Avoiding the “double whammy”: PATH advances immunization in the time of COVID

April 24, 2020 by Kelly Huffman and Hope Randall

COVID-19 is disrupting immunization programs in the communities that count on them most. Despite the pandemic, PATH is working to protect and continue this lifesaving service.

Vaccine-preventable rotavirus is the most lethal form of childhood diarrhea. In Zambia, Teresa is relieved that her son, Vusi, has protection. Immunization against common child killers must continue throughout COVID and beyond. Photo: PATH/Gareth Bentley.

Vaccine-preventable rotavirus is the most lethal form of childhood diarrhea. In Zambia, Teresa is relieved that her son, Vusi, has protection. Immunization against common child killers must continue throughout COVID and beyond. Photo: PATH/Gareth Bentley.

Immunization is a global health success story. From meningitis to measles, vaccines are a proven means to improve health equity, preventing diseases in communities that face the biggest barriers to health care.

But, all over the world, the COVID-19 pandemic has interrupted this vital work. In Zimbabwe and Liberia, for example, PATH has been helping health officials to plan countrywide typhoid vaccination campaigns. The goal: inoculate every child under age 15. But campaigns mean crowds, and both Zimbabwe and Liberia have paused their plans.

Similar stories are unfolding around the globe:

  • In Vietnam, all immunizations (other than hepatitis B birth doses in hospitals) ceased from April 1 to April 15.
  • In Ghana, immunization services came to a halt in areas where movement was restricted. In other areas, the government reduced session sizes in order to limit groups—and because some caregivers hesitated to show up.
  • Partial lockdowns in the main cities in Ghana and Zimbabwe have triggered an exodus of people to their home towns and other rural areas. Children in these communities will likely miss their scheduled immunizations, resulting in reduced coverage.

“I worry about a double whammy, “says Deborah Atherly, PhD, BScPharm, head of policy, access, and introduction for PATH’s Center for Vaccine Innovation and Access. “A struggling health system might see a drop in immunization rates as it responds to COVID-19. Later, the community is even more vulnerable to a surge in measles, typhoid, and other vaccine-preventable illnesses.” That’s what we witnessed during the Ebola outbreak in the Democratic Republic of the Congo, when measles cases in children doubled.

An epidemic of fear

Even in places where immunization services continue, many caregivers hesitate to participate. Fear and misinformation often accompany the novel coronavirus, creating distrust about vaccines and other health interventions. Even when the COVID-19 pandemic wanes, these misperceptions may persist, lowering the demand for vaccines and making it difficult for health workers to regain community confidence.

But is fear of COVID-19 outpacing the actual danger? Unlike measles and typhoid, this new disease presents an unknown threat. “The perceived threat is higher, but we won’t know until later, when the data are in, which disease is more lethal, especially for children,” says Dr. Atherly.

Even as researchers around the world work to develop a COVID-19 vaccine, PATH remains committed to prioritizing access for communities at highest risk of infectious disease. “We must continue this work,” says Dr. Atherly. “Long after COVID-19 is suppressed or a vaccine is available, these communities will still face the scourge of these illnesses.”

Taking action in the face of pandemic

PATH is partnering with governments to help maintain access to immunization services during the COVID-19 outbreak: We’re advocating for increased funding. Helping to address community misperceptions. Evaluating the readiness of manufacturers to produce an eventual vaccine(s). And we’re talking with partners and donors about how PATH can assist with the development of vaccines against COVID-19.

We also provided input into the new global vaccine strategy, Immunization 2030. And we’re partnering to advocate for governments and other funders to make ambitious pledges to Gavi, the Vaccine Alliance, which plays a key role in delivering millions of vaccines to children each year.

The COVID-19 pandemic brings home the fact that diseases know no borders. It also highlights the value of basic public health tools and the importance of extending them everywhere. “Now, more than ever, it’s critical to maintain momentum on immunization,” says Dr. Atherly, “and to do so while preventing the spread of COVID-19.”

Related World Immunization Week posts:

BID Initiative: Accelerating progress this World Immunization Week in the face of a global pandemic

DefeatDD: Finding inspiration from rotavirus vaccines as we rally against COVID-19

Take On Typhoid: A delicate and difficult balance