Worldwide routine immunisation coverage regressed during the first year of the COVID-19 pandemic.

Whilst COVID-19 vaccination strategies continue to receive considerable emphasis worldwide, the extent to which routine immunisation (RI) has been impacted during the first year of the pandemic remains unclear. Understanding the existence, extent, and variations in RI disruptions globally may help inform policy and resource prioritisation as the pandemic continues. We modelled historical, country-specific RI trends using publicly available vaccination coverage data for diphtheria, tetanus and pertussis-containing vaccine first-dose (DTP1) and third-dose (DTP3) from 2000 to 2019. We report a 2·9% (95 % _CI : [2·2%; 3·6%]) global decline in DTP3 coverage from an expected 89·2% to a reported 86·3%; and a 2·2% decline in DTP1 coverage (95 % _CI : [1·6%; 2·8%]). These declines translate to levels of coverage last observed in 2005, thus suggesting a potential 15-years setback in RI improvements. Further research is required to understand which factors - e.g., health seeking behaviours or non-pharmaceutical interventions - linked to the COVID-19 crisis impacted vaccination coverage.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: It is noted that BE has been employed by the Clinton Health Access Initiative in the Global Vaccines team in the last three years; and is currently employed by Gavi. All research contained in this manuscript was conducted during a postgraduate qualification, outside and independent of employment. Neither facilities, data, nor any other forms of input from the Clinton Health Access Initiative or Gavi, were used in this study. The research and manuscript are independent of the Clinton Health Access Initiative and Gavi, and the findings have not been discussed, reviewed, or endorsed by the Clinton Health Access Initiative, the Gavi Secretariat, or any Alliance members.
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