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The impact of COVID-19 on the implementation of routine immunisation for children in Rwanda

Edward Mbonigaba, Fengyun Yu, Mark Donald C. Reñosa, Frederick Nchang Cho, Qiushi Chen et al. · 10 Apr 2025

Abstract

Abstract Introduction The most common indirect impact of the Coronavirus Disease 2019 (COVID-19) pandemic has been the interruption of routine immunisation services, resulting in a significant decline in childhood immunisation rates, particularly during the early stages of the pandemic. This study aimed to explore the socio-demographic characteristics associated with continued routine immunisation in Rwanda. Methods A cross-sectional survey was conducted between January 3 rd to March 31 st , 2022 amongst mothers from five districts in Rwanda. Multinomial logistic regression was used to determine associations between demographic characteristics and the willingness to vaccinate children, considering the impact of the COVID-19 pandemic on vaccination attitudes. Results Among the 2,045 mothers surveyed, 92.2% and 91.6% admitted that their religion and culture support immunisation respectively. Marital status, educational status, and average monthly income were significantly associated with culture and tradition. Out of the 2,045 mothers, 77.3% and 58.7% were concerned about the serious adverse effects of vaccines and COVID-19 vaccines, while 8.1% were concerned with the safety of COVID-19 vaccines. With the exception of age, marital status, and the number of children in the immunisation age bracket, there was a significant association between the perceived risks of vaccination and all other socio-demographic characteristics. Conclusion Global routine immunisation was disrupted throughout the duration of the COVID-19 pandemic. However, Rwanda’s initial preparedness to combat infectious diseases such as Ebola minimized the influence of COVID-19 on routine immunisation in the country. This study suggests an association between routine immunisation and factors such as culture, financial constraints, vaccine misinformation, concern about adverse effects of vaccines, and apprehensions over the safety of COVID-19 vaccines.