Access barriers that affected infectious disease vaccination coverage among children aged five years and younger in Ecuador during the COVID-19 pandemic in 2020.

• DOI: https://doi.org/10.22533/at.ed.15951225240212

• Palavras-chave: childhood vaccination, pandemic, COVID-19, coronavirus, health systems, access

• Keywords: childhood vaccination, pandemic, COVID-19, coronavirus, health systems, access

• Abstract:

  Introduction: The response to the COVID-19 pandemic caused worldwide, interruption of routine immunizations. To understand the barriers to access to routine immunization during the COVID-19 pandemic in the population aged 5 years and younger during 2020, we captured the local experiences of district and area immunization officers in the 24 provinces of the country through a survey.

  Methodology: The study design has a quantitative approach, descriptive, retrospective cross-sectional and non-experimental design, the instrument to be used is a survey (see Annex 1) which is an adaptation of the National Health and Nutrition Survey of the National Institute of Statistics and Census of Ecuador.

  Results: Of the 93 responses received, 88 reported some barriers to access to the regular vaccination schedule in the population aged 5 years and younger.

  The data analysis identified the following causes for not immunizing: closure of health facilities, closure of schools and colleges, lack of population to vaccinate, lack of human talent to vaccinate, health personnel dedicated to the search for cases of COVID-19, health personnel infected with COVID-19, fear declared by the population of contracting COVID-19 by attending health facilities, population that refused the visit of health personnel who were following up on vaccination schedules at home for fear of contracting COVID-19.

  In addition, it was asked if there was compliance with vaccination campaigns that are executed on a regular basis in years without pandemic and the results were as follows: Vaccination day of the Americas during the year 2020 only 76% of the facilities carried it out, in the vaccination campaign against Influenza developed between the months of October November and December 2020 91% of the facilities complied with it in its entirety; and the training activities (national and international) to achieve the goals in vaccination coverage of regular scheme during 2020 only 75% of the facilities carried it out.

  Likewise, a comparative analysis was performed between a year with and without pandemic and there is a significant difference between 2019 and 2020 for Pentavalent vaccine F(440) = 2.817 (p = 0.000) and DPT F(440) = 4.179 (p<0.05). In the case of Pentavalent vaccine the average coverages decreased by 12.04% while for DPT vaccine the average coverage at the cantonal level increased in 2020 by 8.25%, i.e. the country suffered from lack of access in routine vaccination with at least one antigen.

  Conclusion: Respondents reported access barriers regarding routine immunization during 2020. It is concluded that work on the identified critical nodes is needed to strengthen the childhood immunization program, prioritizing health services, logistical support and targeted communication strategies to reinforce routine immunizations during the COVID-19 response.