The ongoing coronavirus crisis has taken a toll on the immunization of children, reported The Telegraph India. As per the advisory by the umbrella association of pediatricians, most toddlers missed their scheduled vaccinations due to their recommendation that vaccinations be postponed till March 31. However, when the doctors came to know that the lockdown wouldn’t be ending anytime soon, they issued another advisory asking doctors to resume scheduled vaccinations following certain guidelines.
Countries have also been warned by the World Health Organization about letting their guard down on immunization of children while fighting the coronavirus.
However, this isn’t happening because of private clinics being shut. This has left parents worried and harrowed. Online queries have spiked due to the same. Worried about their children’s immunity being compromised amid the coronavirus pandemic, the parents are rushing to online platforms. “Online paediatric queries witnessed a growth of 350 per cent since March 1,” said a spokesperson of Practo, a digital healthcare platform.
The spokesperson also added that the top queries were cough and cold in babies and the impact of delayed vaccination during the lockdown.
A 36-year-old teacher from New Alipore looking for a pediatrician to administer the Varicella vaccine, commonly known as the chickenpox vaccine to her 17-month-old said, “The vaccine was due in April. The doctor who administered the previous vaccines has shut his clinic. When I called, he said he would not start the clinic before the lockdown is officially lifted.”
She said that the doctor who was aged 70, was taking “extra precaution because he was in the vulnerable age group.”
Another woman in Salt Lake, is worried because her 10-month-old daughter is yet to get the MMR-I vaccine, for protection against measles, mumps and rubella. The vaccine was due in April. Generally, she takes her daughter to a private hospital for vaccinations but the schedule has been hit due to the Covid-19 crisis. Going to the hospital is a problem. Also, I cannot discount the risk of infection at the hospital. But the doctor has said she would not resume her private clinic before May 21,” she said.
Explaining the importance of vaccinations, Jaydeep Choudhary, a pediatrician associated with the Institute of Child Health said, “Vaccines can be classified into three broad types according to how important they are in the wake of this pandemic outbreak. The absolutely essential primary vaccines should ideally be administered to newborns before they are released from the hospital. The vaccines like triple antigen, polio and rotavirus vaccines, due in periodic intervals over the first few months, are also non-negotiable. The vaccines for lungs and the respiratory tract — for protection against influenza and pneumonia — should also be ideally not delayed because weak lungs would make a baby more vulnerable to Covid-19.”
Choudhary who is also the chairperson of the infectious diseases chapter of the Indian Academy of Pediatrics (IAP) added, “The vaccines for water-borne diseases, like typhoid and hepatitis, can wait for a while.”
The second advisory by the Indian Academy of Pediatrics (IAP) had some “general instructions for vaccination clinics.” The advisory recommended that “a polyclinic/ nursing home/ hospital should have segregated vaccination areas with separate entrance and exit” and “it is essential to stager appointments to avoid crowding at the clinic”.
Doctors who have resumed vaccinations say they are working according to IAP guidelines. “My chamber can accommodate 10 children and their parents following social distancing norms. I am asking the parents to take prior appointments and adhere to the timings. Some of them are waiting inside their cars parked on the road and entering the clinic when their turn comes,” said Apurba Ghosh, the director of the Institute of Child Health. His clinic is in Ballygunge.
Priti Khemka, a pediatrician associated with the Bhagirathi Neotia Woman and Child Care Centre and the digital platform, has handled many online queries over the past month. “Some children have their booster shots (additional dose) due. I have told parents that the main focus should be on primary vaccines. The booster shots can be delayed for a while,” she said.
Fall in shipments
Countries have been warned by the World Health Organization about letting their guard down on immunization of children while fighting the coronavirus.
The United Nations too had said that children’s lives were “at stake” because of the backlog in vaccine shipments all over the world.
Governments, the private sector, the airline industry, and others have been approached to free up freight space at an affordable cost, “and to work with us to find ways around the transport disruptions we face”, said UNICEF spokesperson Marixie Mercado.
“Children’s lives are at stake.”@UNICEF is calling for support to unblock a massive backlog in #vaccine shipments due to unprecedented logistical constraints related to #COVID19 lockdowns in some countries. pic.twitter.com/igqyZmG1kx
— UN Geneva (@UNGeneva) May 1, 2020
“Compounding the challenge is the exorbitant cost of securing flights, with freight rates at 100 to 200 per cent above normal and charter flights even more costly,” she explained. “Countries with limited resources will struggle to pay these higher prices, leaving children vulnerable to vaccine-preventable diseases such as measles and polio.”
Since late March there has been a reported 70 to 80 percent reduction in shipments. Speaking to Business Standard, S Sridhar, managing director of Pfizer, said “All vaccines except those that are given immediately after birth are expected to have been impacted. Sridhar added that the website of GAVI, the Vaccine Alliance, a global public-private health partnership, says delays in vaccination campaigns and routine introductions will mean at least 13.5 million people in 13 of the world’s least-developed countries will be at risk of not being protected against diseases like measles, polio and human papillomavirus (HPV), with millions more likely to follow.
In India, ASHA workers who take up immunization campaigns, especially in rural India, are now credited with the task of surveillance, testing and other work during the Covid-19 crisis. Adar Poonawala of Serum Institute of India said that logistical issues have hit vaccine demand. He said, “n some countries, it is due to the shortage of healthcare workers and in some, the customs and cargos are not available. Other modes of transports like airlines have been impacted as well and most of all the mothers are not willing to bring their children because they fear getting Covid-19.”
Some states are now asking public health centers (PHCs) to start weekly vaccination camps. Chhaya Pachauli, member of the Jan Swasthya Abhiyan (JSA) a national platform that co-ordinates activities on health and health care, said that the organization had written to the Rajasthan government, where they operate, to start door-to-door vaccination drives. “If work on the MGNREGA can begin, why not immunisation drives?” Pachauli asks.
Meanwhile, the Centre has mostly kept mum on the issue and only indicated that there would soon be an advisory on launching “catch-up” immunization drives.
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