The impact of COVID-19 on routine vaccinations
Reflections during World Immunization Week 2020

The global COVID-19 pandemic is overstretching health systems. Health workers are working round-the-clock to respond to the outbreak, putting them at risk of illness and death. Essential health services and vaccination services are disrupted.
As World Immunization Week starts today, we want to remind parents, health workers and partners that immunization is one of the safest and most cost-effective ways to end vaccine-preventable child deaths.
East Asia and Pacific has a mix of countries with strong health systems and weak ones. While even countries with strong health systems are stretched, countries with limited capacity to deal with major disease outbreaks are at breaking point.
People have been unable to access healthcare for regular needs, such as antenatal care, newborn screening, or immunization. They are also afraid to attend healthcare services due to fear of contracting the virus.
We know that children are missing out on critical vaccines. Vaccination campaigns have been postponed following social distancing measures, increasing the risk of disease outbreaks. Malaysia and the Philippines have had to postpone their mass polio vaccination campaigns. Not reaching these children with critical polio vaccines means that they will remain susceptible to polio and there is a danger of spread when movement restrictions ease.
There are also early indications that routine immunization coverage is decreasing, putting some countries at risk of outbreaks of extremely contagious diseases like measles. The region suffered from huge outbreaks of measles in 2018 and 2019, and fortunately these were brought under control.
Reduction in routine immunization coverage, particularly if this continues means that many children will be unvaccinated or under-vaccinated, putting their lives at risk of vaccine preventable diseases. In 2018, approximately 2.6 million children in East Asia and Pacific did not even receive their measles vaccination nor their third dose of Diphtheria, Tetanus and Pertussis (protecting children from debilitating and deadly illnesses) through routine immunization.
These are difficult times. Parents may feel overwhelmed with worries. Our message to them is clear, make sure children receive their routine immunizations while following national and local preventive measures including physical distancing, handwashing, and proper coughing/sneezing hygiene. For parents facing economic hardship, having to treat their children from these vaccine preventable diseases would put them in an even more dire situation.
The temporary interruptions in immunization services while not ideal, are unavoidable as we must contain the spread of COVID-19. It will be important to seek immunization for children as soon as services resume.
COVID-19 and vaccines
The pandemic is a stark reminder of how fast an outbreak can spread without a vaccine to protect us. The science is clear. Vaccines are safe, effective and life-saving tools to control and prevent outbreaks of infectious diseases.
No vaccine exists yet for COVID-19 and one that meets rigorous testing standards is many months away from a widespread roll out. When the vaccine becomes available it will depend on strong immunization services to reach the most vulnerable.
Immunization is one of the best ways to protect children
Thanks to vaccines, many of us have been fortunate to grow up without seeing family or friends die or suffer life-long disability from diseases like measles or polio. Vaccines have eliminated these diseases from many countries.
Most parents choose to vaccinate their children. However, in some countries, misinformation has undermined trust in vaccines, causing some parents to delay or refuse vaccination. Disseminating accurate information and stopping the spread of misinformation is important to ensure that every child is protected with life-saving vaccines
Immunization is the right of every child and should reach every child
Protection from vaccine-preventable diseases is a child’s basic right.
COVID-19 is terrible proof that outbreaks can happen in many countries at the same time. The global resurgence of measles is putting young children at risk.
Now is the time to vigorously monitor the impact on immunization and plan for services that reach the most vulnerable once restrictions are lifted. This careful planning, coupled with safety measures for healthcare providers, caregivers and children, will help prevent future outbreaks and save lives.
Dr. Kunihiko Hirabayashi is Regional Health Advisor at UNICEF East Asia & Pacific