COVID-19-related disruptions to routine vaccination services in India: a survey of paediatric providers

  1. Anita Shet
  2. Baldeep Dhaliwal
  3. Preetika Banerjee
  4. Kelly Carr
  5. Andrea DeLuca
  6. Carl Britto
  7. Rajeev Seth
  8. Bakul Parekh
  9. Gangasamudra V Basavaraj
  10. Digant Shastri
  11. Piyush Gupta

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Abstract

The COVID-19 pandemic has led to disruptions in essential health services globally. We surveyed Indian paediatric providers on their perceptions of the impact of the pandemic on routine vaccination. Among 424 (survey 1) and 141 (survey 2) respondents representing 26 of 36 Indian states and union territories, complete suspension of vaccination services was reported by 33.4% and 7.8%, respectively. In April–June 2020, 83.1% perceived that vaccination services dropped by half, followed by 32.6% in September 2020, indicating slow resumption of services. Concerns that vaccine coverage gaps can lead to mortality were expressed by 76.6%. Concerted multipronged efforts are needed to sustain gains in vaccination coverage.

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  1. Version published to 10.1136/bmjpo-2021-001060
  2. ScreenIT

    SciScore for 10.1101/2021.01.25.21250040: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was reviewed by the JHSPH Institutional Review Board (IRB) and approved as a non-human subjects research.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

    There are several limitations in this study. Immunization is predominantly offered by the public health sector in India, while the private health sector typically covers <10% of the population[20, 21]. Our results reflect a small proportion of the health care system in India, and may not represent effects in government and rural areas. Nonetheless, the private sector represents a substantial number of children in India, and can play an important role in supporting immunization activities undertaken by the government as seen in studies around the world[22]. The sample size was relatively small, and there may be selection bias as only those pediatricians interested in immunization may have responded. There were slight differences in the two rounds of the survey, as questions were modified for the second round based on new learnings, and the number of responses were lower in the second round. There is growing evidence that the risk-benefit ratio is decidedly in favor of continuing vaccination services even when considering consequences of doing so during the pandemic[23]. Gaining provider insights on effective strategies is essential to establishing context-specific mechanisms to prioritize catch-up for missed vaccines, as well as ensure there is infrastructure in place for roll-out of the recently approved COVID-19 vaccine. The way forward should include an increased focus on catch-up campaigns, strong government engagement, effective surveillance, modelling analyses based on v...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.01.25.21250040v1 on medRxiv