Routine Immunization Programs for Children during the COVID-19 Pandemic in Ecuador, 2020—Hidden Effects, Predictable Consequences

Abstract

The COVID-19 pandemic has led to a global disruption of several services, including the healthcare system related to routine immunizations. This effect has been described in several countries, but there are scarce detailed studies in Latin America and no reports in Ecuador. Therefore, this work aimed to quantify the reduction in routine immunizations for infants (children under one year) during the 2020 pandemic of COVID-19 in Ecuador. The 2018, 2019 and 2020 data were obtained from the National Direction of Statistics and Health Information Analysis of the Ministry of Health, Ecuador. The number of doses and immunization coverage were descriptively compared for four types of vaccines: rotavirus (ROTA), poliovirus (PV), pneumococcal (PCV) and pentavalent vaccine (PENTA) for the pre and pandemic year, at national and provincial scales. The percentage of coverage was calculated using the number of infants, and the immunizations applied. There was no significant difference in doses applied during the 2018 and 2019 years. However, a significant (p < 0.05) drop to 137,000 doses delivered was observed in 2020 compared to the pre-pandemic years. Reductions in the percentage of coverage were more pronounced for the PENTA (17.7%), followed by PV (16.4%), ROTA (12%), and PCV (10.7%). Spatial analysis shows a general impact on the vaccination coverage across the territory, although specific provinces from the Coast and Highland regions of the country were the most affected. The pandemic had significantly impacted the immunization programs for infants across Ecuador. This retrospective analysis shows an urgent need to protect vulnerable zones and populations during public health emergencies. Funding Information: This work was supported by a grant from DII-P011617_2 (JCN, JRR, JGS), Directorate of Research and Innovation, Universidad Internacional SEK (UISEK). Conflict of Interests: The authors declare no Conflicts of Interest. Ethical Approval: The databases of all provinces were provided and approved for use under the authorizations MSP-DNEPC-2021-0003-O and MSP-DNEAIS-2021-0069-O by the National Direction of Statistics and Health Information Analysis of the Ministry of Health (MSP), Ecuador.

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