Resilience learning from the COVID-19 pandemic and its relevance for routine immunization programs

ABSTRACT

Introduction

The COVID-19 pandemic represents a threat that has posed a challenge to public health response and threatens immunization programs globally. Despite recommendations to continue routine immunization services, disruptions have been observed to these and mass vaccination campaigns. This may result in setbacks to immunization initiative successes and a rise in cases of vaccine-preventable diseases.

Areas Covered

We conducted a systematic literature review to identify studies globally that described how indicators of health system resilience, defined using the Resilient Health System Framework, enabled routine immunizations to continue during the COVID-19 pandemic. A systematic search was conducted in Embase, Web of Science, PsychInfo, medRxiv, bioRxiv, and the gray literature between 1 January 2020, and 12 November 2021. Information was extracted from the studies identified describing how the specific elements of resiliency (being aware, diverse, self-regulating, integrated, and adaptive) were applied to their routine immunization programs.

Expert opinion

Our study demonstrates the use of tools that contributed to immunization program resilience during the COVID-19 pandemic in all geographic regions and for countries with different income levels. These tools may help inform preparations for other immunization programs to catch up from the COVID-19 pandemic or mitigate the impact of future threats.

KEYWORDS:

• Resilience
• immunization program
• routine immunization
• COVID-19
• pandemic

Article highlights

• The COVID-19 pandemic has posed a challenge to routine immunization programs globally and despite recommendations to continue with routine immunizations, disruptions have still been observed. This may cause a setback to the success of immunization initiatives and a rise in VPDs

• This paper describes a systematic review to identify studies that illustrated elements of health system resilience

• The Resilient Health System Framework proposed by Kruk et al (2017) was used to measure the extent to which an effective response was implemented

• Results showed that there were immunization programs in all regions that demonstrated resilience, using tools to mitigate the negative impact of the pandemic

• Resilience was demonstrated through communication strategies, diversifying available resources, collaboration with global, public, and private groups to develop guidelines and adapting immunization programs to allow safe vaccination procedures and by using alternative vaccination points

• These tools may help to inform preparations for other immunization programs that need to mitigate the impact of future threats or ‘shocks’ to their routine immunization services

Acknowledgments

The work has not been presented previously at a conference or similar. We acknowledge John Forbes and Kate Lothman of RTI Health Solutions for editing the manuscript

Declaration of interests

O. Falope and K. Nyaku were employees at Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA when this study was performed. C O’Rourke, LV Hermany, and B Plavchak, are currently employees at Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA and shareholders in Merck & Co., Inc., Rahway, NJ, USA. J Mauskopf and L Hartley are employees of RTI Health Solutions. RTI Health Solutions received funding from Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA to work on the study. RTI Health Solutions perform consulting services for many pharmaceutical companies. M Kruk is a member of the Harvard T.H. Chan School of Public Health, Boston, MA, USA and received no funding for her participation in this study.

Reviewer disclosures

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

Author contributions

All authors contributed to formulate concepts, identify important intellectual content, and data interpretation. LH led the systematic search process. OF, JM, and MKN drafted the manuscript. All authors reviewed and edited the drafts of the manuscript and have given final approval of the version to be published.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This paper was funded by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA.