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Sierra Leone reversing immunization decline in wake of COVID-19 | ReliefWeb.

[News and Press Release] [Source: WHO] [Posted: 1 Oct 2020] [Originally Published: 1 Oct 2020] [Origin: View original]

Freetown, 1 October 2020 - Although the first case of COVID-19 didn’t emerge until late in March in Sierra Leone, by late April, immunization rates and the use of child health care services had worryingly declined by about 19%.

Mothers like Hawa Dumbuya feared making visits to a health facility, because they were concerned that with COVID-19 circulating by doing so they would put themselves and their children in harm’s way.

“I was afraid that going to the health facility would expose us to coronavirus,” Dumbuya admits.

The Ministry of Health and Sanitation moved quickly to stem the growing anxieties and reverse the avoidance of critical child health care services.

Working with district communications unit staff and in collaboration with UNICEF and the World Health Organization (WHO), the Ministry ramped up public health messaging through radio stations. The informative announcements, played nationwide, urged mothers and caregivers to continue taking their children to health centres for the routine immunizations.

These messages gave parents like Dambuya reassurance to take her baby, born in May, to her local health facility and to check on her own health. “Coming for delivery was a difficult decision because of the fear of COVID-19, but it was good that I was brought here,” says Dambuya.

“As we learned more about the disease and how to stay safe, it gave me courage to continue to seek health services while using a mask and other preventive measures,” she says. “I came for vaccine for my child, and she was vaccinated. We mothers were reminded to sit apart and to use our mask properly. And the nurses were also fully masked up. So that was reassuring.”

The Ministry also ensured that vaccines were available at the district level with no depletion, which would have discouraged health facility attendance by parents and caregivers. The Ministry aggressively safeguarded supplies to guarantee that all immunizations would be available for anyone seeking them.

“First of all, we made sure there was a sufficient stock of vaccines in the country. Then we monitored the distribution to public health facilities. We also monitored service utilization by collecting and analysing data and providing feedback to the districts on their performance,” explains Dr Tom Sesay, Manager of the Ministry’s Expanded Programme on Immunization.

COVID-19 has imposed challenges to maintaining immunization and child health care services. The WHO Sierra Leone country office has escalated its technical assistance, with all immunization staff deployed to the field to help integrate immunization activities into the COVID-19 response, particularly at health facilities.

To raise awareness of the need for continuity of immunization and essential child health care services, WHO also deployed integrated supportive supervision teams and STOP polio consultants, to draw on their years of community outreach experience and knowledge.

Dr Thompson Igbu, who heads the WHO Sierra Leone Expanded Programme on Immunization team, emphasizes the importance of this continuity: “One of the most cost-effective public health interventions is vaccination because it protects a lot of children. In Sierra Leone, we have 12 antigens in the routine immunization system. Providing this service regularly to every eligible child means we are able to prevent illnesses that would have otherwise occurred if those children were not protected.”

The quick antidote to the heightened anxieties and disruptions to the routine immunization regimen among the general public is paying off. The rates of immunization are beginning to return to the pre-COVID-19 levels of 90% for the third dose of pentavalent vaccine, which is administered at 6 weeks, 10 weeks and 14 weeks of age. The pentavalent vaccine gives protection against diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenza type b (Hib).

The next step is to offer families catch-up vaccination campaigns, complete with all infection prevention and control measures – physical distancing, face masks, hand hygiene.

Dr Igbu, like every public health professional, knows only too well how even the smallest interruption to the routine immunization of children can have widespread negative impact for families and communities. “A sick child is unable to attend school or play actively, and the caregiver has to take time from work to care for the child’s health and buy medicines,” he says. “This contributes to increasing household expenditures and reduces the family funds that would be available for other things. Disease outbreaks can occur easily. Going unchecked, it will have a lot of negative impacts on society.”

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Urban-rural differences in factors associated with incomplete basic immunization among children in Indonesia: A nationwide multilevel study | Pediatrics and Neonatology.

[Open Access] [Received: March 23, 2020; Received in revised form: August 5, 2020; Accepted: September 2, 2020; Published online: September 19, 2020] [In Press Corrected Proof]



Identifying risk factors of incomplete immunization among children is crucial to developing relevant policies to improve immunization coverage. In this study, we investigated factors associated with incomplete immunization among children in Indonesia and elucidated differences in risk factors between urban and rural areas.


The data came from a national-wide survey, the 2017 Indonesia Demographic Health Surveys. In total, 3264 children aged 12–23 months were included in the study. An incomplete immunization status was defined as a child who did not complete the ten doses of basic vaccinations, consisting of one dose of bacille Calmette-Guérin, one dose of hepatitis B, three doses of pentavalent vaccine (diphtheria, pertussis, tetanus, hemophilus influenza type B, and hepatitis B vaccine), four doses of polio vaccine, and one dose of measles vaccine. Generalized linear mixed models were constructed to examine the effects of different levels of risk factors on the incomplete immunization status. We further conducted stratified analyses by urban and rural areas.


