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Impact of the COVID-19 pandemic on routine childhood immunisation in Colombia
  1. Jose Moreno-Montoya1,
  2. Silvia Marcela Ballesteros1,
  3. Jaid Constanza Rojas Sotelo2,
  4. Clara Lucia Bocanegra Cervera2,
  5. Pedro Barrera-López1,
  6. José A De la Hoz-Valle1
  1. 1Clinical Studies and Clinical Epidemiology Division, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogota, Colombia
  2. 2Ministerio de Salud y Protección Social, Gobierno de Colombia, Bogota, Colombia
  1. Correspondence to Dr Jose Moreno-Montoya, Clinical Studies and Clinical Epidemiology Division, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogota, Colombia; josemorenomontoya{at}gmail.com

Abstract

Objective To assess the impact of the COVID-19 pandemic on routine childhood vaccination coverage in Colombia by age group, rural/urban residence, state and vaccine type.

Design Ecological study of official monthly vaccination records.

Setting Vaccination records from the Colombian Ministry of Health (March–October 2019 and 2020).

Participants Aggregated data for Colombian children (<12 months, n=676 153; 12–23 months, n=700 319; and 5 years, n=734 295) participating in the Expanded Program on Immunization.

Main outcome measures Proportion of eligible population receiving vaccination.

Results Vaccination coverage showed an overall decline of approximately 14.4% from 2019 to 2020 (2019 coverage=76.0, 2020 coverage=61.6%). The greatest reduction in proportion vaccinated was observed in children <12 months of age for pneumococcal vaccine (second dose) (2019 coverage=81.4%; 2020 coverage=62.2%; 2019–2020 absolute difference, 19.2%; 95% CI 14.8% to 23.7%). For children aged 12–23 months, the proportion vaccinated for yellow fever declined by 16.4% (12.4% to 20.9%) from 78.3% in 2019 to 61.8% in 2020. Among children 5 years of age, the biggest decrease occurred for the oral polio vaccine (second dose), with a difference of 11.4% (7.1% to 15.7%) between 2019 and 2020 (73.1% and 61.7% for 2019 and 2020). We observed a statistically significant effect on vaccine coverage in rural versus urban areas for children <12 months and 5 years of age.

Conclusions Reduced uptake of immunisations during the COVID-19 pandemic poses a serious risk of vaccine-preventable disease outbreaks. Colombia and other middle-income countries need to continue to monitor immunisation programme coverage and disease outbreaks at the national and subnational levels and undertake catch-up vaccination activities.

  • COVID-19
  • epidemiology
  • health services research

Data availability statement

Data are available upon reasonable request from the Colombian Ministry of Health and Social Protection. Restrictions apply to the availability of these data, which were used under licence for this study. Data are available from the authors with the permission of the Ministry of Health and Social Protection.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Data availability statement

Data are available upon reasonable request from the Colombian Ministry of Health and Social Protection. Restrictions apply to the availability of these data, which were used under licence for this study. Data are available from the authors with the permission of the Ministry of Health and Social Protection.

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Footnotes

  • Contributors JM-M conceived the study and performed the analysis and interpretation of the data. JCRS and CLBC contributed towards the acquisition of data for the work. JM-M, SMB, JCRS, CLBC, PB-L and JADlH-V drafted the manuscript and revised it critically for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.