PDF(Pubmed)
Abstract：
BACKGROUND: In the Americas, deaths by diseases avoidable with vaccines are a significant contributor to child mortality. An essential means of reducing this is through broad vaccine coverage. The COVID-19 pandemic has posed a potential disruption to vaccine coverage due to its effects on the healthcare system.
OBJECTIVE: this study aims to evaluate the impact of the COVID-19 pandemic on DTP3 vaccination coverage in the Americas, investigating trends from 2012 to 2022 to identify significant changes, regional disparities, and the overall effect of the pandemic on progress towards global immunization targets.
METHODS: This study used the coverage data for the third dose of the diphtheria, tetanus, and pertussis vaccine (DTP3) pulled from UNICEF databases spanning 2012 to 2022. We conducted a Joinpoint regression to identify points of significant trend changes. The annual percentage change (APC) and 95% confidence intervals (95% CIs) were calculated for America and its regions. We also used segmented regression analysis. Using the Chi-square test, we compared DTP3 vaccination coverage for each country between 2019 and 2022.
RESULTS: Overall, America saw a decrease in vaccine coverage during this period, with an APC of -1.4 (95% CI -1.8; -1.0). This trend varied across regions. In North America, the decrease was negligible (-0.1% APC). South America showed the steepest decrease, with an APC of -2.5%. Central America also declined, with an APC of -1.3%. Our findings suggest a concerning trend of declining DTP-vaccination rates in the Americas, exacerbated in certain regions, in the wake of the COVID-19 pandemic. The absolute decrease in vaccine coverage in the Americas was -4% between 2019 and 2022, with the most important drop being in Central America (-7%). However, six countries reported increased vaccination rates post-COVID-19, led by Brazil, with a 7% increase. Conversely, twenty-two countries registered a decline in DTP3 vaccine coverage, with the average decrease being -7.37%. This decline poses an important challenge to achieving the WHO\'s target of 90% coverage for the third dose of DTP by 2030, as evidenced by the reduction in the number of countries meeting this target from 2019 to 2022.
CONCLUSIONS: The COVID-19 pandemic has impacted vaccine coverage in America, leading to a decrease, especially across Central America.
OBJECTIVE: this study aims to evaluate the impact of the COVID-19 pandemic on DTP3 vaccination coverage in the Americas, investigating trends from 2012 to 2022 to identify significant changes, regional disparities, and the overall effect of the pandemic on progress towards global immunization targets.
METHODS: This study used the coverage data for the third dose of the diphtheria, tetanus, and pertussis vaccine (DTP3) pulled from UNICEF databases spanning 2012 to 2022. We conducted a Joinpoint regression to identify points of significant trend changes. The annual percentage change (APC) and 95% confidence intervals (95% CIs) were calculated for America and its regions. We also used segmented regression analysis. Using the Chi-square test, we compared DTP3 vaccination coverage for each country between 2019 and 2022.
RESULTS: Overall, America saw a decrease in vaccine coverage during this period, with an APC of -1.4 (95% CI -1.8; -1.0). This trend varied across regions. In North America, the decrease was negligible (-0.1% APC). South America showed the steepest decrease, with an APC of -2.5%. Central America also declined, with an APC of -1.3%. Our findings suggest a concerning trend of declining DTP-vaccination rates in the Americas, exacerbated in certain regions, in the wake of the COVID-19 pandemic. The absolute decrease in vaccine coverage in the Americas was -4% between 2019 and 2022, with the most important drop being in Central America (-7%). However, six countries reported increased vaccination rates post-COVID-19, led by Brazil, with a 7% increase. Conversely, twenty-two countries registered a decline in DTP3 vaccine coverage, with the average decrease being -7.37%. This decline poses an important challenge to achieving the WHO\'s target of 90% coverage for the third dose of DTP by 2030, as evidenced by the reduction in the number of countries meeting this target from 2019 to 2022.
