Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015–2021
Introduction The COVID-19 pandemic caused widespread morbidity and mortality and resulted in the biggest setback in routine vaccinations in three decades. Data on the impact of the pandemic on immunisation in Africa are limited, in part, due to low-quality routine or administrative data. This study...
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/8/12/e014225.full |
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| author | Oghenebrume Wariri Chris Grundy Beate Kampmann Uduak Okomo Golam Sarwar Kris A Murray Lamin Saidy Chigozie Edson Utazi Alieu Sowe Malick Sogur Sidat Fofanna Esu Ezeani Bai-Lamin Dondeh |
| author_facet | Oghenebrume Wariri Chris Grundy Beate Kampmann Uduak Okomo Golam Sarwar Kris A Murray Lamin Saidy Chigozie Edson Utazi Alieu Sowe Malick Sogur Sidat Fofanna Esu Ezeani Bai-Lamin Dondeh |
| author_sort | Oghenebrume Wariri |
| collection | DOAJ |
| description | Introduction The COVID-19 pandemic caused widespread morbidity and mortality and resulted in the biggest setback in routine vaccinations in three decades. Data on the impact of the pandemic on immunisation in Africa are limited, in part, due to low-quality routine or administrative data. This study examined coverage and timeliness of routine childhood immunisation during the pandemic in The Gambia, a country with an immunisation system considered robust.Methods We obtained prospective birth cohort data of 57 286 children in over 300 communities in two health and demographic surveillance system sites, including data from the pre-pandemic period (January 2015–February 2020) and the three waves of the pandemic period (March 2020–December 2021). We determined monthly coverage and timeliness (early and delayed) of the birth dose of hepatitis B vaccine (HepB0) and the first dose of pentavalent vaccine (Penta1) during the different waves of the pandemic relative to the pre-pandemic period. We implemented a binomial interrupted time-series regression model.Result We observed no significant change in the coverage of HepB0 and Penta1 vaccinations from the pre-pandemic period up until the periods before the peaks of the first and second waves of the pandemic in 2020. However, there was an increase in HepB0 coverage before as well as after the peak of the third wave in 2021 compared with the pre-pandemic period (pre-third wave peak OR = 1.83, 95% CI 1.06 to 3.14; post-third wave period OR=2.20, 95% CI 1.23 to 3.92). There was some evidence that vaccination timeliness changed during specific periods of the pandemic. Early Penta1 vaccination decreased by 70% (OR=0.30, 95% CI 0.12 to 0.78) in the period before the second wave, and delayed HepB0 vaccination decreased by 47% (OR=0.53, 95% CI 0.29 to 0.97) after the peak of the third wave in 2021.Conclusion Despite the challenges of the COVID-19 pandemic, The Gambia’s routine vaccination programme has defied the setbacks witnessed in other settings and remained resilient, with coverage increasing and timeliness improving during the second and third waves. These findings highlight the importance of having adequate surveillance systems to monitor the impact of large shocks to vaccination coverage and timeliness. |
| format | Article |
| id | doaj-art-01b3fad9c0bd45fbb7f9ac0fd8970510 |
| institution | DOAJ |
| issn | 2059-7908 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
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| spelling | doaj-art-01b3fad9c0bd45fbb7f9ac0fd89705102025-08-20T02:41:17ZengBMJ Publishing GroupBMJ Global Health2059-79082023-12-0181210.1136/bmjgh-2023-014225Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015–2021Oghenebrume Wariri0Chris Grundy1Beate Kampmann2Uduak Okomo3Golam Sarwar4Kris A Murray5Lamin Saidy6Chigozie Edson Utazi7Alieu Sowe8Malick Sogur9Sidat Fofanna10Esu Ezeani11Bai-Lamin Dondeh12Vaccine Centre, London School of Hygiene and Tropical Medicine, London, UKDepartment of Population Health, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK11 Centre for Global Health, Charité Universitatsmedizin Berlin, Berlin, GermanyVaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Gambia8 Health and Demographic Surveillance System (HDSS), MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambiaprofessor of environmental change and health9 Data Management & Architecture, MRC Unit The Gambia a London School of Hygiene and Tropical Medicine, Banjul, The Gambia4 WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK7 Expanded Programme on Immunization, Ministry of Health and Social Welfare, Banjul, The Gambia7 Expanded Programme on Immunization, Ministry of Health and Social Welfare, Banjul, The Gambia7 Expanded Programme on Immunization, Ministry of Health and Social Welfare, Banjul, The GambiaDisease Control and Elimination, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Gambia9 Data Management & Architecture, MRC Unit The Gambia a London School of Hygiene and Tropical Medicine, Banjul, The GambiaIntroduction The COVID-19 pandemic caused widespread morbidity and mortality and resulted in the biggest setback in routine vaccinations in three decades. Data on the impact of the pandemic on immunisation in Africa are limited, in part, due to low-quality routine or administrative data. This study examined coverage and timeliness of routine childhood immunisation during the pandemic in The Gambia, a country with an immunisation system considered robust.Methods We obtained prospective birth cohort data of 57 286 children in over 300 communities in two health and demographic surveillance system sites, including data from the pre-pandemic period (January 2015–February 2020) and the three waves of the pandemic period (March 2020–December 2021). We determined monthly coverage and timeliness (early and delayed) of the birth dose of hepatitis B vaccine (HepB0) and the first dose of pentavalent vaccine (Penta1) during the different waves of the pandemic relative to the pre-pandemic period. We implemented a binomial interrupted time-series regression model.Result We observed no significant change in the coverage of HepB0 and Penta1 vaccinations from the pre-pandemic period up until the periods before the peaks of the first and second waves of the pandemic in 2020. However, there was an increase in HepB0 coverage before as well as after the peak of the third wave in 2021 compared with the pre-pandemic period (pre-third wave peak OR = 1.83, 95% CI 1.06 to 3.14; post-third wave period OR=2.20, 95% CI 1.23 to 3.92). There was some evidence that vaccination timeliness changed during specific periods of the pandemic. Early Penta1 vaccination decreased by 70% (OR=0.30, 95% CI 0.12 to 0.78) in the period before the second wave, and delayed HepB0 vaccination decreased by 47% (OR=0.53, 95% CI 0.29 to 0.97) after the peak of the third wave in 2021.Conclusion Despite the challenges of the COVID-19 pandemic, The Gambia’s routine vaccination programme has defied the setbacks witnessed in other settings and remained resilient, with coverage increasing and timeliness improving during the second and third waves. These findings highlight the importance of having adequate surveillance systems to monitor the impact of large shocks to vaccination coverage and timeliness.https://gh.bmj.com/content/8/12/e014225.full |
| spellingShingle | Oghenebrume Wariri Chris Grundy Beate Kampmann Uduak Okomo Golam Sarwar Kris A Murray Lamin Saidy Chigozie Edson Utazi Alieu Sowe Malick Sogur Sidat Fofanna Esu Ezeani Bai-Lamin Dondeh Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015–2021 BMJ Global Health |
| title | Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015–2021 |
| title_full | Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015–2021 |
| title_fullStr | Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015–2021 |
| title_full_unstemmed | Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015–2021 |
| title_short | Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015–2021 |
| title_sort | impact of the covid 19 pandemic on the coverage and timeliness of routine childhood vaccinations in the gambia 2015 2021 |
| url | https://gh.bmj.com/content/8/12/e014225.full |
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