About 40% of the 3264 children were incompletely immunized, among whom 45.3% were in urban areas and 54.7% were in rural areas. Eight of the 34 provinces had incomplete immunization rates exceeding 50%, and the Papua and Maluku regions had the highest rates of incomplete child immunization. The multivariate analyses showed that when women attended fewer than four antenatal care sessions and resided outside the Nusa Tenggara region, their children were more likely to have incomplete immunization in both urban and rural areas. On the other hand, having no health insurance was positively associated with incomplete immunization in urban areas, whereas having received a tetanus vaccination during pregnancy was negatively associated with incomplete immunization in rural areas.


Results of this study suggest that tailored interventions should be developed to address significant risk factors in rural and urban areas.

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Challenges in the prevention or treatment of RSV with emerging new agents in children from low- and middle-income countries | Expert Review of Anti-infective Therapy.

[Pay to View Full Text] [Received 02 Jul 2020, Accepted 23 Sep 2020, Accepted author version posted online: 24 Sep 2020] [Accepted author version]



Respiratory syncytial virus (RSV) causes approximately 120,000 deaths annually in children <5 years, with 99% of fatalities occurring in low- and middle-income countries (LMICs).

Areas covered.

There are numerous RSV interventions in development, including long-acting monoclonal antibodies, vaccines (maternal and child) and treatments which are expected to become available soon. We reviewed the key challenges and issues that need to be addressed to maximize the impact of these RSV interventions in LMICs. The epidemiology of RSV in LMICs was reviewed (PubMed search to 30-Jun-20 inclusive) and the need for more and better-quality data, encompassing hospital admissions, community contacts, and longer-term respiratory morbidity, emphasized. The requirement for an agreed clinical definition of RSV lower respiratory tract infection was also proposed. The pros and cons of the new RSV interventions are reviewed from the perspective of LMICs.

Expert opinion.

We believe that a vaccine (or combination of vaccines, if practicable) is the only viable solution to the burden of RSV in LMICs. A coordinated program, analogous to that with polio, involving governments, non-governmental organizations, the World Health Organization, the manufacturers and the healthcare community is required to realize the full potential of vaccine(s) and end the devastation of RSV in LMICs.

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Statement by Henrietta H. Fore, UNICEF Executive Director at the high-level side event on the ACT-Accelerator at the 75th session of UN General Assembly | ReliefWeb.

[News and Press Release] [Source: UNICEF] [Posted: 30 Sep 2020] [Originally Published: 30 Sep 2020] [Origin: View original]

"UNICEF is proud to be part of this historic initiative.

“Three decades ago, we led the universal child immunization initiative.

“Today, with our partners — and thanks to dedicated frontline workers and volunteers worldwide — we deliver nearly 2.5 billion doses of vaccines every year.

“We’ve built an incredible track record of scaling new vaccines for children.

“And most importantly — to your question — we understand the vital importance of preparing countries and communities for vaccines, on both the supply and demand sides.

“Delivery and acceptance go hand-in-hand.

“On the supply side, securing more than two billion doses of vaccine by 2021 will require every ounce of UNICEF’s strengths and expertise in market-shaping and strategic procurement.

“We’re working with WHO and local partners to help prepare governments to receive and deliver a COVID-19 vaccine.

“Even before the pandemic, with our friends at GAVI, we invested nearly $500 million in the last few years to strengthen cold chain infrastructure. Investments that will make it easier to deliver the COVID vaccine where it’s needed.

“But we also know that there are still gaps. So our Country Offices are now working with governments on an urgent basis to close these gaps on the ground.

“On the demand side, we must build confidence and trust in vaccines and in the health systems delivering them.

“The pandemic has brought to light the lingering challenges of mistrust, misinformation and rumours around vaccines — their safety and effectiveness.

“Our teams on the ground are reporting that baseless rumours about the COVID-19 vaccine are eroding trust in other vaccination programmes. In fact, some communities have rejected polio campaigns outright for fear of being subjected to COVID-19 vaccine trials.

“UNICEF has now activated our social mobilization networks for polio to build demand and enhance acceptance. And we’re working with our partners and communities to use social media and other tools to stamp-out rumours and misinformation.

“This work will also be vital as we deploy additional tools like therapeutics and diagnostics, and continue our work to re-build stronger health systems in the aftermath of COVID-19.

“But our success depends on all of us.

“To governments — help us prepare for the rollout of a vaccine in your countries, and keep other campaigns up-and running.

“To donors — help us give this work the funding it deserves, especially in countries that are suffering economically from the pandemic. They need our help.

“And to our partners — let’s keep up the good work and match the historic promise of this exciting initiative with an equally historic effort.”

Media Contacts

Sabrina Sidhu
Tel: +1 917 476 1537

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