Table_4_Disruptions to routine childhood vaccinations in low- and middle-income countries during the COVID-19 pandemic: A systematic review.docx

BackgroundThe COVID-19 pandemic has disrupted routine childhood vaccinations worldwide with low- and middle-income countries (LMICs) most affected. This study aims to quantify levels of disruption to routine vaccinations in LMICs.MethodsA systematic review (PROSPERO CRD42021286386) was conducted of MEDLINE, Embase, Global Health, CINAHL, Scopus and MedRxiv, on the 11th of February 2022. Primary research studies published from January 2020 onwards were included if they reported levels of routine pediatrics vaccinations before and after March 2020. Study appraisal was performed using NHLBI tool for cross-sectional studies. Levels of disruption were summarized using medians and interquartile ranges.ResultsA total of 39 cross-sectional studies were identified. These showed an overall relative median decline of −10.8% [interquartile range (IQR) −27.6%, −1.4%] across all vaccines. Upper-middle-income countries (upper-MICs) (−14.3%; IQR −24.3%, −2.4%) and lower-MICs (−18.0%; IQR −48.6%, −4.1%) showed greater declines than low-income countries (−3.1%; IQR −12.8%, 2.9%), as did vaccines administered at birth (−11.8%; IQR −27.7%, −3.5%) compared to those given after birth (−8.0%; IQR −28.6%, −0.4%). Declines during the first 3 months of the pandemic (−8.1%; IQR −35.1%, −1.4%) were greater than during the remainder of 2020 (−3.9%; IQR −13.0%, 11.4%) compared to baseline.ConclusionThere has been a decline in routine pediatric vaccination, greatest in MICs and for vaccines administered at birth. Nations must prioritize catch-up programs alongside public health messaging to encourage vaccine uptake.Systematic review registrationIdentifier: CRD42021286386.

背景：COVID-19疫情全球范围内打乱了常规儿童疫苗接种，尤其是低收入和中等收入国家（LMICs）受到的影响最为严重。本研究旨在量化LMICs常规疫苗接种的干扰程度。
方法：于2022年2月11日，对MEDLINE、Embase、全球健康、CINAHL、Scopus和MedRxiv数据库进行了系统评价（PROSPERO CRD42021286386）。纳入了自2020年1月以后发表的研究，只要它们报告了2020年3月前后常规儿科疫苗接种的水平。研究评估采用了NHLBI横断面研究工具。干扰程度使用中位数和四分位数范围进行总结。
结果：共确定了39项横断面研究。这些研究显示，所有疫苗的总体相对中位数下降为-10.8%[四分位数范围(IQR) -27.6%，-1.4%]。上中等收入国家（upper-MICs）(-14.3%；IQR -24.3%，-2.4%)和下中等收入国家（lower-MICs）(-18.0%；IQR -48.6%，-4.1%)的下降幅度大于低收入国家(-3.1%；IQR -12.8%，2.9%)，与出生时接种的疫苗(-11.8%；IQR -27.7%，-3.5%)相比，出生后接种的疫苗(-8.0%；IQR -28.6%，-0.4%)下降幅度更大。与基线相比，疫情前三个月的下降幅度(-8.1%；IQR -35.1%，-1.4%)大于2020年余下的时间(-3.9%；IQR -13.0%，11.4%)。
结论：常规儿科疫苗接种水平有所下降，其中中等收入国家（MICs）和出生时接种的疫苗下降幅度最大。各国必须将公共卫生信息传播与疫苗接种率促进相结合，优先实施追赶计划。
系统评价注册标识符：CRD42021286386。