PDF(Pubmed)
Abstract：
BACKGROUND: The COVID-19 pandemic had a profound impact on healthcare systems and services, including routine immunization (RI). To date, there is limited information on the effects of the COVID-19 pandemic on RI in West African countries such as Sierra Leone, which had already experienced public health emergencies that disrupted its healthcare system. Here, we describe the impact of the COVID-19 pandemic on the RI of key antigens in Sierra Leone.
METHODS: We used vaccination data from the District Health Information System for BCG, measles-rubella 1 and 2, and pentavalent 1 and 3 antigens. We compared 2019, 2020, 2021, and 2022 annual coverage rates for the selected antigens at the national and district levels. We used the Pearson chi-square test to assess the difference between annual coverage rates between 2019 and 2020, 2020-2021, and 2021-2022.
RESULTS: National coverage rates for all antigens declined in 2019-2020, notably measles-rubella 1 and pentavalent 3 (-5.4% and - 4.9%). Between 2020 and 2021, there was an overall increase in coverage (+ 0.2% to + 2.5%), except for measles-rubella 2 (-1.8%). Measles-rubella antigens rebounded in 2021-2022, while others decreased between - 0.5 and - 1.9% in coverage. Overall, all district-level coverage rates in 2022 were lower than those in 2019. Most districts decreased between 2019 and 2022, though a few had a continuous increase; some had an increase/recovery between 2020 and 2021; some districts had recovered 2019 levels by 2022.
CONCLUSIONS: The COVID-19 pandemic impacted Sierra Leone\'s national BCG, measles-rubella, and pentavalent antigen immunization, which were not fully restored in 2022. Most districts experienced notable coverage declines during the pandemic, though a few reached or surpassed 2019 rates in 2022. Examining pandemic impact can benefit from a focus beyond the national level to identify vulnerable regions. Sierra Leone\'s post-pandemic RI reestablishment needs targeted strategies and continual investments for equitable access and coverage, as well as to prevent vaccine-preventable diseases.
METHODS: We used vaccination data from the District Health Information System for BCG, measles-rubella 1 and 2, and pentavalent 1 and 3 antigens. We compared 2019, 2020, 2021, and 2022 annual coverage rates for the selected antigens at the national and district levels. We used the Pearson chi-square test to assess the difference between annual coverage rates between 2019 and 2020, 2020-2021, and 2021-2022.
RESULTS: National coverage rates for all antigens declined in 2019-2020, notably measles-rubella 1 and pentavalent 3 (-5.4% and - 4.9%). Between 2020 and 2021, there was an overall increase in coverage (+ 0.2% to + 2.5%), except for measles-rubella 2 (-1.8%). Measles-rubella antigens rebounded in 2021-2022, while others decreased between - 0.5 and - 1.9% in coverage. Overall, all district-level coverage rates in 2022 were lower than those in 2019. Most districts decreased between 2019 and 2022, though a few had a continuous increase; some had an increase/recovery between 2020 and 2021; some districts had recovered 2019 levels by 2022.
CONCLUSIONS: The COVID-19 pandemic impacted Sierra Leone\'s national BCG, measles-rubella, and pentavalent antigen immunization, which were not fully restored in 2022. Most districts experienced notable coverage declines during the pandemic, though a few reached or surpassed 2019 rates in 2022. Examining pandemic impact can benefit from a focus beyond the national level to identify vulnerable regions. Sierra Leone\'s post-pandemic RI reestablishment needs targeted strategies and continual investments for equitable access and coverage, as well as to prevent vaccine-preventable diseases.
摘要：
背景：COVID-19大流行对医疗保健系统和服务产生了深远的影响，包括常规免疫（RI）。迄今为止,关于COVID-19大流行对塞拉利昂等西非国家RI的影响的信息有限，它已经经历了突发公共卫生事件，扰乱了它的医疗系统。这里,我们描述了COVID-19大流行对塞拉利昂关键抗原RI的影响。
方法：我们使用了来自地区卫生信息系统的BCG疫苗接种数据，麻疹风疹1和2，以及五价1和3抗原。我们比较了国家和地区层面2019年、2020年、2021年和2022年选定抗原的年覆盖率。我们使用皮尔逊卡方检验评估了2019年与2020年、2020-2021年和2021-2022年的年度覆盖率差异。
结果：全国所有抗原的覆盖率在2019-2020年下降，特别是麻疹-风疹1和五价3（-5.4％和-4.9％）。在2020年至2021年之间，覆盖率总体上升（+0.2%至+2.5%），除麻疹-风疹2例外(-1.8%)。麻疹-风疹抗原在2021-2022年反弹，而其他抗原的覆盖率下降了-0.5％至-1.9％。总的来说,2022年所有区级覆盖率均低于2019年。大多数地区在2019年至2022年期间有所下降，尽管有一些地区持续增加；一些地区在2020年至2021年期间有所增长/复苏；一些地区在2022年之前已经恢复了2019年的水平。
结论：COVID-19大流行影响了塞拉利昂的国家卡介苗，麻疹-风疹,和五价抗原免疫，2022年没有完全恢复。大流行期间，大多数地区的覆盖率显着下降，尽管其中一些在2022年达到或超过2019年的比率。检查大流行的影响可以受益于在国家一级以外确定脆弱区域的重点。塞拉利昂大流行后RI的重建需要有针对性的战略和持续投资，以实现公平的获取和覆盖，以及预防疫苗可预防的疾病。
方法：我们使用了来自地区卫生信息系统的BCG疫苗接种数据，麻疹风疹1和2，以及五价1和3抗原。我们比较了国家和地区层面2019年、2020年、2021年和2022年选定抗原的年覆盖率。我们使用皮尔逊卡方检验评估了2019年与2020年、2020-2021年和2021-2022年的年度覆盖率差异。
结果：全国所有抗原的覆盖率在2019-2020年下降，特别是麻疹-风疹1和五价3（-5.4％和-4.9％）。在2020年至2021年之间，覆盖率总体上升（+0.2%至+2.5%），除麻疹-风疹2例外(-1.8%)。麻疹-风疹抗原在2021-2022年反弹，而其他抗原的覆盖率下降了-0.5％至-1.9％。总的来说,2022年所有区级覆盖率均低于2019年。大多数地区在2019年至2022年期间有所下降，尽管有一些地区持续增加；一些地区在2020年至2021年期间有所增长/复苏；一些地区在2022年之前已经恢复了2019年的水平。
结论：COVID-19大流行影响了塞拉利昂的国家卡介苗，麻疹-风疹,和五价抗原免疫，2022年没有完全恢复。大流行期间，大多数地区的覆盖率显着下降，尽管其中一些在2022年达到或超过2019年的比率。检查大流行的影响可以受益于在国家一级以外确定脆弱区域的重点。塞拉利昂大流行后RI的重建需要有针对性的战略和持续投资，以实现公平的获取和覆盖，以及预防疫苗可预防的疾病。
