Routine childhood immunisation during the COVID-19 pandemic in Africa: a benefit-risk analysis of health benefits versus excess risk of SARS-CoV-2 infection

July 17, 2020

Abbas K, Procter SR, van Zandvoort K, et al.

Lancet Global Health

To understand the effects of suspending mass vaccination campaigns, Abbas et al. conducted a benefit-risk analysis of childhood immunization during the pandemic, utilizing data from all 54 countries in Africa. Specifically, the study compared vaccine-preventable deaths averted through scheduled childhood immunization to deaths due to SARS-CoV-2 contracted through visiting vaccine sites for routine vaccination. Modelling efforts focused on the delivery of childhood immunizations at five points throughout infancy during a six- month period and utilized health impact estimates to calculate an annual number of deaths averted per 1000 vaccinated children. Results of the modelling efforts showed that, in a high impact situation, for every death due to SARS-CoV-2 exposure during routine childhood immunization programs, these programs would prevent 84 (95% UI 14-267) deaths in children under 5 years of age. One third of the 702,000 averted deaths, in children up to 5 years of age in Africa over a six-month period, were attributed to measles and pertussis, followed by DTP, hepatitis B, and S pneumoniae, and others. Excess deaths due to SARS-CoV-2 infections primarily occurred among parents, adult caregivers, and older adults in the household of the vaccinated child. In low impact scenarios, the benefit-risk ratio for the majority of countries in Africa as greater than one. This indicates the overall benefits of continuing childhood vaccination programs during the pandemic, granted that vaccination centers continue with implementing infection prevention and control measures.

Abbas K, Procter SR, van Zandvoort K, et al. Routine childhood immunisation during the COVID-19 pandemic in Africa: a benefit–risk analysis of health benefits versus excess risk of SARS-CoV-2 infection. Lancet Glob Heal 2020; 8: e1264–72.

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