Risks of low vaccination coverage and strategies to prevent the resurgence of vaccine-preventable diseases in infants in the COVID-19 pandemic scenario: recommendations for Latin America and the Caribbean by the group of experts on infant immunization for Latin America

ABSTRACT

Introduction

The WHO 2030 Immunization Agenda (IA-2030) harmonizes immunization activity plans at community, national, regional and global levels. Additionally, medical societies play an important role. The Latin American Group of Experts on Infant Immunization, established in 2018, advises on the harmonization, update, and optimization of infant vaccination programs in Latin America and the Caribbean (LAC). In September 2021, 41 such experts from 13 LAC countries met to develop recommendations for increasing regional vaccination coverage to avoid the reemergence of vaccine-preventable diseases and/or the occurrence of outbreaks.

Areas covered

The following items were evaluated: (i) immunization challenges before and during the COVID-19 pandemic; (ii) the status of current immunization programs, particularly infant pertussis and polio vaccination; (iii) possible solutions for overcoming vaccination challenges and achieving regional vaccination coverage targets.

Expert opinion/commentary

Medical societies provide valuable recommendations to guide and update vaccination schedules. In the LAC region, possible strategies to achieve target vaccination rates include the use of combination vaccines, strengthening surveillance systems, improving school attendance, advancing vaccine education and confidence, striving for vaccination equity, widening operational capacity, creating strategic alliances, and strengthening the role of medical groups. It is hoped that these recommendations will be implemented in the LAC region.

KEYWORDS:

• Vaccination challenges
• COVID-19
• medical societies
• pertussis
• polio
• recommendation
• regional

Article highlights

• Vaccination coverage has fallen sharply in recent years, which has been made worse by the impact of the COVID-19 pandemic.

• Low rates of vaccination lead inevitably to the resurgence of vaccine-preventable diseases.

• The global resurgence of whooping cough and poliomyelitis are of particular concern, with increased incidence linked to a range of factors, including inequities in vaccine access, suboptimal infant vaccine coverage, vaccine hesitancy, migration, and circulating oral polio vaccine-derived polioviruses.

• Medical societies, such as the Latin American Group of Experts on Infant Immunization are important in the development of recommendations to support the harmonization, update, and optimization of infant vaccination programs at the regional and national levels.

• Recommendations to overcome the challenges associated with the resurgence of vaccine-preventable childhood diseases in Latin America and the Caribbean include strengthening surveillance systems, improving school attendance, advancing vaccine education and confidence, striving for vaccination equity, widening operational capacity, creating strategic alliances, and strengthening the role of medical groups.

• The use of pentavalent or hexavalent combination pediatric vaccines allows for protection against 5 or 6 common childhood diseases in a single injection, and leads to improved vaccine coverage, compliance and equity, reduced use of supplies, and simplified implementation of vaccination programs.

• Expert recommendations should be disseminated in Latin America and the Caribbean to combat the re-emergence and/or the occurrence of outbreaks of vaccine-preventable diseases.

Declaration of interests

ML Ávila-Agüero declares consulting fees (consulting and advisory boards) from Sanofi, Pfizer, MSD, and Johnson & Johnson, and honoraria from Sanofi, Pfizer, and MSD for lecturing or chairing events. J Brea-del Castillo declares consulting fees (consulting and advisory boards) from Sanofi and MSD, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Pfizer, MSD, and Sanofi, and leadership or fiduciary role in other board, society, committee or advocacy group (unpaid) for the Latino American Pediatric Infectious Diseases Society and the Dominican Society of Vaccinology. LH Falleiros-Arlant declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sanofi, MSD, Sociedad Latinoamericana de Infectologia Pediatrica (SLIPE), and Brazilian Society of Inmunization (SBIm), support for attending meetings and/or travel from Sanofi, MSD, SLIPE, and SBIm, participation on a Data Safety Monitoring Board or Advisory Board for Sanofi, SLIPE, and SBIm, leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, for Sanofi, SLIPE, SBIm, and Technical Committee of Certification of Polio Eradication (Brazilian Ministry of Health). E Berezin declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Pfizer and Sanofi, payment for expert testimony from Pfizer and MSD, and support for attending meetings and/or travel from Sanofi and MSD. C Torres Martínez declares consulting fees from Sanofi, Pfizer, and MSD (consulting and advisory boards) and Medscape (consulting), payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sanofi, Pfizer, and MSD, and support for attending meetings and/or travel from Pfizer and Sanofi. EL Lopez declares consulting fees from Sanofi, Pfizer, and MSD (consulting and advisory boards) and Medscape (consulting), payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sanofi, Pfizer, and MSD, and support for attending meetings and/or travel from Pfizer and Sanofi. A Laris-Gonzalez declares a one-time payment (consulting fee) for the current work, support for attending meetings and/or travel from Sanofi. JPTT declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sanofi. E López-Medina declares grants or contracts from Sanofi, GSK, and Janssen, and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sanofi, MSD, GSK, Pfizer, and Takeda. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors made substantial contributions to the development of the work, the analysis and interpretation of the data, reviewed it critically, approved the final version to be published, and are fully accountable for all aspects of the work.

Acknowledgements

Dr Andrew Lane (Lane Medical Writing) provided medical writing assistance, funded by Sanofi, in the preparation and development of the manuscript in accordance with the European Medical Writers Association guidelines and Good Publication Practice.

Additional information

Funding

This manuscript was funded by Sanofi.