Impact of the coronavirus disease (COVID-19) pandemic on routine childhood immunization in Mwanza-Malawi, version 1.0
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Date
16-03-22
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Publisher
Kamuzu University of Health Sciences
Abstract
The type of research study: Before and after study design using routine immunization data collected in all Mwanza health facilities.
- The problem COVID-19 pandemic has created a number of global challenges which includes access to the general health care. Routine child immunization maybe part of the components affected by the COVID-19 pandemic as several studies done in different countries have shown reduction in vaccine coverage before and after or during COVID-19. The impact of COVID-19 in low income settings may be far more than what has been shown in studies conducted in other settings.
Immunization has played a major role in reducing child mortality world-wide. Reduction in coverage may thus affect the fight in reducing global child mortality. Understanding the impact of COVID-19 on immunization may therefore help in putting up targeted intervention to improve immunization amidst the COVID-19 pandemic.
- The broad objective
To compare the vaccine coverage before and during (COVID-19) pandemic on routine
childhood immunization among under-five children in Mwanza district
- Specific objective
1. To equate coverage of three specific vaccines (DPT, PCV and Measles vaccine) received by under-five children between pre and post Covid-19 at Mwanza health facility
2. To balance vaccine coverage between male and female under-five children who got their immunization services from Mwanza health facilities between pre-pandemic period
(January to December 2019) and during pandemic period (January to December 2021)
3. To assimilate vaccine coverage among under-five children who got their vaccines timely according to vaccine schedule based on age between pre-pandemic period (January to December 2019) and during pandemic period (January to December 2021) - Methodology
A before and after study design will be used for this study. All the children who received vaccine
before covid-19 and those who received vaccine during covid-19 will be included into the study
until the sample size is reached, using routinely collected medical data dated 1st April to 31st July,
2019 and 1st April to 31st July, 2020.. This study will collect demographic data of children,
Children vaccination data before Covid-19, and Children vaccination data during Covid-19
pandemic. Our Primary outcomes will be the percentage difference in the proportion of vaccinated
and the secondary outcome is Vaccine preventable outbreak.
Distributions of age, and sex will be compared between the 2019 pre-COVID-19 period and 2020 COVID-19 period. Trend analysis will be done to see the progress of vaccination. The percentage differences of routine vaccine doses administered during the pre-pandemic period (April to July 2019) and during the period of COVID-19 (April to July 2020) will be calculated and compared.
The percentage difference of routine vaccine doses administered at each health facility before and during COVID-19 will be calculated and compared. The percentage difference of routine vaccine doses administered based on age eligibility will be calculated and compared. The difference-indifference (DID) analyses will be done to take care of any normal trends due to changes in the size of the population and vaccine acceptance. And Pearson Chi-square test will be used for statistical significance test. Complete vaccination coverage for all mentioned routinely-recommended vaccines at each milestone age (6, 10, 14, weeks, 9 months and 12-15 months) in a period will be
calculated by dividing the number of children who received all routine vaccine doses before a milestone age by the number of eligible children who reached that milestone age during the period. Complete vaccination coverage by month from April to July 2019 and April to July 2020 will be estimated.
- Expected findings and their dissemination.
The study anticipates finding reduced vaccine coverage. Findings will prompt the Government of Malawi and stakeholders to introduce or roll out adequate communication strategies in order to reduce concerns about vaccinations and to redress the decline in vaccination coverage that will occur during the covid-19 pandemic period. At the same time, it will inform ministry for the need for immunization catch up campaign.
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Keywords
Impact of the coronavirus disease (COVID-19) pandemic on routine childhood immunization