Silva Larissa A N, Costa Francine S, Cata-Preta Bianca O, Huicho Luis, Lanata Claudio F, Araujo Maria Ana Mendoza, Ochoa Theresa J, Mengistu Tewodaj, Hogan Dan, Barros Aluisio J D, Victora Cesar G
International Center for Equity in Health and Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° Piso, Bairro Centro - Pelotas, RS, Caixa Postal 464, Pelotas, 96020-220, Brazil.
Public Health Department, Federal University of Parana, Curitiba, Brazil.
Int J Equity Health. 2025 May 15;24(1):138. doi: 10.1186/s12939-025-02505-3.
We examined the impact of COVID-19 on childhood immunization coverage and inequalities in Peru, focusing on pentavalent, rotavirus, and pneumococcal (PCV) vaccines. Since the 1990s, Peru has worked to improve childhood vaccine coverage, but the COVID-19 pandemic posed significant challenges to the health system.
We analysed data from nationally representative health surveys conducted annually between 2015 and 2023. The surveys measured vaccine coverage among children aged 18-29 months, namely three doses for pentavalent and PCV and two doses for the rotavirus vaccine, based on data from home-based records. We studied inequalities at the individual child level using the slope index of inequality (SII) based on household wealth quintiles.
In 2019, the home-based record coverage levels for pentavalent, PCV and rotavirus vaccines were 78.0%, 74.5%, and 75.9%, respectively. In 2020, these rates dropped significantly due to pandemic disruptions: PCV and pentavalent coverage fell by 14% points, and rotavirus by 12 points. By 2021, coverage levels improved, returning to pre-pandemic rates by 2022 and 2023. Individual-level analyses showed that pro-rich inequalities were present during the full study period, but these increased sharply during the pandemic in 2020, with poorer children experiencing more significant drops in coverage than wealthier children. This trend reversed by 2021 and 2022 when inequality measures returned to pre-pandemic levels. Due to reasons that are still unclear, inequality increased again in 2023. Nevertheless, the confidence intervals for the summary inequality measures are wide and must be interpreted cautiously.
The COVID-19 pandemic temporarily disrupted Peru's childhood immunization efforts, particularly affecting poorer populations, but coverage rebounded to pre-pandemic levels by 2022. These findings contribute to the scant literature on the pandemic's impact on vaccine equity.
我们研究了新冠疫情对秘鲁儿童免疫接种覆盖率及不平等情况的影响，重点关注五价疫苗、轮状病毒疫苗和肺炎球菌（PCV）疫苗。自20世纪90年代以来，秘鲁一直致力于提高儿童疫苗接种覆盖率，但新冠疫情给卫生系统带来了重大挑战。
我们分析了2015年至2023年期间每年进行的具有全国代表性的健康调查数据。这些调查根据家庭记录数据，测量了18至29个月大儿童的疫苗接种覆盖率，即五价疫苗和PCV疫苗接种三剂，轮状病毒疫苗接种两剂。我们使用基于家庭财富五分位数的不平等斜率指数（SII），研究了个体儿童层面的不平等情况。
2019年，五价疫苗、PCV疫苗和轮状病毒疫苗的家庭记录接种覆盖率分别为78.0%、74.5%和75.9%。2020年，由于疫情干扰，这些比率大幅下降：PCV疫苗和五价疫苗接种覆盖率下降了14个百分点，轮状病毒疫苗接种覆盖率下降了12个百分点。到2021年，接种覆盖率有所提高，到2022年和2023年恢复到疫情前水平。个体层面分析表明，在整个研究期间都存在有利于富裕人群的不平等现象，但在2020年疫情期间这种不平等现象急剧增加，贫困儿童的接种覆盖率下降幅度比富裕儿童更大。到2021年和2022年，不平等指标恢复到疫情前水平，这种趋势发生了逆转。由于尚不清楚的原因，2023年不平等现象再次增加。然而，总体不平等指标的置信区间较宽，必须谨慎解读。
新冠疫情暂时扰乱了秘鲁的儿童免疫接种工作，尤其影响了贫困人群，但到2022年接种覆盖率回升至疫情前水平。这些发现为关于疫情对疫苗公平性影响的稀少文献提供了补充。
