿中（9.8%，52/532）。不到2%的错过免疫接种是由于卫生单位未营业，2020年1月在农村市镇最高（1.6%，27/1673）。
我们的研究表明，针对大流行的公共卫生措施对儿童免疫接种率的干扰影响可以得到缓解，对于农村等卫生系统脆弱的地区需要提供支持。
