Peer-reviewed article
The Impact of COVID-19 Pandemic on Inequity in Routine Childhood Vaccination Coverage: A Systematic Review
Nick J Spencer, Wolfgang A. Markham, Samantha Ann Johnson, Emmanuelle Arpin, Rita Nathawad et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examined how the COVID-19 pandemic affected inequities in routine childhood vaccination coverage across countries. The researchers searched 13 studies published between January 2020 and January 2022 that reported vaccination data stratified by equity measures. The review found moderate evidence that vaccination coverage inequities increased during COVID-19 lockdowns compared to pre-pandemic periods, with some evidence suggesting higher inequity among infants and in middle-income countries. The authors conclude that more research from diverse countries is needed to understand the global impact.
Key points
- Thirteen studies met inclusion criteria from 1,453 reviewed, indicating limited evidence base
- Moderate evidence found for inequity in reducing vaccination coverage during COVID-19 lockdowns
- Moderately strong evidence for increased inequity compared with pre-pandemic months
- Two studies reported higher inequity rates among children aged less than one year
- One study showed higher inequity rates in middle-income compared with high-income countries
Limitations
The review included only thirteen studies, representing a limited evidence base, and the geographic representation was uneven. The authors acknowledge that more research from diverse countries is needed to assess the true global effect of the pandemic on vaccination inequity.
Abstract
BACKGROUND: Routine childhood vaccination coverage rates fell in many countries during the COVID-19 pandemic, but the impact of inequity on coverage is unknown. METHODS: We synthesised evidence on inequities in routine childhood vaccination coverage (PROSPERO, CRD 42021257431). Studies reporting empirical data on routine vaccination coverage in children 0-18 years old during the COVID-19 pandemic by equity stratifiers were systematically reviewed. Nine electronic databases were searched between 1 January 2020 and 18 January 2022. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Tool for Cohort Studies. Overall, 91 of 1453 studies were selected for full paper review, and thirteen met the inclusion criteria. RESULTS: The narrative synthesis found moderate evidence for inequity in reducing the vaccination coverage of children during COVID-19 lockdowns and moderately strong evidence for an increase in inequity compared with pre-pandemic months (before March 2020). Two studies reported higher rates of inequity among children aged less than one year, and one showed higher inequity rates in middle- compared with high-income countries. CONCLUSIONS: Evidence from a limited number of studies shows the effect of the pandemic on vaccine coverage inequity. Research from more countries is required to assess the global effect on inequity in coverage.