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Mansaray A, Bangura M, Watson-Jones D, Greenwood B, Burns R, Susan Lees S, Faye F, Leigh B, Enria L. Engaging the public in decisions about emergency vaccine deployment strategies: Lessons from scenario-based discussions in Sierra Leone. Glob Public Health 2024; 19:2334887. [PMID: 38625999 DOI: 10.1080/17441692.2024.2334887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/20/2024] [Indexed: 04/18/2024]
Abstract
ABSTRACTThe COVID-19 pandemic has amplified discussions on emergency vaccine deployment strategies, with current perspectives often neglecting extensive community involvement in ethical, logistical and political aspects. Existing social science literature predominantly delves into factors influencing trust, overlooking the untapped potential for community engagement.Our study examines community preparedness in Sierra Leone's Kambia District, exploring diverse viewpoints on vaccine deployment strategies, emphasising Ebola and COVID-19 vaccinations. Utilising extensive ethnographic research from the Ebola vaccine trials (EBOVAC Salone) conducted in Kambia District from 2015 to 2021, including participant observation and tailored focus group discussions, we investigated various deployment scenarios with community leaders and citizens.Our findings underscore the multifaceted contributions of social science research with communities in shaping emergency vaccination strategies. These contributions span logistical insights, aligning campaigns with local livelihoods and social structures, and grounded ethical concerns assessing social justice outcomes across epidemic scenarios. This study emphasises the imperative of integrating discussions on vaccine confidence and deployment. It highlights communities' proficiency in epidemiological reasoning and their ability to bring this in conversation with salient socio-cultural, economic and religious dimensions. We therefore promote the cultivation of public dialogue, collaborative creation of impactful vaccination initiatives alongside relevant communities in recognition of their invaluable perspectives .
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Affiliation(s)
| | - Mahmood Bangura
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | | | | | - Rose Burns
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Farba Faye
- London School of Hygiene and Tropical Medicine, London, UK
| | - Bailah Leigh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Luisa Enria
- London School of Hygiene and Tropical Medicine, London, UK
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Mwinnyaa G, Peters MA, Shapira G, Neill R, Sadat H, Yuma S, Akilimali P, Hossain S, Wendrad N, Atiwoto WK, Ofosu AA, Alfred JP, Kiarie H, Wesseh CS, Isokpunwu C, Kangbai DM, Mohamed AA, Sidibe K, Drouard S, Fernandez PA, Azais V, Hashemi T, Hansen PM, Ahmed T. Vaccination Utilization and Subnational Inequities during the COVID-19 Pandemic: An Interrupted Time-Series Analysis of Administrative Data across 12 Low- and Middle-Income Countries. Vaccines (Basel) 2023; 11:1415. [PMID: 37766092 PMCID: PMC10536121 DOI: 10.3390/vaccines11091415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/31/2023] [Accepted: 08/17/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND During and after the SARS-CoV-2 (COVID-19) pandemic, many countries experienced declines in immunization that have not fully recovered to pre-pandemic levels. This study uses routine health facility immunization data to estimate variability between and within countries in post-pandemic immunization service recovery for BCG, DPT1, and DPT3. METHODS After adjusting for data reporting completeness and outliers, interrupted time series regression was used to estimate the expected immunization service volume for each subnational unit, using an interruption point of March 2020. We assessed and compared the percent deviation of observed immunizations from the expected service volume for March 2020 between and within countries. RESULTS Six countries experienced significant service volume declines for at least one vaccine as of October 2022. The shortfall in BCG service volume was ~6% (95% CI -1.2%, -9.8%) in Guinea and ~19% (95% CI -16%, 22%) in Liberia. Significant cumulative shortfalls in DPT1 service volume are observed in Afghanistan (-4%, 95% CI -1%, -7%), Ghana (-3%, 95% CI -1%, -5%), Haiti (-7%, 95% CI -1%, -12%), and Kenya (-3%, 95% CI -1%, -4%). Afghanistan has the highest percentage of subnational units reporting a shortfall of 5% or higher in DPT1 service volume (85% in 2021 Q1 and 79% in 2020 Q4), followed by Bangladesh (2020 Q1, 83%), Haiti (80% in 2020 Q2), and Ghana (2022 Q2, 75%). All subnational units in Bangladesh experienced a 5% or higher shortfall in DPT3 service volume in the second quarter of 2020. In Haiti, 80% of the subnational units experienced a 5% or higher reduction in DPT3 service volume in the second quarter of 2020 and the third quarter of 2022. CONCLUSIONS At least one region in every country has a significantly lower-than-expected post-pandemic cumulative volume for at least one of the three vaccines. Subnational monitoring of immunization service volumes using disaggregated routine health facility information data should be conducted routinely to target the limited vaccination resources to subnational units with the highest inequities.
