The COVID-19 pandemic is changing the landscape for immunization and other primary health care services across the world, including in low- and middle-income countries. While the World Health Organization has issued clear guidance that immunization is an essential service that countries must continue to prevent the resurgence of killer diseases (e.g., measles, polio, pneumonia, whooping cough), damage from COVID-19 is widespread, particularly in lower-income countries that have weak health infrastructures. Major constraints include:
- Transportation disruptions: Vaccine distribution has been interrupted because of fewer flights from manufacturing sites to national warehouses and in-country transport constraints to clinics. Without vaccines, there’s no vaccination.
- Service interruptions: Community-based outreach services, a mainstay for providing immunization to remote populations, have been suspended in many countries.
- Reduced health worker availability: Health workers are diverted to pandemic response tasks and are also concerned for their own safety. Insufficient supplies of personal protective equipment, practical barriers to critical measures like frequent handwashing, and limited transport to places of work have led to impaired services.
- Low service utilization: Community turnout for immunization has also fallen as caregivers are instructed to stay home and are concerned about going to health centers for preventive services.