Childhood vaccinations: Hidden impact of COVID-19 on children in Singapore

Vaccine. 2021 Jan 29;39(5):780-785. doi: 10.1016/j.vaccine.2020.12.054. Epub 2020 Dec 26.

Abstract

Although the direct health impact of Coronavirus disease (COVID-19) pandemic on child health is low, there are indirect impacts across many aspects. We compare childhood vaccine uptake in three types of healthcare facilities in Singapore - public primary care clinics, a hospital paediatric unit, and private paediatrician clinics - from January to April 2020, to baseline, and calculate the impact on herd immunity for measles. We find a 25.6% to 73.6% drop in Measles-Mumps-Rubella (MMR) uptake rates, 0.4 - 10.3% drop for Diphtheria-Tetanus-Pertussis-inactivated Polio-Haemophilus influenza (5-in-1), and 8.0-67.8% drop for Pneumococcal conjugate vaccine (PCV) across all 3 sites. Consequent herd immunity reduces to 74-84% among 12-month- to 2-year-olds, well below the 95% coverage that is protective for measles. This puts the whole community at risk for a measles epidemic. Public health efforts are urgently needed to maintain efficacious coverage for routine childhood vaccines during the COVID-19 pandemic.

Publication types

  • Multicenter Study

MeSH terms

  • COVID-19 / epidemiology*
  • COVID-19 / prevention & control
  • Child Health / statistics & numerical data*
  • Child, Preschool
  • Diphtheria-Tetanus-Pertussis Vaccine / administration & dosage
  • Haemophilus Vaccines / administration & dosage
  • Hepatitis B Vaccines / administration & dosage
  • Humans
  • Immunity, Herd
  • Immunization Schedule
  • Infant
  • Measles-Mumps-Rubella Vaccine / administration & dosage
  • Poliovirus Vaccine, Inactivated / administration & dosage
  • Public Health / standards*
  • Retrospective Studies
  • Singapore / epidemiology
  • Vaccination Coverage / statistics & numerical data*

Substances

  • Diphtheria-Tetanus-Pertussis Vaccine
  • Haemophilus Vaccines
  • Hepatitis B Vaccines
  • Measles-Mumps-Rubella Vaccine
  • Poliovirus Vaccine, Inactivated