The Hidden Impact of the COVID-19 Pandemic on Routine Childhood Immunization Coverage in Cameroon.
Yauba Saidu, Pietro Di Mattei, Sangwe Clovis Nchinjoh, Nnang Nadege Edwige, Bernard Nsah, Nkwain Jude Muteh, Shalom Tchokfe Ndoula, Rakiya Abdullahi, Chen Stein Zamir, Andreas Ateke Njoh, Amani Adidja, Sidy Ndiaye, Owens Wiwa, Emanuele Montomoli, Sue Ann Costa Clemens
Author Information
Yauba Saidu: Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon. ORCID
Pietro Di Mattei: Gavi, The Vaccine Alliance, 1202 Geneva, Switzerland.
Sangwe Clovis Nchinjoh: Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon. ORCID
Nnang Nadege Edwige: Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon.
Bernard Nsah: Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon.
Nkwain Jude Muteh: Gavi, The Vaccine Alliance, 1202 Geneva, Switzerland.
Shalom Tchokfe Ndoula: Expanded Program on Immunization, Cameroon Ministry of Public Health, Yaounde P.O. Box 2084, Cameroon.
Rakiya Abdullahi: Global Vaccine Team, Clinton Health Access Initiative Inc., Boston, MA 02127, USA.
Chen Stein Zamir: Faculty of Medicine, The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel. ORCID
Andreas Ateke Njoh: Expanded Program on Immunization, Cameroon Ministry of Public Health, Yaounde P.O. Box 2084, Cameroon.
Amani Adidja: Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaounde B.P. 337, Cameroon.
Sidy Ndiaye: Regional Office for Africa, World Health Organization, Brazzaville P.O. Box 06, Congo.
Owens Wiwa: Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon.
Emanuele Montomoli: Institute for Global Health, University of Siena, 53100 Siena, Italy.
Sue Ann Costa Clemens: Institute for Global Health, University of Siena, 53100 Siena, Italy.
: The third round of the global pulse survey demonstrated that the abrupt and rapid progression of the COVID-19 pandemic significantly disrupted childhood immunization in many countries. Although Cameroon has reported over 120,000 COVID-19 cases, the reported national childhood vaccination coverage during the pandemic seems to have increased compared to that during the pre-COVID-19 period. Indeed, the first dose of the diphtheria, tetanus, and pertussis-containing vaccine (DTP-1) coverage increased from 85.4% in 2019 to 87.7% in 2020, and DTP-3 coverage increased from 79.5% in 2019 to 81.2% in 2020. The paucity of literature on the impact of COVID-19 on childhood vaccination in COVID-19 hotspot regions poses a challenge in developing a context-specific immunization recovery plan, hence the need to conduct this study. : We conducted a cross-sectional study using 2019 (pre-pandemic period) and 2020 (pandemic period) district childhood immunization data from the DHIS-2 database, weighted using completeness for each data entry against regional data completeness in 2020. Based on COVID-19 incidence, two hotspot regions were selected, with all districts (56/56) included in the final analysis. The Chi-square test was used to compare DTP-1 and DTP-3 coverage during the pre-pandemic and pandemic periods. : In the two hotspot regions, 8247 children missed DTP-1, and 12,896 children did not receive DTP-3 vaccines in the pandemic period compared to the results from the pre-pandemic period. Indeed, there was a significant drop in DTP-1 and DTP-3 coverage of 0.8% ( = 0.0002) and 3.1% ( = 0.0003), respectively, in the Littoral Region. Moreover, the Centre Region reported a 5.7% ( < 0.0001) and 7.6% ( < 0.0001) drop in DTP-1 and DTP-3 coverage, respectively. Most districts in the hotspot regions reported a decline in childhood immunization access (62.5%) and utilization (71.4%). Indeed, in the Littoral Region, 46% (11/24) and 58% (14/24) of districts experienced decreased vaccination access and utilization, respectively. Meanwhile, 75% (24/32) and 81% (26/32) of districts in the Centre Region experienced a drop in vaccination access and utilization, respectively. : This study reported a situation where the national immunization indicators mask the impact of COVID-19 on childhood immunization in heavily hit regions. Therefore, this study presents valuable information for ensuring continuous vaccination service delivery during public health emergencies. The findings could also contribute to developing an immunization recovery plan and informing policy on future pandemic preparedness and response.
