COVID-19 Impact on Disparity in Childhood Immunization in Low- and Middle-Income Countries Through the Lens of Historical Pandemics.

Purpose of Review: The COVID-19 pandemic, since 2020, has affected health care services and access globally. Although the entire impact of COVID-19 pandemic on existing global public health is yet to be fully seen, the impact of COVID-19 pandemic on global childhood immunization programs is of particular importance. Recent Findings: Disruptions to service delivery due to lockdowns, challenges in vaccination programs, vaccine misinformation and hesitancy, and political and social economic inequalities all posed a threat to existing childhood immunization programs. These potential threats were especially critical in LMIC where childhood immunization programs tend to experience suboptimal implementation. Summary: This review provides an overview of childhood immunizations and discusses past pandemics particularly in LMIC, factors contributing to disparities in childhood immunizations, and reviews potential lessons to be learned from past pandemics. Vaccine hesitancy, social determinants of health, and best practices to help lessen the pandemic's influence are also further elaborated. To address current challenges that hindered the progress made in prevention of childhood illnesses through vaccination campaigns and increased vaccine availability, lessons learned through best practices explored from past pandemics must be examined to mitigate impact of COVID-19 on childhood immunization and in turn conserve health and improve economic well-being of children especially in LMIC.

COVID-19 and Routine Childhood and Adolescent Immunizations: Evidence from Louisiana Medicaid.

The COVID-19 pandemic disrupted routine vaccinations for children and adolescents. However, it remains unclear whether the impact has been different for children and adolescents from low-income families. To address this, we compared monthly routine vaccination use per 1000 vaccine-eligible children and adolescents enrolled in Louisiana Medicaid in the years before (2017-2019) and during the COVID-19 pandemic (2020). Compared to the 2017-2019 average vaccination rates, we found a 28% reduction in measles, mumps, and rubella (MMR), a 35% reduction in human papillomavirus (HPV), and a 30% reduction in tetanus, diphtheria, pertussis (Tdap) vaccinations in 2020. Vaccine uptake was lower in April 2020 after the declaration of a state of emergency and in late summer when back-to-school vaccinations ordinarily occur. We found little evidence of recovery in later months. Our findings suggest that a substantial number of disadvantaged children may experience longer periods of vulnerability to preventable infections because of missed vaccinations.