- Due to the circulation of the virus causing COVID 19 and the current pandemic there has been a disruption in routine immunization activities due to
- Burden on the health care system
- Community reluctance
- Decreased demand for vaccination due to physical distancing requirements
WHO in a interior guidance report published on 26th March 2020 (Guiding principles for immunization activities during COVID 19 pandemic) has expressed serious concerns about possiblity of outbreaks of VPD (Vaccine preventable Disease) e.g. Measles, pneumonia, diarrhoea, etc
There was a similar situation during EBOLA outbreak in 2014-2015. The deaths caused by measles, malaria, tuberculosis due to health systems failure in Africa was far greater than deaths caused by EBOLA.
A modelling study done by scientists at the London school of hygiene and Tropical medicine on the impact of suspending routine vaccine sessionsto prevent spread of COVID 19 and further deaths due to COVID 19 in Africa has shown that for each COVID 19 death prevented there would be as many as 34,1274 further deaths due to disease including measles, yellow fever, polio, meningitis, pneumonia etc. So any flare of VPDs will additionally burden the already distressed health care system. The ministry of home affairs in its guidelines dated April 15, 2020 has directed that essential medical services be maintained during the lockdown.
It should be emphasised that “Immunization is a core Health service, that should be prioritized for the prevention of communicable disease and safeguarded for continuity during the COVID 19 pandemic wherever feasible.”
At present there is no documented risk of immunizing a well child during covid 19 pandemic .
COVID 19 is a evolving disease and hence we need to monitor strictly for any increase in AEFI (adverse effects following immunisation).
- NITAGS (National Immunization Technical Advisory Group) have been advised to advice the government regarding maintenance, adaptation, suspension and/or reinstatement of immunization services.
- Based on the current understanding of transmission of COVID 19 virus and recommendation of physical distancing mass vaccination campaigns should be temporarily suspended.
- Where health system capacity is intact and essential health services are operational, fixed site immunization services and VPD surveillance should be executed while maintaining physical distancing measures
- Formulate catch up vaccination strategies for post-COVID period
ACVIP has given guidelines on
- Continuation of immunization activities,
- Prioritization of certain vaccine,
- Precaution to be taken while immunising.
- Exclusive vaccine sessions.
- Triaging of patients and separation of fever and RTI patients.
- Senior citizens not to accompany children.
- All caretakers and children except infants (<1-1.5 yr) should wear masks.
- Vaccination by appointment.
- Stagger appointment to avoid crowding.
- Vaccinate newborns in maternity set up before discharge–BCG/OPV and Hepatitis B.
- Prioritize primary vaccination series DPT, HepB, HiB, OPV/IPV, Rotavirus, PCV, Influenza, Chicken pox and MR/MMR. Avoid postponing these vaccines
- Typhoid conjugate vaccines may be clubbed with influenza at 6 months or MR/MMR at 9 months.
- Inactivated JE vaccines at 1 year.
- Hepatitis A vaccine and HPV vaccine may be postponed to a later date.
- Multiple vaccine can be given in one session .
- Vaccines can be rescheduled.
- Government machinery will restart immunization at the earliest.
- Doctors and health machinery are aware of the importance of immunization.