The impact of COVID-19 on routine child immunisation in South Africa.

Journal: BMC public health

Volume: 24

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  Final Mile Consulting, South Africa Office, Rosebank Corner, Jan Smuts Avenue, Parktown North, Johannesburg, South Africa. sangiwe.moyo@thefinalmile.com. International Business Park, Final Mile ConsultingCommerz IIOberoi Garden City, India Office, Level Western Express Highway, Goregaon (East), Mumbai, , India. Final Mile Consulting, South Africa Office, Rosebank Corner, Jan Smuts Avenue, Parktown North, Johannesburg, South Africa. Department of Global Health and Development, School of Hygiene & Tropical Medicine, University of London, London, UK. Final Mile Consulting, United States Office, One World Trade Center, Suite J, New York, NY, , USA.

Abstract summary 

The COVID-19 pandemic disrupted immunisation programs worldwide, reversing gains that had brought vaccine-preventable diseases largely under control. This study explored the impact of COVID-19 on the uptake of routine child immunisation services in South Africa.We conducted qualitative research using in-depth interviews with 51 purposively selected parents/caregivers of children below the age of five who missed or delayed one or more scheduled immunisation doses in 2020-2022 and with 12 healthcare providers who provided public immunisation services during the pandemic.During the pandemic lockdowns, most caregivers perceived the risk of their child being infected with COVID-19 during a clinic visit as more salient than the risk of missing immunisation doses. Caregivers reported minimal exposure to routine immunisation communication, as well as shortages of routine vaccines for children at public health facilities, healthcare workers experienced anxiety and burnout. There was a post-pandemic shift to more active decision-making about immunisation, which had previously been an almost automatic behaviour, leading some caregivers to delay vaccinating their children. There was also evidence of a "bad vaccine" mental model among some caregivers regarding COVID vaccinations, which could lead to doubts about the safety of routine childhood vaccinations.The shift from default to active decision-making highlights a risk that routine immunisation will backslide in future pandemics. Governments should build resilient health systems at all levels and communicate clearly about the benefits and availability of RIs and the safety of vaccinations in general, alongside supply-side interventions.Routine immunisation is widely accepted in South Africa, driven by generational norms and provider recommendations. During the COVID-19 pandemic, many caregivers faced the dilemma of balancing COVID-19 exposure risk with the risk of their child developing a deadly VPD, leading to missed RI visits. This shift to active decision-making highlights a future pandemic risk. Governments should build resilient health systems and focus on understanding and engaging procrastinating and doubtful caregivers. Clear communication about RI benefits and vaccine safety is crucial, as misinformation can lead to distrust in new vaccines.

Authors & Co-authors:  Moyo Sangiwe S Ashok Anushka A Myers Laura L Nyankieya Rebecca R Sharma Saransh S Prasad Ram R

Study Outcome 

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Statistics
Citations :  Adamu AA, Jalo RI, Habonimana D, Wiysonge CS. COVID-19 and routine childhood immunisation in Africa: leveraging systems thinking and implementation science to improve immunisation system performance. Int J Infect Dis. 2020;98:161–5 Elsevier BV.
Authors :  6
Identifiers
Doi : 3077
SSN : 1471-2458
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Behavioural science;Pandemic preparedness;Routine immunisation;South Africa;Vaccine-preventable disease
Study Design
Study Approach
Qualitative
Country of Study
South Africa
Publication Country
England