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. 2024 Apr 25;12(5):458.
doi: 10.3390/vaccines12050458.

The Impact of the Coronavirus Pandemic on Vaccination Coverage in Latin America and the Caribbean

Ignacio E Castro-Aguirre  1 , Dan Alvarez  1 , Marcela Contreras  1 , Silas P Trumbo  2 , Oscar J Mujica  3 , Daniel Salas Peraza  1 , Martha Velandia-González  1
Affiliations

The Impact of the Coronavirus Pandemic on Vaccination Coverage in Latin America and the Caribbean

Ignacio E Castro-Aguirre et al. Vaccines (Basel). .

Abstract

Background: Routine vaccination coverage in Latin America and the Caribbean declined prior to and during the coronavirus pandemic. We assessed the pandemic's impact on national coverage levels and analyzed whether financial and inequality indicators, immunization policies, and pandemic policies were associated with changes in national and regional coverage levels.

Methodology: We compared first- and third-dose coverage of diphtheria-pertussis-tetanus-containing vaccine (DTPcv) with predicted coverages using time series forecast modeling for 39 LAC countries and territories. Data were from the PAHO/WHO/UNICEF Joint Reporting Form. A secondary analysis of factors hypothesized to affect coverages during the pandemic was also performed.

Results: In total, 31 of 39 countries and territories (79%) had greater-than-predicted declines in DTPcv1 and DTPcv3 coverage during the pandemic, with 9 and 12 of these, respectively, falling outside the 95% confidence interval. Within-country income inequality (i.e., Gini coefficient) was associated with significant declines in DTPcv1 coverage, and cross-country income inequality was associated with declines in DTPcv1 and DTPcv3 coverages. Observed absolute and relative inequality gaps in DTPcv1 and DTPcv3 coverage between extreme country quintiles of income inequality (i.e., Q1 vs. Q5) were accentuated in 2021, as compared with the 2019 observed and 2021 predicted values. We also observed a trend between school closures and greater-than-predicted declines in DTPcv3 coverage that approached statistical significance (p = 0.06).

Conclusion: The pandemic exposed vaccination inequities in LAC and significantly impacted coverage levels in many countries. New strategies are needed to reattain high coverage levels.

Keywords: coronavirus pandemic; diphtheria–tetanus–pertussis-containing vaccine; health disparities; immunization coverage levels; vaccination of newborns; zero-dose children.

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Conflict of interest statement

The authors are staff members of the Pan American Health Organization. The author alone is responsible for the views expressed in this publication, and they do not necessarily represent the decisions or policies of the Pan American Health Organization.

Figures

Figure 1
Figure 1
DTPcv1 and DTPcv3 coverage levels in Latin America and the Caribbean, 1990–2022.
Figure 2
Figure 2
Observed versus predicted changes in DTPcv1 and DTPcv3 coverage in 2021 in Latin America and the Caribbean, 39 countries and territories with available data.
Figure 3
Figure 3
Income-related cross-country inequality gradients in DTPcv1 and DTPcv3 coverage, Latin America and the Caribbean, 2019 and 2021.
See this image and copyright information in PMC

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