The Importance of Maintaining Routine Immunizations during the COVID-19 Pandemic

The COVID-19 vaccine rollout is an opportunity to remind the community about the importance of routine immunizations. During the pandemic, many healthcare services including routine immunizations were disrupted by lockdowns, as many governments mandated stay at home orders. Even a temporary interruption of basic healthcare delivery such as routine immunization services can have severe consequences for a community. This is especially true for those with underlying health conditions who are at a greater risk of developing severe illness from COVID-19.

As a health worker, it is important to continue to advise caregivers to get their children vaccinated, as you would normally do. Continuing immunization services is essential for protecting community members and their loved ones from vaccine-preventable diseases and outbreaks. The immunizations required for children may be unique to your country or region.

Diseases such as influenza, measles, meningitis, whooping cough, and pneumonia are all vaccine preventable diseases. If caught, it can cause respiratory damage and weaken the immune system, putting people at high risk of getting COVID-19. Thus, VPD surveillance should be maintained to enable early detection and management of VPD cases, and if possible, support COVID-19 surveillance. Continue to educate and encourage your community to get their routine vaccinations. Inform the community that travel to health facilities for routine vaccines is essential and permitted. Mothers and children should never miss a vaccination, as their immune systems are more vulnerable to disease.

Routine childhood vaccinations also protect people living with immunized children (e.g., siblings, parents, household members) from other infectious diseases and illnesses that could increase their risk of COVID-19 complications.

Prevent outbreaks of measles and rubella within quarantine and health-care facilities experiencing increased patient volumes due to the COVID-19 pandemic. These settings present a high risk for transmission for these VPDs. Take special care in such settings and ensure all patients and staff are vaccinated against measles and rubella to prevent outbreaks.

As much as possible, continue the delivery of routine immunization services, while complying with government instructions on physical distancing. Above all, health services have a responsibility to keep health workers safe. All interactions with patients in health facilities must be conducted under conditions that will protect health workers, caregivers, and patients from infection.

Use COVID-19 precautions to reduce transmission of infection at immunization events like wearing protective clothing (masks, gloves, gowns, etc.) as well as handwashing with soap, water and disposable towels at each interaction.

It is important to maintain routine immunization services during the COVID-19 pandemic so other disease outbreaks do not occur. Adapt immunization practices to the changing local conditions, challenges and constraints arising from the COVID-19 pandemic. Potential strategies include:

1. Delaying all routine childhood health checks and conduct only newborn checks and immunization sessions.
2. Holding immunization sessions may at a different time and/or location than for sick patients.
3. If immunization services are compromised due to limited resources, vaccines for more contagious diseases may need to be prioritized while vaccination of other antigens may be delayed. Alternatively, intervals between doses in a multidose series may need to be lengthened.

Where it is not feasible to continue immunization services due to availability of health-care resources or ongoing physical distancing measures, routine immunization services may need to be halted temporarily, either partially or fully.

If routine immunization services must be limited or interrupted, ensure the following:

1. Restart services at full capacity as soon as possible to limit the number of unvaccinated people who may now be at risk.
2. Prepare to identify and provide catch-up vaccinations for those who have missed scheduled appointments, as soon as it is safe to do so. Where possible, this may include actively maintaining lists of people who have missed their vaccinations to guide catch-up activities.

Frequently re-evaluating MOH policies and COVID-19 transmission rates will help ensure that service delivery is as safe as possible.

The community engagement principles from course 9.2 apply to routine immunizations also. Use those strategies to encourage routine immunizations with parents. Several studies have shown that community involvement can help routine immunization programmes increase their coverage and reduce dropout rates.

Consider the following when engaging with the community to promote routine immunizations:

1. Offer flexible hours, days, and settings;
2. immunizations can be provided during other healthcare services to reduce the number of visits;
3. use effective techniques for interpersonal communication.