COVID-19's lost generation of unvaccinated children

In their modelling study, Kaja Abbas and colleagues (October, 2020)1 state that routine childhood immunisation is “at risk of suspension” and “should be sustained in Africa as much as possible… during the COVID-19 pandemic”. It is now more than 6 months since the paper was first posted as a working paper, approximating the 6-month COVID-19 risk period modelled by the authors. We now know that immunisation programmes in Africa (and beyond) were severely disrupted.2

The authors' two scenarios show how uncertain our understanding is of the pandemic's indirect health effects on immunisation services. The deaths due to the disruption of routine immunisation were estimated to be between 25 584 ([194 388 + 10 282] × 12·5%) in the low-impact scenario and 701 828 in the high-impact scenario. That is a 27-times difference, driven exclusively by whether catch-up activities occur.