Contextual Narratives Associated With Immunization Services During COVID-19 Disease Outbreak in Chennai, Tamil Nadu

Authors

  • Sree T Sucharitha Tagore Medical College and Hospital, Tamil Nadu, Chennai https://orcid.org/0000-0001-8992-7387
  • Aravind Manoharan Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu https://orcid.org/0000-0003-2540-7432
  • Jaishree Vasudevan Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu
  • Aaditya Fernando Tagore Medical College and Hospital, Tamil Nadu, Chennai

DOI:

https://doi.org/10.55489/njcm.130620221711

Keywords:

SARS-CoV-19, pediatricians, immunization services, contextual narratives

Abstract

Background: Essential health services including immunization were significantly impacted due to COVID-19 with devastating outcomes in low- and middle-income countries (LMIC). The disruption in immunization services due to global pandemic and measures undertaken at regional levels to overcome need to be studied as pandemic preparedness strategy.

Objective: To document the contextual narratives related to immunization services during the Covid-19 disease outbreak by interviewing qualified pediatricians in the field practice area of private tertiary care teaching medical college

Methodology: In-depth phone-based interviews were conducted with pediatricians in diverse settings during November 2020 to March 2021. Reflexive thematic analysis was performed, major themes identified, and case studies documented.

Results: Pediatricians shared rich experiences related to immunization services impacted due to COVID-19 especially during the earlier months due to imposition of lockdowns leading to discontinuation, disruption of services, decrease in volume of immunizations, modest transition to telehealth service delivery, facility-level changes brought in to ensure immunization services, capacity building measures for upskilling.

Conclusions: Contextual narratives revealed in this study provide rich narrative about the disruption of immunization services due to COVID-19. These findings need to be understood and leveraged to be future ready and prevent further disruptions by identifying and scaling up key solutions piloted in this study.

References

Hard fought gains in immunization coverage at risk without critical health services, warns WHO [Internet]. Who.int. 2022 [cited 17 January 2022]. Available from: https://www.who.int/news/item/23-04-2020-hard-fought-gains-in-immunization-coverage-at-risk-without-critical-health-services-warns-who0

WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. Who.int. 2022 [cited 17 January 2022]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020

Pan American Health Organization. The Immunization Program in the Context of the COVID-19 Pandemic, 26 March 2020 [Internet]. Iris.paho.org. 2022 [cited 18 February 2022]. Available from: https://iris.paho.org/handle/10665.2/51992

World Health Organization. Guiding principles for immunization activities during the COVID-19 pandemic: interim guidance, 26 March 2020 [Internet]. Apps.who.int. 2022 [cited 16 March 2022]. Available from: https://apps.who.int/iris/handle/10665/331590

World Health Organization. At least 80 million children under one at risk of diseases such as diphtheria, measles and polio as COVID-19 disrupts routine vaccination efforts, warn Gavi, WHO and UNICEF [Internet]. Who.int. 2022 [cited 16 March 2022]. Available from: https://www.who.int/news/item/22-05-2020-at-least-80-million-children-under-one-at-risk-of-diseases-such-as-diphtheria-measles-and-polio-as-covid-19-disrupts-routine-vaccination-efforts-warn-gavi-who-and-unicef

Nelson R. COVID-19 disrupts vaccine delivery. The Lancet Infectious Diseases. 2020;20(5):546. doi: https://doi.org/10.1016/S1473-3099(20)30304-2

Roberton T, Carter E, Chou V, Stegmuller A, Jackson B, Tam Y et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. The Lancet Global Health. 2020;8(7):e901-e908. doi: https://doi.org/10.1016/S2214-109X(20)30229-1

Saxena S, Skirrow H, Bedford H. Routine vaccination during covid-19 pandemic response. BMJ. 2020;369: m2392. doi: https://doi.org/10.1136/bmj.m2392 PMid:32546575

World Health Organization. At least 80 million children under one at risk of diseases such as diphtheria, measles and polio as COVID-19 disrupts routine vaccination efforts, warn Gavi, WHO and UNICEF [Internet]. Who.int. 2022 [cited 16 March 2022]. Available from: https://www.who.int/news/item/22-05-2020-at-least-80-million-children-under-one-at-risk-of-diseases-such-as-diphtheria-measles-and-polio-as-covid-19-disrupts-routine-vaccination-efforts-warn-gavi-who-and-unicef

