The impact of the COVID-19 pandemic on vaccine coverage in Kilifi, Kenya: A retrospective cohort study

• Published in: Vaccine 2023-01, Vol.41 (3), p.666-675
• Main Authors: Lucinde, R.K., Karia, B., Ouma, N., Amadi, D., Nyundo, C., Mataza, C., Nyaguara, A., Scott, J.A.G., Gallagher, K.E., Kagucia, E.
• Format: Article
• Language: English
• Subjects: Age; Birth order; Caregivers; Child; Children & youth; Cohort analysis; Coronaviruses; Coverage; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 vaccines; Data collection; Drug dosages; Education; Health facilities; Health services; Humans; Immunization Programs; Infant; Kenya - epidemiology; Maternal & child health; Measles; Measles Vaccine; Medical research; Pandemics; Public health; Random sampling; Retrospective Studies; Routine immunization; Rubella; Severe acute respiratory syndrome coronavirus 2; Socioeconomic factors; Statistical analysis; Statistical sampling; Surveillance systems; Surveys; Survival analysis; Vaccination; Vaccine; Vaccines
• ISSN: 0264-410X; 1873-2518; 1873-2518
• DOI: 10.1016/j.vaccine.2022.10.074

The COVID-19 pandemic caused unprecedented disruption in health service delivery, globally. This study sought to provide evidence on the impact of the pandemic on vaccine coverage in Kilifi County, Kenya. We conducted a vaccine coverage survey between April and June 2021 within the Kilifi Health and Demographic Surveillance System (KHDSS). Simple random sampling was used to identify 1500 children aged 6 weeks–59 months. Participants were grouped into three retrospective cohorts based on when they became age-eligible for vaccination: before the pandemic, during the first year, or during the second year of the pandemic. Survival analysis with Cox regression was used to evaluate the association between the time-period at which participants became age-eligible for vaccination and the rate of vaccination within a month of age-eligibility for the third dose of pentavalent vaccine (Pentavalent-3) and within three months of age-eligibility for the first dose of Measles vaccine (MCV-1). A total of 1,341 participants were included in the survey. Compared to the pre-COVID-19 baseline period, the rate of vaccination within a month of age-eligibility for Pentavalent-3 was not significantly different in the first year of the pandemic (adjusted hazard ratio [aHR] 1.03, 95 % confidence interval [CI] 0.90–1.18) and was significantly higher during the second year of the pandemic (aHR 1.33, 95 % CI 1.07–1.65). The rate of vaccination with MCV-1 within three months of age-eligibility was not significantly different among those age-eligible for vaccination during the first year of the pandemic (aHR 1.04, 95 % CI 0.88–1.21) and was 35 % higher during the second year of the pandemic (95 % CI 1.11–1.64), compared to those age-eligible pre-COVID-19. After adjusting for known determinants of vaccination, the COVID-19 pandemic did not adversely affect the rate of vaccination within the KHDSS.