Effect of Covid-19 on Uptake of Routine Immunization in Goma, Democratic Republic of Congo.

Abstract

The routine immunization process continues to save millions of children's lives worldwide. The previous pandemic like Ebola impacted the health system in Africa. There was a need to investigate if COVID-19, with its restrictions and containment measures, affected the Democratic Republic of Congo health system, particularly the routine vaccination programme. The study examined the effect of the pandemic on coverage/uptake, sequence, and timing process during routine vaccination. The study was cross-sectional. The quantitative method was used to collect data from 423 children aged of 12-23 months and 27 health workers through structured interview and self-administered questionnaires, respectively, at Mabanga area in Goma city, in DRC. The Chi-square test was used to test the independence between out-of-sequence vaccination and full immunization coverage, and the chi-square test for Goodness of fit was used to test the difference between full immunization in this study and the country target. Differences in vaccine coverages, out-of-sequence, and timely and untimely vaccination were compared by using a T-test. Simple and multiple logistic regressions were used to determine the predictors of full and partial immunization coverage. Simple and multiple ordinal regressions were used to determine the predictors of attitude and perceptions of change among the health workers at a 95 % confidence interval. The full and partial immunization coverages were respectively 96.7% and 99.3%. The children whose parents were aged 18- 25years and 26-33years had a high probability of being fully immunized than those whose parents were aged 34 and above years old. The likelihood for unemployed parents to fully immunized their children was 3.17 when compared to employed parents. The children whose parents possessed the vaccination cards were more likely to be fully immunized compared to their counterparts. The likelihood of full immunization was high for the children whose parents declared the immunization completion during the interview than

for their counterparts. The predictors of partial immunization coverage before COVID- 19 occurrence period were caretakers bracket age18-25years (OR: 0.21, P< 0.05),child

sex (OR:0.45,p<0.05).During the pandemic: the likelihood of parents aged between 18- 25 years old partially immunizing their children was high ( OR:3.57,p<0.05) likewise the likelihood of female children(OR:2.234, P<0.05), the uptake mean of BCG, OPV0,1, Pentavalent1,Rotavirus1, and PCV1 decreased from 48 to 17 doses while it increased from 17 to 81 doses for the other vaccines, and the untimely mean doses of all vaccines were high also.39.24 % was the overall out-sequence vaccination; the out-of-sequence vaccination was independent of the full immunization coverage( p >0.05). The health workers with less than 4 years of experience had more positive attitudes and perceived the change more than those with more than 4 years. The study revealed the disruption of routine immunization outcomes specifically the out-of-sequence and untimely vaccination which are essential in the prevention and control of childhood mortality, despite the high full immunization coverage.