부산대학교 도서관

Background: In 2020, the SARS-CoV-2 (COVID-19) pandemic and lockdown control measures threatened to disrupt routine childhood immunisation programmes with early reports suggesting uptake would fall. In response, public health bodies in Scotland and England collected national data for childhood immunisations on a weekly or monthly basis to allow for rapid analysis of trends. The aim of this study was to use these data to assess the impact of different phases of the pandemic on infant and preschool immunisation uptake rates. Methods and findings: We conducted an observational study using routinely collected data for the year prior to the pandemic (2019) and immediately before (22 January to March 2020), during (23 March to 26 July), and after (27 July to 4 October) the first UK "lockdown". Data were obtained for Scotland from the Public Health Scotland "COVID19 wider impacts on the health care system" dashboard and for England from ImmForm. Five vaccinations delivered at different ages were evaluated; 3 doses of "6-in-1" diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and hepatitis B vaccine (DTaP/IPV/Hib/HepB) and 2 doses of measles, mumps, and rubella (MMR) vaccine. This represented 439,754 invitations to be vaccinated in Scotland and 4.1 million for England. Uptake during the 2020 periods was compared to the previous year (2019) using binary logistic regression analysis. For Scotland, uptake within 4 weeks of a child becoming eligible by age was analysed along with geographical region and indices of deprivation. For Scotland and England, we assessed whether immunisations were up-to-date at approximately 6 months (all doses 6-in-1) and 16 to 18 months (first MMR) of age. We found that uptake within 4 weeks of eligibility in Scotland for all the 5 vaccines was higher during lockdown than in 2019. Differences ranged from 1.3% for first dose 6-in-1 vaccine (95.3 versus 94%, odds ratio [OR] compared to 2019 1.28, 95% confidence intervals [CIs] 1.18 to 1.39) to 14.3% for second MMR dose (66.1 versus 51.8%, OR compared to 2019 1.8, 95% CI 1.74 to 1.87). Significant increases in uptake were seen across all deprivation levels. In England, fewer children due to receive their immunisations during the lockdown period were up to date at 6 months (6-in-1) or 18 months (first dose MMR). The fall in percentage uptake ranged from 0.5% for first 6-in-1 (95.8 versus 96.3%, OR compared to 2019 0.89, 95% CI 0.86– to 0.91) to 2.1% for third 6-in-1 (86.6 versus 88.7%, OR compared to 2019 0.82, 95% CI 0.81 to 0.83). The use of routinely collected data used in this study was a limiting factor as detailed information on potential confounding factors were not available and we were unable to eliminate the possibility of seasonal trends in immunisation uptake. Conclusions: In this study, we observed that the national lockdown in Scotland was associated with an increase in timely childhood immunisation uptake; however, in England, uptake fell slightly. Reasons for the improved uptake in Scotland may include active measures taken to promote immunisation at local and national levels during this period and should be explored further. Promoting immunisation uptake and addressing potential vaccine hesitancy is particularly important given the ongoing pandemic and COVID-19 vaccination campaigns. Fiona McQuaid and colleagues assess the uptake of infant and pre-school immunisations in Scotland and England during the COVID-19 pandemic. Author summary: Why was this study done?: Early reports from multiple countries suggested that the SARS-CoV-2 (COVID-19) pandemic and associated control measures such as "lockdowns" could be detrimental to routine childhood immunisation uptake. A fall in the number of children receiving their routine immunisations could leave the population vulnerable to multiple infectious diseases such as measles. However, these reports generally only assessed the immediate effect within a few weeks of national lockdowns, and the longer-term impact of COVID-19 control measures on routine childhood immunisation uptake requires further evaluation. It is important to understand how the pandemic affected the uptake of routine childhood immunisations in order to discover what factors influence immunisation uptake and help plan for the future. What did the researchers do and find?: Information on childhood immunisation uptake is routinely collected in Scotland and England. Because of concerns about the effect of the pandemic on immunisation uptake, this information was collected in more detail and we used this to examine what happened over the lockdown period. To see if there was any change in immunisation uptake, we compared the information from immediately before, during, and after the 2020 lockdown in the United Kingdom to information from the previous year (2019). We found that immunisation uptake in Scotland rose significantly across lockdown, with over 7,000 more children receiving their immunisations on time compared to the previous year. In England, there was a slight fall in uptake. What do these findings mean?: These findings suggest that, despite early concerns, infant and preschool immunisation uptake increased in Scotland over the lockdown period. We do not yet have enough information to determine the reasons behind this positive change in Scotland or why uptake fell in England. The next step is to assess what factors may have led to this apparent increase in uptake, which could improve uptake of infant and preschool immunisations beyond the pandemic. Due to the type of information used, we were unable to fully explore the possibility of immunisation uptake varying by the time of year, and some potentially important details, such as ethnicity, were not available. [ABSTRACT FROM AUTHOR]