Tracking the impact of the COVID-19 pandemic on routine infant vaccinations in the Dominican Republic

ABSTRACT

As the COVID-19 pandemic progresses, millions of infants are unprotected against immune-preventable diseases due to interruptions in vaccination services. The direct effects of the pandemic, as well as the non-pharmacological interventions for its containment, mitigation and suppression adopted by many countries, have affected their vaccination programs. We conducted an ecological study analyzing the performance of the vaccination program in the Dominican Republic before (2019) and during the COVID-19 pandemic (2020). We compared annual public coverage data, analyzed trends and changes in coverage, dropout rate, and number of partially and unvaccinated infants by geographic area and COVID-19 incidence rate. Compared to baseline, coverage for all vaccines decreased by 10.4 (SD, 3.6) percent; among these, coverage for the third dose of the pentavalent vaccine decreased from 90.1% in 2019 to 81.1% in 2020. The number of partially vaccinated (n = 34,185) and unvaccinated (n = 5,593) infants increased 66% and 376%, respectively. The slight increase in the annual dropout rate (1.1%) was directly proportional to the number of COVID-19 cases per month. We found a significant association between the annual absolute change of Penta3 and the subnational Human Development Index. The pandemic significantly weakened the performance of the routine vaccination program. Interventions are needed to recover and maintain lost vaccination coverage, reducing the risk of outbreaks of preventable diseases, especially in those provinces with less human development.

KEYWORDS:

• COVID-19
• immunization coverage
• public health
• routine immunization
• vaccination

Acknowledgments

We thank Carlos Sosa for statistical comments and Antonio Peramo for comments, suggestions, and language improvement.

Author contributions

MC conceived and designed the study, carried out the statistical analysis, and drafted the paper; JD and AG analyzed the data, interpreted the results, and contributed drafting the manuscript. All authors read and approved the final manuscript.

Disclosure of potential conflicts of interest

No potential conflicts of interest were disclosed.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website at https://doi.org/10.1080/21645515.2021.1972708.