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Affiliation(s)
- George Mwinnyaa
- The Global Financing Facility for Women, Children, and Adolescents, Washington, DC 1818, USA
| | | | - Gil Shapira
- The World Bank, Washington, DC 20433, USA (G.S.)
| | - Rachel Neill
- The Global Financing Facility for Women, Children, and Adolescents, Washington, DC 1818, USA
| | - Husnia Sadat
- The Global Financing Facility for Women, Children, and Adolescents, Washington, DC 1818, USA
| | - Sylvain Yuma
- Ministe’re de la Sante, Kinshasa 4310, Democratic Republic of the Congo
| | - Pierre Akilimali
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa P.O. Box 11850, Democratic Republic of the Congo
| | | | | | | | | | - Jean Patrick Alfred
- Ministère de la Sante Publique et de la Population, Port-au-Prince HT6123, Haiti
| | - Helen Kiarie
- Ministry of Health, Nairobi P.O. Box 30016-00100, Kenya
| | | | | | | | | | - Kadidja Sidibe
- The Global Financing Facility for Women, Children, and Adolescents, Washington, DC 1818, USA
| | | | | | - Viviane Azais
- The Global Financing Facility for Women, Children, and Adolescents, Washington, DC 1818, USA
| | - Tawab Hashemi
- The Global Financing Facility for Women, Children, and Adolescents, Washington, DC 1818, USA
| | - Peter M. Hansen
- The Global Financing Facility for Women, Children, and Adolescents, Washington, DC 1818, USA
| | - Tashrik Ahmed
- The Global Financing Facility for Women, Children, and Adolescents, Washington, DC 1818, USA
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Buonsenso D, Mariani F, Biala J, Goletti D. COVID-19 effect on tuberculosis care in Sierra Leone: Are we in the recovery phase? Pulmonology 2022; 29:244-246. [PMID: 36473827 PMCID: PMC9618437 DOI: 10.1016/j.pulmoe.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- D. Buonsenso
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italia,Corresponding author at:
| | - F. Mariani
- Pediatric Resident, Università Cattolica del Sacro Cuore, Rome, Italy
| | - J.S. Biala
- Tuberculosis Unit, Tombo Community Health Centre, Western Rural Area, Sierra Leone
| | - D. Goletti
- Translational Research Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases-IRCCS L. Spallanzani, Rome, Italy
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Cardoso Pinto AM, Ranasinghe L, Dodd PJ, Budhathoki SS, Seddon JA, Whittaker E. Disruptions to routine childhood vaccinations in low- and middle-income countries during the COVID-19 pandemic: A systematic review. Front Pediatr 2022; 10:979769. [PMID: 36034563 PMCID: PMC9403570 DOI: 10.3389/fped.2022.979769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background The COVID-19 pandemic has disrupted routine childhood vaccinations worldwide with low- and middle-income countries (LMICs) most affected. This study aims to quantify levels of disruption to routine vaccinations in LMICs. Methods A systematic review (PROSPERO CRD42021286386) was conducted of MEDLINE, Embase, Global Health, CINAHL, Scopus and MedRxiv, on the 11th of February 2022. Primary research studies published from January 2020 onwards were included if they reported levels of routine pediatrics vaccinations before and after March 2020. Study appraisal was performed using NHLBI tool for cross-sectional studies. Levels of disruption were summarized using medians and interquartile ranges. Results A total of 39 cross-sectional studies were identified. These showed an overall relative median decline of -10.8% [interquartile range (IQR) -27.6%, -1.4%] across all vaccines. Upper-middle-income countries (upper-MICs) (-14.3%; IQR -24.3%, -2.4%) and lower-MICs (-18.0%; IQR -48.6%, -4.1%) showed greater declines than low-income countries (-3.1%; IQR -12.8%, 2.9%), as did vaccines administered at birth (-11.8%; IQR -27.7%, -3.5%) compared to those given after birth (-8.0%; IQR -28.6%, -0.4%). Declines during the first 3 months of the pandemic (-8.1%; IQR -35.1%, -1.4%) were greater than during the remainder of 2020 (-3.9%; IQR -13.0%, 11.4%) compared to baseline. Conclusion There has been a decline in routine pediatric vaccination, greatest in MICs and for vaccines administered at birth. Nations must prioritize catch-up programs alongside public health messaging to encourage vaccine uptake. Systematic review registration Identifier: CRD42021286386.
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Affiliation(s)
| | - Lasith Ranasinghe
- Academic Foundation Doctor, Imperial College London, London, United Kingdom
| | - Peter J Dodd
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Shyam Sundar Budhathoki
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - James A Seddon
- Department of Infectious Disease, Imperial College London, London, United Kingdom
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - Elizabeth Whittaker
- Department of Infectious Disease, Imperial College London, London, United Kingdom
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