The impact of COVID-19 and catch-up strategies on routine childhood vaccine coverage trends in Latin America: A systematic literature review and database analysis

Figures & data

Figure 1. (a) Vaccination coverage rates for selected vaccines among six countries in Latin America, 2017–2020. (b) Annual range of the change in vaccination coverage of selected vaccines among six countries in Latin America, 2020^a.

BCG, Bacillus Calmette-Guérin vaccine; DTP-3, diphtheria–tetanus–pertussis, three doses; MCV-1, measles-containing vaccine, one dose; PCV 2 or 3, pneumococcal conjugate vaccine, two or three doses; Penta, pentavalent vaccine; Rota-2, rotavirus vaccine, two doses.

*Measles-containing vaccine (measles–mumps–rubella, measles–mumps–rubella–varicella, etc.).

**For Brazil, data from WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) (July 2021) were used¹⁹, as there were no 2020 data in the Pan American Health Organization immunization report for PCV.

^aThe negative signs in the presented values refer to a decrease in coverage during/post pandemic. These values are regional ranges – for example, for the rotavirus vaccine there was a change in coverage in the selected countries ranging from 2.5% to -11.5% which comes from Mexico (biggest increase of 2.5%) and Peru (biggest decrease of 11.5%).

Figure 2. PRISMA diagram.

PRISMA, Preferred Reporting Items for Systematic Literature Reviews and Meta-Analyses; n, number of publications.

Table 1. Summary of strategies and recommendations.^{13–15,21–25,30.}.

Guidance	WHO recommends all mass vaccination campaigns be temporarily halted with exception of a VPD outbreak Vaccination of newborns and primary vaccination series were prioritized
Observations	All Latin American countries reported a decline in childhood vaccination coverage The decline in vaccination coverage was prevalent prior to the COVID-19 pandemic, suggesting the influence of multiple factors
Strategy/Recommendations	Prioritize primary vaccination series, vaccination of COVID-19 cases and individuals suspected of COVID-19 infection Controlled surveillance of VPD outbreaks Standardize catch-up strategies for missed vaccinations for the entire region

Figure 3. Plain language summary (PLS).

World Health Organization. WHO/UNICEF estimates of national immunization coverage. WUENIC; 2021 [ accessed Nov 11]. https://www.who.int/teams/immunization-vaccines-and-biologicals/immunization-analysis-and-insights/global-monitoring/immunization-coverage/who-unicef-estimates-of-national-immunization-coverage.

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World Health Organization. Immunization in the context of COVID-19 pandemic. World Health Organization; 2020 [ accessed Nov 11]. https://www.who.int/publications/i/item/immunization-in-the-context-of-covid-19-pandemic.

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