Dear viewers
I wish to share the following concerns keeping in view of COVID-19 pandemic.
According to the “Guiding principles for immunization activity during the COVID-19 pandemic”, there is a need to sustain Routine Immunization (RI) services along with adherence to COVID-19 preventive measures for preventing accumulation of susceptible, widening population immunity gap, leading to emergence of sporadic cases, untimely / unwanted out-brakes of Vaccine Preventable Diseases (VPDs) and postponing the achievement of national and global goals.
Occurrence of out-brakes of VPDs at this juncture of COVID-19 pandemic will over fatigue already overburdened Health Care Service providers. Hence, it is wise to sustain routine immunization services to pregnant women during their Antenatal checkups, administering newborn vaccines at birthing facilities (ongoing), vaccines to <2 year healthy children brought by healthy parents at least in the well established fixed strategically placed centers like Planning Units / GH / Dist Hosp / Medical Colleges in the dedicated venue preserving required social distancing.
Up to about 8% infants permanently miss the opportunity of attaining FIC before one year if RI service is suspended for one month. If this is extended for more than a quarter, it may reverse our control / elimination / eradication reverting back to the square. In a planning unit attached to our college with >95% FIC and 1st booster coverage, Expected Due Children (EDC) is around 50% of annual target which has now crossed 80% of annual target with suspension of RI services for one month. If this gets extended for a quarter, EDC will cross 2 to 3 times the annual target.
India with 65% FIC as per Rapid Survey Of Children (RSOC), launched Mission Indradhnush (MI) in Dec 2014; through recurrent phases since then is unable to attain 90% FIC till now. Hence, once again attaining to sustain >90% FIC will be a herculean task and may take a few years – not just 4 rounds (apprehension).
Timely vaccination of children can potentially minimize vulnerable children population to the ongoing pandemic too through extra targeted (extra vaccinial) property of boosting “innate immunity” especially by the live attenuated vaccines. As a spin off, parental contact while delivering vaccination service can be better utilized for programme specific IEC / IPC.
In view of the above requesting the stakeholders / policy makers / programme managers to issue country / state / district specific guidelines as WHO has already alerted and issued for the world as a whole. Now, as per WHO directives, country specific directives and local innovations for effective operationalization with due respect to COVID-19 prevention are very much needed – a stitch in time saves nine.
With warm regards for promoting universal health
Dr Narayana Holla
Professor, Community Medicine,
KVG Medical College, Sullia
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