Inequalities in COVID-19 disruption of routine immunisations and returning to pre-COVID immunisation rates

As the world continues to navigate the unprecedented impact of the COVID-19 pandemic, in the absence of effective treatments and curative pharmaceutical interventions, countries have resorted to behavioural measures to mitigate the impact of the pandemic. Widespread national and regional lockdowns, curfews, and social distancing have become the norm, with devastating consequences for all aspects of life, including public health. The pandemic has disrupted all essential health services. However, routine immunisation services are amongst the hardest hit, with a suspension of mass vaccination campaigns, low footfall across vaccination centres, and disruptions in global vaccine supply chains [[1]].

In this issue of The Lancet Regional Health – Western Pacific, a cross-sectional survey by Harris and colleagues [[2]] shows that 18 out of 19 participating countries in the Southeast Asia and Western Pacific regions reported disruption to routine immunisations across all age groups, with a median of 15 antigens disrupted per country. The authors further showed that DTP, measles, rubella, and inactivated polio vaccines were affected in 17 out of the 19 countries. The oral polio vaccine (OPV) was impacted in all 12 countries that routinely delivered the vaccine. These findings substantiate the extent of disruption and serve as a harbinger for future outbreaks of vaccine-preventable diseases in children as collateral damage of the pandemic. Preliminary evidence of dangerous immunity gaps worldwide is already coming to the forefront, evident from recent surges of measles and polio outbreaks in around 30 countries including Niger, Afghanistan, and Pakistan [[3]].