COVID-19 related immunization disruptions in Rajasthan, India: A retrospective observational study.
COVID-19 related immunization disruptions in Rajasthan, India: A retrospective observational study.
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DOI：
10.1016/j.vaccine.2021.06.022
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发表时间：
2021-07-13
期刊：
影响因子：
5.5
通讯作者：
Dupas P
中科院分区：
文献类型：
--
作者：
Jain R;Chopra A;Falézan C;Patel M;Dupas P
新冠肺炎封锁期间的中断导致儿童错过了疫苗接种。政府的追赶努力极大地逆转了这些影响。然而，在封锁期间应该接种疫苗的儿童在4-5个月后接种疫苗的可能性仍然降低了10%-15%。在社会经济地位较低的儿童中，追赶更有可能是不完整的。确保所有儿童充分接种疫苗需要仔细跟踪和分类数据。世界各国政府暂停了免疫推广活动，以控制新冠肺炎的传播。自那以后，许多人恢复了服务，重点是补种疫苗。这篇论文评估了印度2020年3月至5月封锁期间的免疫中断，以及随后的追赶努力在多大程度上逆转了印度拉贾斯坦邦的免疫中断。在这项回溯性观察性研究中，我们进行了电话调查，收集了2,144名在2020年1月至10月期间满一岁的儿童的免疫接种细节。我们使用Logistic回归来比较在封锁之前(未暴露)、在(严重暴露)和之后(暴露后)应接种的儿童在免疫及时性和完成第一年免疫状态方面的差异。与未暴露的儿童相比，严重暴露的儿童在9个月或之前接种疫苗的可能性显著降低(OR 0.550；95%CI 0.367-0.824；p=0.004)，但在10-12个月时接种的可能性更大(OR 1.761；95%CI 1.196-2.591；p=0.004)。到调查时，他们也不太可能完成第一年的关键免疫接种(OR 0.624；95%CI 0.478-0.816；P=0.001)。相比之下，暴露后的儿童与未暴露的儿童相比，在及时性或完成第一年免疫方面没有差异，尽管他们的年龄更小。重度暴露儿童的第一年免疫覆盖率下降了6.9%，降至10.4%(9.7%至14.0%)。在较贫穷、受教育程度较低、种姓较低和居住在COVID红色地带的家庭的儿童中，免疫覆盖率的下降幅度更大，尽管亚组比较在统计上没有显著意义。免疫服务的中断导致儿童在封锁期间错过了免疫接种，但在封锁放松后的追赶努力确保了许多儿童在较晚的年龄获得接种。然而，追赶还没有完成，在封锁解除后4-5个月内，应在封锁期间接种疫苗的儿童仍不太可能完全接种疫苗，尽管较年轻的队列应在6月份或更晚时接种疫苗，恢复到封锁前的时间表。
Disruptions during the COVID-19 lockdown caused children to miss immunizations. Government catch-up efforts substantially reversed these effects. Yet, children that were due vaccinations during the lockdown remained 10–15% less likely to be immunized 4–5 months later. Catch-up was more likely to be incomplete among children of low socioeconomic status. Ensuring all children are fully immunized requires careful tracking and disaggregated data. Governments around the world suspended immunization outreach to control COVID-19 spread. Many have since resumed services with an emphasis on catch-up vaccinations. This paper evaluated immunization disruptions during India’s March-May 2020 lockdown and the extent to which subsequent catch-up efforts reversed them in Rajasthan, India. In this retrospective observational study, we conducted phone surveys to collect immunization details for 2,144 children that turned one year old between January and October 2020. We used logistic regressions to compare differences in immunization timeliness and completed first-year immunization status among children that were due immunizations just before (unexposed), during (heavily exposed), and after (post-exposure) the lockdown. Relative to unexposed children, heavily exposed children were significantly less likely to be immunized at or before 9 months (OR 0.550; 95% CI 0.367–0.824; p = 0.004), but more likely to be immunized at 10–12 months (OR 1.761; 95% CI 1.196–2.591; p = 0.004). They were also less likely to have completed their key first-year immunizations (OR 0.624; 95% CI 0.478–0.816; p = 0.001) by the time of survey. In contrast, post-exposure children showed no difference in timeliness or completed first-year immunizations relative to unexposed children, despite their younger age. First-year immunization coverage among heavily exposed children decreased by 6.9 pp to 10.4 pp (9.7% to 14.0%). Declines in immunization coverage were larger among children in households that were poorer, less educated, lower caste, and residing in COVID red zones, although subgroup comparisons were not statistically significant. Disruptions to immunization services resulted in children missing immunization during the lockdown, but catch-up efforts after it was eased ensured many children were reached at later ages. Nevertheless, catch-up was incomplete and children due their immunizations during the lockdown remained less likely to be fully immunized 4–5 months after it lifted, even as younger cohorts due immunizations in June or later returned to pre-lockdown schedules.
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影响因子：
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