About: 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

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About: 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 Goto Sponge NotDistinct Permalink

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Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	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
Creator	Funk, Sebastian Jit, Mark Van Zandvoort, Kevin Abbas, Kaja Clark, Andrew Procter, Simon Dansereau, Emily Hogan, Dan Mengistu, Tewodaj
Source	Elsevier; Medline; PMC
abstract	BACKGROUND: National immunisation programmes globally are at risk of suspension due to the severe health system constraints and physical distancing measures in place to mitigate the ongoing COVID-19 pandemic. We aimed to compare the health benefits of sustaining routine childhood immunisation in Africa with the risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection through visiting routine vaccination service delivery points. METHODS: 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. In the high-impact scenario, we used previously reported country-specific child mortality impact estimates of childhood immunisation for diphtheria, tetanus, pertussis, hepatitis B, Haemophilus influenzae type b, Streptococcus pneumoniae, rotavirus, measles, meningitis A, rubella, and yellow fever to approximate the future deaths averted before 5 years of age by routine childhood vaccination during a 6-month COVID-19 risk period without catch-up campaigns. In the low-impact scenario, we approximated the health benefits of sustaining routine childhood immunisation on only the child deaths averted from measles outbreaks during the COVID-19 risk period. We assumed that contact-reducing interventions flattened the outbreak curve during the COVID-19 risk period, that 60% of the population will have been infected by the end of that period, that children can be infected by either vaccinators or during transport, and that upon child infection the whole household will be infected. Country-specific household age structure estimates and age-dependent infection-fatality rates were applied to calculate the number of deaths attributable to the vaccination clinic visits. We present benefit–risk ratios for routine childhood immunisation, with 95% uncertainty intervals (UIs) from a probabilistic sensitivity analysis. FINDINGS: In the high-impact scenario, for every one excess COVID-19 death attributable to SARS-CoV-2 infections acquired during routine vaccination clinic visits, 84 (95% UI 14–267) deaths in children could be prevented by sustaining routine childhood immunisation in Africa. The benefit–risk ratio for the vaccinated children is 85 000 (4900–546 000), for their siblings (<20 years) is 75 000 (4400–483 000), for their parents or adult carers (aged 20–60 years) is 769 (148–2700), and for older adults (>60 years) is 96 (14–307). In the low-impact scenario that approximates the health benefits to only the child deaths averted from measles outbreaks, the benefit–risk ratio to the households of vaccinated children is 3 (0–10); if the risk to only the vaccinated children is considered, the benefit–risk ratio is 3000 (182–21 000). INTERPRETATION: The deaths prevented by sustaining routine childhood immunisation in Africa outweigh the excess risk of COVID-19 deaths associated with vaccination clinic visits, especially for the vaccinated children. 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. FUNDING: Gavi, the Vaccine Alliance; Bill & Melinda Gates Foundation.
has issue date	2020-07-17(xsd:dateTime)
bibo:doi	10.1016/s2214-109x(20)30308-9
bibo:pmid	32687792
has license	no-cc
sha1sum (hex)	e133fe094637347ac784cf95a3284d29b4e83db8
schema:url	https://doi.org/10.1016/s2214-109x%2820%2930308-9
resource representing a document's title	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
has PubMed Central identifier	PMC7367673
has PubMed identifier	32687792
schema:publication	Lancet Glob Health
resource representing a document's body	covid:e133fe094637347ac784cf95a3284d29b4e83db8#body_text
is schema:about of	named entity 'visiting' named entity 'COVID-19' named entity 'IMMUNISATION' covid:arg/e133fe094637347ac784cf95a3284d29b4e83db8 named entity 'risk' named entity 'health system' named entity 'immunisation' named entity 'COVID' named entity 'severe acute respiratory syndrome coronavirus 2' named entity 'public health' named entity 'measles outbreak' named entity 'points' named entity 'Africa' named entity 'severe acute respiratory syndrome coronavirus 2' named entity 'childhood immunisation' named entity 'childhood immunisation' named entity 'vaccination' named entity 'infection control' named entity 'immunisation' named entity 'childhood immunisation' named entity 'missing data' named entity 'COVID-19' named entity 'Africa' named entity 'deaths in children' named entity 'infection' named entity 'EPI' named entity 'EPI' named entity 'older adults' named entity 'COVID' named entity 'physical distancing' named entity 'vaccination' named entity 'Africa' named entity 'immunisation' named entity 'vaccination' named entity 'per-capita' named entity 'Africa' named entity 'COVID-19 pandemic in Africa' named entity 'transmissibility' named entity 'measles' named entity 'tuberculosis' named entity 'yellow fever' named entity 'fatality rate' named entity 'EPI' named entity 'ethics' named entity 'COVID-19' named entity 'physical distancing' named entity 'Haemophilus influenzae' named entity 'vaccine-preventable diseases' named entity 'cold-chain' named entity 'quality-adjusted life-years' named entity 'hepatitis' named entity 'Chad' named entity 'Egypt' named entity 'EPI' named entity 'older adults' named entity 'immunisation programme' named entity 'immunisation' named entity 'childhood immunisation' named entity 'infection control' named entity 'Africa' named entity 'SARS-CoV-2' named entity 'childhood immunisation' named entity 'childhood immunisation' named entity 'key factor' named entity 'Africa' named entity 'equitable access' named entity 'SARS-CoV-2' named entity 'immunisation' named entity 'COVID-19 pandemic' named entity 'vaccine-preventable' named entity 'DTP' named entity 'herd immunity' named entity 'childhood immunisation'

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