Danovaro C, Gurung S, Ho LL, Lindstrand A. Understanding the disruption to programmes through rapid polling. WHO Global Immunization News (GIN) newsletter. 2020. [Internet]. Who.int. 2022 [cited 20 March 2022]. Available from: https://www.who.int/publications/m/item/gin-march-april-2020

World Health Organization. Second round of the national pulse survey on continuity of essential health services during the COVID-19 pandemic [Internet]. Who.int. 2022 [cited 20 March 2022]. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS-continuity-survey-2021.1

Roberts L. Why measles deaths are surging - and coronavirus could make it worse. Nature. 2020;580(7804):446-447. doi: https://doi.org/10.1038/d41586-020-01011-6 PMid:32265541

World Health Organization. More than 117 million children at risk of missing out on measles vaccines, as COVID-19 surges [Internet]. Unicef.org. 2022 [cited 16 April 2022]. Available from: https://www.unicef.org/press-releases/more-117-million-children-risk-missing-out-measles-vaccines-covid-19-surges

Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qualitative research in sport, exercise and health. 2019 Aug 8;11(4):589-97. doi: https://doi.org/10.1080/2159676X.2019.1628806

O'Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Academic medicine. 2014 Sep 1;89(9):1245-51. doi: https://doi.org/10.1097/ACM.0000000000000388 PMid:24979285

Harris R, Chen Y, Côte P, Ardillon A, Nievera M, Ong-Lim A et al. Impact of COVID-19 on routine immunisation in South-East Asia and Western Pacific: Disruptions and solutions. The Lancet Regional Health - Western Pacific. 2021;10:100140. doi: https://doi.org/10.1016/j.lanwpc.2021.100140 PMid:33899040 PMCid:PMC8057868

14. Mansour Z, Arab J, Said R, Rady A, Hamadeh R, Gerbaka B et al. Impact of COVID-19 pandemic on the utilization of routine immunization services in Lebanon. PLOS ONE. 2021;16(2):e0246951. doi: 10.1371/journal.pone.0246951. doi: https://doi.org/10.1371/journal.pone.0246951 PMid:33596271 PMCid:PMC7888608

Saso A, Skirrow H, Kampmann B. Impact of COVID-19 on immunization services for maternal and infant vaccines: results of a survey conducted by imprint-the immunising pregnant women and infants network. Vaccines. 2020 Sep;8(3):556. doi: https://doi.org/10.3390/vaccines8030556 PMid:32972015 PMCid:PMC7563512

Sultana J, Mazzaglia G, Luxi N, Cancellieri A, Capuano A, Ferrajolo C et al. Potential effects of vaccinations on the prevention of COVID-19: rationale, clinical evidence, risks, and public health considerations. Expert Review of Vaccines. 2020;19(10):919-936. doi: https://doi.org/10.1080/14760584.2020.1825951 PMid:32940090

Su W, Wang H, Sun C, Li N, Guo X, Song Q et al. The Association Between Previous Influenza Vaccination and COVID-19 Infection Risk and Severity: A Systematic Review and Meta-analysis. American Journal of Preventive Medicine. 2022. doi: https://doi.org/10.1016/j.amepre.2022.02.008 PMid:35410774 PMCid:PMC8920881

Monaghesh E, Hajizadeh A. The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health. 2020;20(1).1-9. doi: https://doi.org/10.1186/s12889-020-09301-4 PMid:32738884 PMCid:PMC7395209

Ghatak N, Marzo RR, Saleem SM, Sharma N, Bhattacharya S, Singh A. Impact on routine immunization services during the lockdown period in India: Implications and future recommendations. European Journal of Molecular and Clinical Medicine. 2020;7(5):35-40. https://doi.org/10.36295/ASRO.2020.232146

Ackerson B, Sy L, Glenn S, Qian L, Park C, Riewerts R et al. Pediatric Vaccination During the COVID-19 Pandemic. Pediatrics. 2021;148(1). doi: https://doi.org/10.1542/peds.2020-047092 PMid:33858983

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Published

2022-06-30

How to Cite

1.
Sucharitha ST, Manoharan A, Vasudevan J, Aaditya Fernando. Contextual Narratives Associated With Immunization Services During COVID-19 Disease Outbreak in Chennai, Tamil Nadu. Natl J Community Med [Internet]. 2022 Jun. 30 [cited 2024 Nov. 23];13(06):352-8. Available from: https://njcmindia.com/index.php/file/article/view/1711

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Original Research Articles