Experts Urge Continued Immunizations During COVID-19 Pandemic

As people remain under stay-at-home orders around the world, experts are increasingly concerned that vaccine-preventable disease outbreaks could follow the coronavirus disease 2019 (COVID-19) outbreak, due to global interruptions of immunization programs.

Organizations such as the Measles & Rubella Initiative have warned that disruptions in immunization services could lead to outbreaks in many vaccine-preventable diseases, which could then further overwhelm health systems fighting COVID-19.¹

“Disease outbreaks must not remain a threat when we have safe and effective vaccines to protect us,” said World Health Organization (WHO) Director-General Tedros Adhanom, PhD, in a statement.¹

Measles is of particular concern. According to a statement from the Measles & Rubella Initiative, as many as 800,000 people may have been infected with measles in 2019, and a resurgence could follow later in 2020 if vaccination rates fall.¹

The WHO issued a document in April with guiding principles and recommendations for ensuring continued immunizations, including adapting new strategies to protect health workers, caregivers, and patients.

“Immunization is a core health service that should be prioritized for the prevention of communicable diseases and safeguarded for continuity during the COVID-19 pandemic, where feasible,” the statement said.²

According to the WHO recommendations, vaccine-preventable disease surveillance should be maintained and reinforced, and should be monitored in tandem with the dynamics of COVID-19. If immunization services are impacted, individual countries should create strategies to catch up and should make plans to anticipate a gradual recovery. These strategies will require tracking and follow-up with individuals who missed vaccinations, assessing of immunity gaps, and re-establishing community demand.²

These strategies and decisions will be influenced by local mandates regarding physical distancing and will depend on whether the local health systems have reached capacity. Wherever the capacity is intact and essential health services are still operational, fixed site immunization services and disease surveillance should be continued while maintaining safety procedures. Alternative strategies may be considered in some cases, however, and may include outreach or mobile services.²

Finally, in areas where immunization services must be minimized or suspended, the WHO recommendations urged countries to reinstate their services as soon as possible once reduced local transmission of COVID-19 permits health services to resume. If resources are still limited, catch-up activities should prioritize outbreak-prone diseases such as measles, polio, diphtheria, and yellow fever.²

“While the world strives to develop a new vaccine for COVID-19 at record speed, we must not risk losing the fight to protect everyone, everywhere against vaccine-preventable diseases,” Adhanom concluded in a statement from the WHO. “These diseases will come roaring back if we do not vaccinate.”¹

REFERENCES

1. Hard fought gains in immunization coverage at risk without critical health services, warns WHO [news release]. Measles & Rubella Initiative; April 23, 2020.https://measlesrubellainitiative.org/measles-news/hard-fought-gains-in-immunization-coverage-at-risk-without-critical-health-services-warns-who/. Accessed May 7, 2020.
2. Guiding principles for immunization activities during the COVID-19 pandemic. World Health Organization; March 26, 2020.https://apps.who.int/iris/bitstream/handle/10665/331590/WHO-2019-nCoV-immunization_services-2020.1-eng.pdf. Accessed May 7, 2020.