An Impact Study of the COVID-19 Pandemic on Routine Paediatric Immunisation in Nigeria: Recommendations to Strengthen Routine Immunization during a Pandemic

Abstract

The COVID-19 pandemic spread to Nigeria, resulting in a nationwide lockdown from 30th March 2020. Consequently, there was enormous impact on the health and socio-economic facets of life affecting individuals, families, and communities. A key component of primary health care that was affected was routine childhood immunisation which is one of the fundamental pillars of the Nigerian government’s child health care policy. The study aimed at evaluating the impact of the pandemic on routine immunization, as well as, make recommendations to strengthen routine immunization during a pandemic based on lessons learnt. Primary data were collected using semi-structured questionnaires administered to 150 parents or caregivers across the childcare and wellness clinics of four selected secondary health facilities in the Federal Capital Territory (FCT) from January to June 2020 (January to March representing the pre-lockdown period while April to June, the lockdown period). Secondary data were collected from immunisation records of these facilities. The mean changes in the immunisation coverage of pre-lockdown period were compared with the lockdown period using student t-test. A p-value of < 0.05 was considered statistically significant. There was a significant decline of 19.1% in the total number of immunizations given in the pre- and during the lockdown period [t=2.86, p=0.035]. This reduction was diverse across all districts and all vaccine antigens. The highest decline was seen for the 6 weeks’ vaccines (31.2%), followed by the 10 weeks (28.7%). Fear of contracting COVID was the commonest reason for missing vaccines (26.4%) followed by lack of transportation money (5.7%). For those that presented, the main reason for not getting vaccinated was that the vaccination centres were closed (55.6%). About 46.9% and 34.5% of the participants responded that they would prefer home-visits by the healthcare workers and hospital ‘drive-by’ for delivery of routine vaccination during a pandemic. The COVID-19 pandemic significantly affected the routine immunisation in the FCT. Routine immunisation services should continue during pandemics while health promotion should be continued by the government, healthcare professionals and other stakeholders. Also pivotal is to ensure that healthcare workers have adequate training regarding infection, prevention and control measures, and vaccine logistics, while adhering to strict standard protocols. Appointment-based visits can be scheduled using phone calls, emails, and SMS to have less people in waiting areas. Drive-by and home-based services are acceptable alternatives for parents and caregivers in addition to fixed-site vaccination activities during a pandemic.