The Impact of COVID-19 Restrictions on Childhood Vaccination Uptake: A Rapid Review

Vaccines are highly effective for preventing a range of childhood infections. However, there have been concerns about the decrease in childhood vaccinations in 2020, with the WHO and UNICEF warning of an ‘alarming decline’ due to the COVID-19 pandemic. By analysing 35 published studies and 10 reports by national or international agencies, we found reductions in diphtheria tetanus pertussis, BCG, measles and polio vaccine uptake, as well as a range of other vaccines regularly given to children. Reductions in many settings were reversed once restrictions were lifted. However, not all settings reported a return to complete normality. Smaller declines were seen in younger children than older children. In addition, children born to women who could not read and write were more likely to be incompletely immunised. Barriers to access and maintaining public transport infrastructure impacted uptake of childhood vaccinations as well.The evidence in this review shows that obstacles to the delivery of vaccination services during the COVID-19 pandemic drove down immunisation rates, especially in disadvantaged people and poorer countries.AppendicesAppendix 1. The Impact of COVID-19 Restrictions on Childhood Vaccination UptakeFiguresFigure 1. PRIMSA 2020 Flow DiagramFigure 2. PRISMA ChecklistTablesTable 1. Primary Studies on Childhood Vaccination UptakeTable 2. Reports by National and International Agencies

疫苗在预防多种儿童感染方面具有极高的有效性。然而，2020年儿童疫苗接种率的下降引起了广泛关注，世界卫生组织（WHO）和联合国儿童基金会（UNICEF）对因COVID-19大流行而导致的‘令人担忧的下降’发出了警告。通过对35项已发表研究和10份来自国家或国际机构的报告进行分析，我们发现百白破、BCG、麻疹和脊髓灰质炎疫苗的接种率有所下降，以及其他常规给予儿童的各类疫苗的接种率也出现了下滑。在解除限制后，许多地区的接种率有所回升，但并非所有地区都报告了完全恢复正常。与年长儿童相比，年幼儿童的接种率下降更为明显。此外，对于那些母亲无法读写的孩子，不完全接种疫苗的可能性更高。公共交通运输基础设施的获取和维护障碍也对儿童疫苗接种率产生了影响。本综述的证据表明，在COVID-19大流行期间，疫苗接种服务的提供障碍降低了疫苗接种率，尤其是在弱势群体和贫困国家中。附录附录1：COVID-19限制对儿童疫苗接种率的影响图表图表1：PRIMSA 2020流程图图表2：PRISMA清单表格表格1：关于儿童疫苗接种率的主要研究表格2：国家与国际机构的报告