Resilience of routine childhood immunization services in two counties in Kenya in the face of the COVID-19 pandemic

Abstract

The recently emerged coronavirus disease 2019 (COVID-19) has caused considerable morbidity and mortality worldwide and disrupted health services. We describe the effect of the COVID-19 pandemic on utilization of childhood vaccination services during the pandemic. Using a mixed methods approach combining retrospective data review, a cross-sectional survey, focus group discussions among care givers and key informant interviews among nurses, we collected data between May and September 2021 in Mombasa and Nakuru counties. Overall, there was a <2 % decline in the number of vaccine doses administered during the pandemic period compared to the pre-pandemic period but this was statistically insignificant, both for the pentavalent-1 vaccine (ß = -0.013, p = 0.505) and the pentavalent-3 vaccine (ß = -0.012, p = 0.440). In government health facilities, there was 7.7 % reduction in the number of pentavalent-1 (ß = -0.08, p = 0.010) and 10.4 % reduction in the number of pentavalent-3 (ß = -0.11, p < 0.001) vaccine doses that were administered during the pandemic period. In non-government facilities, there was a 25.8 % increase in the number of pentavalent-1 (ß=0.23, p < 0.001) and 31.0 % increase in the number of pentavalent-3 (ß = -0.27, p < 0.001) vaccine doses that were administered facilities during the pandemic period. The strategies implemented to maintain immunization services during the pandemic period included providing messaging on the availability and importance of staying current with routine vaccination and conducting catch-up vaccinations and vaccination outreaches. Our findings suggest that the COVID-19 pandemic did not impact childhood vaccination services in Mombasa and Nakuru counties in Kenya. The private health facilities cushioned vaccination services against the effects of the pandemic and the strategies that were put in place by the ministry of health ensured continuation of vaccination services and encouraged uptake of the services during the pandemic period in the two counties in Kenya. These findings provide useful information to safeguard vaccination services during future pandemics.

Keywords: COVID-19; Essential health services; Kenya; Pandemic; Vaccination.

Fig. 1.

Time series analyses of pentavalent-1 vaccine doses administered in the pre-pandemic and pandemic periods in Mombasa and Nakuru counties and in both counties combined.

Fig. 2.

Time series analyses of pentavalent-2 vaccine doses administered in the pre-pandemic and pandemic periods in Mombasa and Nakuru counties and in both counties combined.

Fig. 3.

Time series analyses of pentavalent-1 vaccine doses administered in the pre-pandemic and pandemic periods in government and non-government health facilities in Mombasa and Nakuru counties and in both counties combined.

Fig. 4.

Time series analyses of pentavalent-3 vaccine doses administered in the pre-pandemic and pandemic periods in government and non-government health facilities in Mombasa and Nakuru counties and in both counties combined.