The vaccination coverage rate in under-5 children in Nasiriyah, Iraq before and during the COVID-19 pandemic

다국어 초록 (Multilingual Abstract)

OBJECTIVES: This study compared the vaccination coverage rate (VCR) in children under 5 years old in Nasiriyah, Iraq before and during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS: This cross-sectional study was conducted in the city of Nasiriyah in southeastern Iraq, with data collected from 79 primary healthcare facilities. This study evaluated the VCR in 3 periods (2018, 2019, and 2020) using multi-level random sampling. Pertinent data were extracted from the vaccination records of 598 children for Bacillus Calmette-Guérin (BCG); pentavalent 1, 2, and 3; measles; and activated oral poliovirus vaccine 1 and 2. Missing data were completed by telephone calls to participants’ parents. Logistic regression was applied to compare and estimate the odds ratios (ORs) with 95% confidence intervals (CIs) for the association between VCR and related factors.
RESULTS: The data showed the greatest decline in the studied vaccines in 2020. Among the vaccines studied, BCG had the highest rate in all 3 periods (100% VCR) and measles had the lowest rate (83.7%), reaching 63.6% in 2020 (p< 0.001). The highest OR among all types of vaccine were found for the pentavalent-3 vaccine among city dwellers and those born in 2020 (OR, 2.67; 95% CI, 1.39 to 5.10 and OR, 2.34; 95% CI, 1.28 to 4.28, respectively).
CONCLUSIONS: The VCR for children decreased during the COVID-19 pandemic in Iraq, and new health policies are needed to increase the coverage rate. Improving the knowledge and attitudes of parents, as well as removing barriers or risk factors, can also be effective in improving the VCR.

참고문헌 (Reference)

1 Bustreo F, "World Health Organization perspectives on the contribution of the Global Alliance for Vaccines and Immunization on reducing child mortality" 100 (100): S34-S37, 2015

2 Singh GK, "Widening rural-urban disparities in all-cause mortality and mortality from major causes of death in the USA, 1969-2009" 91 : 272-292, 2014

3 Wodi P, "Vaccine safety"

4 Andre FE, "Vaccination greatly reduces disease, disability, death and inequity worldwide" 86 : 140-146, 2008

5 United Nations Children’s Fund, "UNICEF and WHO sound the alarm on the health dangers of children in Iraq missing routine immunization during the Covid-19 pandemic"

6 "UNESCO Institute for Statistics. Iraq"

7 Lassi ZS, "The impact of the COVID-19 pandemic on immunization campaigns and programs : a systematic review" 18 : 988-, 2021

8 Armocida B, "The Italian health system and the COVID-19 challenge" 5 : e253-, 2020

9 Chu IY, "Social consequences of mass quarantine during epidemics : a systematic review with implications for the COVID-19 response" 27 : taaa192-, 2020

10 Paguio JA, "Silver lining of COVID-19 : heightened global interest in pneumococcal and influenza vaccines, an infodemiology study" 38 : 5430-5435, 2020

11 Li X, "Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan" 146 : 110-118, 2020

12 World Health Organization, "Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report"

13 Williams N, "Primary care strategies to improve childhood immunisation uptake in developed countries : systematic review" 2 : 81-, 2011

14 Ackerson BK, "Pediatric vaccination during the COVID-19 pandemic" 148 : e2020047092-, 2021

15 Bell S, "Parents’ and guardians’ views and experiences of accessing routine childhood vaccinations during the coronavirus(COVID-19)pandemic : a mixed methods study in England" 15 : e0244049-, 2020

16 United Nations Children’s Fund, "Iraq: multiple indicator cluster survey 2018: survey findings report"

17 Lami F, "Iraq experience in handling the COVID-19 pandemic: implications of public health challenges and lessons learned for future epidemic preparedness planning" 43 (43): iii19-iii28, 2021

18 Restrepo-Méndez MC, "Inequalities in full immunization coverage : trends in low-and middle-income countries" 94 : 794-805B, 2016

19 Almoosa Z, "Impact of coronavirus disease 2019(COVID-19)pandemic on routine pediatric vaccination in eastern region, Saudi Arabia" 24 : 4672-4681, 2020

20 Mansour Z, "Impact of COVID-19 pandemic on the utilization of routine immunization services in Lebanon" 16 : e0246951-, 2021

21 Harris RC, "Impact of COVID-19 on routine immunisation in South-East Asia and Western Pacific : disruptions and solutions" 10 : 100140-, 2021

22 Urooj U, "Expectations, fears and perceptions of doctors during Covid-19 pandemic" 36 (36): S37-S42, 2020

23 Cetorelli V, "Expansion of health facilities in Iraq a decade after the US-led invasion, 2003-2012" 8 : 16-, 2014

24 Causey K, "Estimating global and regional disruptions to routine childhood vaccine coverage during the COVID-19 pandemic in 2020 : a modelling study" 398 : 522-534, 2021

25 Rana MS, "Emergence of measles during the COVID-19 pandemic threatens Pakistan’s children and the wider region" 27 : 1127-1128, 2021

26 Santoli JM, "Effects of the COVID-19 pandemic on routine pediatric vaccine ordering and administration-United States, 2020" 69 : 591-593, 2020

27 McDonald HI, "Early impact of the coronavirus disease(COVID-19)pandemic and physical distancing measures on routine childhood vaccinations in England, January to April 2020" 25 : 2000848-, 2020

28 World Health Organization, "Director-General’s opening remarks at the media briefing on COVID-19-11 March 2020"

29 Lazzerini M, "Delayed access or provision of care in Italy resulting from fear of COVID-19" 4 : e10-e11, 2020

30 Bramer CA, "Decline in child vaccination coverage during the COVID-19 pandemic-Michigan Care Improvement Registry, May 2016-May 2020" 20 : 1930-1931, 2020

31 World Health Organization, "Coronavirus disease (COVID-19): data as received by WHO from national authorities, as of 11 October 2020, 10 am CEST"

32 Jeste S, "Changes in access to educational and healthcare services for individuals with intellectual and developmental disabilities during COVID-19 restrictions" 64 : 825-833, 2020

33 Blumenthal D, "COVID-19-implications for the health care system" 383 : 1483-1488, 2020

34 Adamu AA, "COVID-19 and routine childhood immunization in Africa : leveraging systems thinking and implementation science to improve immunization system performance" 98 : 161-165, 2020