A benefit–risk analysis of health benefits versus excess risk of SARS-CoV-2 infection
For each excess COVID-19 death due to infections acquired during routine vaccination clinic visits, 84 deaths in children could be prevented by continuing routine childhood vaccination in Africa, according to a scenario modeled by the London School of Hygiene & Tropical Medicine.
Findings were published in The Lancet Global Health.
Childhood immunisation programmes around the world face substantial disruptions because of pandemic resource constraints and distancing policies.
“We considered a high-impact scenario and a low-impact scenario to approximate the child deaths that could be caused by immunisation coverage reductions during COVID-19 outbreaks,” authors wrote.
In the high-impact scenario, the team examined how much childhood immunisation is estimated to have reduced mortality from diphtheria, tetanus, pertussis, hepatitis B, Haemophilus influenzae type b, Streptococcus pneumoniae, rotavirus, measles, meningitis A, rubella, and yellow fever.
This allowed the team to approximate deaths averted before 5 years of age by routine childhood vaccination during a 6-month COVID-19 risk interval, without catch-up campaigns. In the low-impact scenario, the approximated the health benefits of sustaining routine childhood immunisation on only the child deaths averted from measles outbreaks during the COVID-19 risk period.
The team relied on several assumptions for the sake of modeling: the continued use of some mitigation efforts during the COVID-19 risk period, a 60% population infection rate by the end of the modeling period period, that children can be infected either by medical personnel at vaccine sites or during travel, and that upon child infection the whole household is at risk of infection.
In both high and low impact scenarios, deaths averted by continuing routine childhood immunisation in Africa outweigh the excess risk of COVID-19 deaths associated with clinic visits, especially for vaccinated children themselves.
“Routine childhood immunisation should be sustained in Africa as much as possible, while considering other factors such as logistical constraints, staff shortages, and reallocation of resources during the COVID-19 pandemic,” authors concluded.