Navigating Barriers to Adequate Vaccination Coverage: Impact of the COVID-19 pandemic and Post-Pandemic Strategies

Abstract

The COVID-19 pandemic disrupted global vaccination programs through various non-pharmacological interventions and posed significant challenges to the administration of childhood vaccinations. This literature review examines the impact of the pandemic on vaccination coverage, emphasizing the decline in coverage ratios and the emergence of vaccine-preventable diseases like measles. It accentuates the importance of addressing barriers to vaccination, including cultural, social, and socioeconomic factors. For example, while higher education and income levels correlate with greater vaccination acceptance, lower educational and income groups only show more vaccine hesitancy but not a higher rate of refusal. Targeted education campaigns are essential to mitigate vaccine hesitancy and improve coverage and should not be limited to specific income or educational groups. This review also highlights the unequal recovery in vaccination coverage across regions and income groups, emphasizing the need for comprehensive strategies to ensure equity in immunization. Most regions returned to (almost) pre-COVID-19 levels of vaccination coverage ratio in 2022, however, when countries were grouped on gross national income, the vaccination coverage ratio of low-income countries was still declining in 2022. People-centred, locally tailored approaches, such as those employed by the GAVI vaccine alliance, offer potential solutions by identifying and addressing low-coverage areas. In the post-pandemic years, efforts to restore and strengthen vaccination programs are crucial, especially with the resurgence of vaccine-preventable diseases. The year 2023, which is deemed "Big Catch-Up", is aligned with the Immunization Agenda 2030 and aims to mitigate the pandemic's consequences and accelerate universal vaccination coverage. The experiences of past outbreaks, such as the Ebola outbreak, underscore the urgency of these efforts. To achieve the Immunization Agenda 2030's ambitious goals and to ensure "no one is left behind", collaborative efforts should be made to increase vaccination coverage and address barriers to immunization uptake. These important steps are necessary to achieve the ultimate goal of adequately protecting the health of children worldwide against vaccine preventable diseases.