CONCLUSIONS: The COVID-19 pandemic has impacted vaccine coverage in America, leading to a decrease, especially across Central America.
摘要：
背景：在美洲，疫苗可避免的疾病死亡是儿童死亡率的重要因素。减少这种情况的重要手段是通过广泛的疫苗覆盖率。由于COVID-19大流行对医疗保健系统的影响，它对疫苗覆盖率构成了潜在的破坏。
目的：本研究旨在评估COVID-19大流行对美洲DTP3疫苗接种率的影响，调查2012年至2022年的趋势，以确定重大变化，地区差异，以及大流行对实现全球免疫目标的总体影响。
方法：这项研究使用了第三剂白喉的覆盖率数据，破伤风,和百日咳疫苗（DTP3）从联合国儿童基金会数据库中提取了2012年至2022年。我们进行了Joinpoint回归来识别显著趋势变化的点。计算了美国及其地区的年度百分比变化（APC）和95％置信区间（95％CIs）。我们还使用了分段回归分析。使用卡方检验，我们比较了2019年至2022年每个国家的DTP3疫苗接种覆盖率。
结果：总体而言，在此期间，美国的疫苗覆盖率有所下降，APC为-1.4（95%CI-1.8；-1.0）。这一趋势因地区而异。在北美,减少可以忽略不计(-0.1%APC).南美下降幅度最大，APC为-2.5%。中美洲也下降了，APC为-1.3%。我们的研究结果表明，美洲DTP疫苗接种率下降的趋势令人担忧，在某些地区加剧，在COVID-19大流行之后。2019年至2022年间，美洲疫苗覆盖率的绝对下降为-4%，其中最重要的下降是中美洲（-7%）。然而,六个国家报告说，以巴西为首的COVID-19疫苗接种率增加，增加7%。相反，22个国家的DTP3疫苗覆盖率下降，平均降幅为-7.37%。这种下降对实现世卫组织到2030年第三剂DTP覆盖率90%的目标构成了重要挑战，从2019年到2022年实现这一目标的国家数量减少就证明了这一点。
结论：COVID-19大流行影响了美国的疫苗覆盖率，导致下降，尤其是在中美洲。
目的：本研究旨在评估COVID-19大流行对美洲DTP3疫苗接种率的影响，调查2012年至2022年的趋势，以确定重大变化，地区差异，以及大流行对实现全球免疫目标的总体影响。
方法：这项研究使用了第三剂白喉的覆盖率数据，破伤风,和百日咳疫苗（DTP3）从联合国儿童基金会数据库中提取了2012年至2022年。我们进行了Joinpoint回归来识别显著趋势变化的点。计算了美国及其地区的年度百分比变化（APC）和95％置信区间（95％CIs）。我们还使用了分段回归分析。使用卡方检验，我们比较了2019年至2022年每个国家的DTP3疫苗接种覆盖率。
结果：总体而言，在此期间，美国的疫苗覆盖率有所下降，APC为-1.4（95%CI-1.8；-1.0）。这一趋势因地区而异。在北美,减少可以忽略不计(-0.1%APC).南美下降幅度最大，APC为-2.5%。中美洲也下降了，APC为-1.3%。我们的研究结果表明，美洲DTP疫苗接种率下降的趋势令人担忧，在某些地区加剧，在COVID-19大流行之后。2019年至2022年间，美洲疫苗覆盖率的绝对下降为-4%，其中最重要的下降是中美洲（-7%）。然而,六个国家报告说，以巴西为首的COVID-19疫苗接种率增加，增加7%。相反，22个国家的DTP3疫苗覆盖率下降，平均降幅为-7.37%。这种下降对实现世卫组织到2030年第三剂DTP覆盖率90%的目标构成了重要挑战，从2019年到2022年实现这一目标的国家数量减少就证明了这一点。
结论：COVID-19大流行影响了美国的疫苗覆盖率，导致下降，尤其是在中美洲。
