Call to Action On Routine and Life-Course Immunization in the Context of the COVID-19 Pandemic

Milestones :: Perspectives :: Research


Call to Action On Routine and Life-Course Immunization in the Context of the COVID-19 Pandemic
09 December 2020
[Test bolding from original; referenced at PDF link above]

A call to action for global and regional stakeholders and governments to strengthen pandemic preparedness and responsiveness by taking a lifecourse immunization (LCI) approach which will expand access to vaccines, improve uptake, and ensure optimal protection of all populations.

People everywhere have been devasted by the loss of loved ones and impacted by economic and social disruptions caused by the COVID-19 pandemic. Policies that strengthen health systems will be critical for staving off additional harm and rebuilding economies.1 This is particularly the case for countries with limited healthcare capacity, but even in countries with robust health systems, COVID-19 has caused interruptions in immunization services. The WHO and UNICEF warn that 2020 could be the first time in 28 years that the world sees a reduction in the annual childhood immunization coverage rate.2

Despite the widespread availability of many safe and effective vaccines across the life course, disease outbreaks, disability and deaths from vaccine-preventable diseases continue to occur due to poor vaccine coverage at all ages. The disruption in immunization services as a result of the pandemic may lead to more outbreaks of vaccine-preventable diseases, if not redressed quickly, and this will add further strain to healthcare systems already overburdened because of COVID-19. In addition, the potential for co-circulation of influenza, or any other epidemic pathogens (for example, measles, respiratory syncytial virus, and meningitis), and COVID-19 could further burden healthcare systems in the upcoming months.3

Significant efforts are being put into the development of safe and effective COVID-19 vaccines. Until these vaccines become available, we urge governments everywhere to follow guidance from the World Health Organization to urgently make efforts to safely resume routine immunization4 and conduct urgent catch-up vaccinations as soon as possible, prioritizing those most at risk (including children, adolescents, older adults, healthcare workers, and pregnant women).5 6 7 8 We call attention to the role of vaccination in protecting the health and well-being of all people around the world, and to the importance of health system capacity and resilience to deliver immunization services across the life span.9


We urge governments and all global and regional stakeholders to:
Strengthen public health systems for future mass vaccination with COVID-19 vaccines by expanding
vaccination delivery channels to include pharmacies.
:: Governments should reduce access barriers to vaccines and vaccination across all
populations, in order to recover from the negative impacts of the pandemic on routine
vaccination coverage, and in order to be able to implement effective vaccination campaigns
against COVID-19 when a vaccine becomes available.
:: Governments should expand vaccine delivery channels to include pharmacy-based,
community-based, employer-based, residential-care-based, and school-based delivery
of vaccinations, to support a successful implementation of life-course immunization.
Developing additional channels for delivery of life-course immunization provides
governments with an ideal platform on which to build delivery of mass vaccination for
pandemics. Additional vaccination access points can also facilitate the conduct of vaccination
catch-up campaigns, which may be needed because of the disruptions to routine vaccination
services caused by the COVID-19 pandemic.
:: Since pharmacies are often the entry point to the health system for many10 for whom
pharmacists are the most accessible healthcare professionals, pharmacy-based delivery of
vaccination can play a critical role in expanding access to immunization services.11
:: Increased community delivery of immunization may also have a role to play in countering
vaccine hesitancy by increasing the linkages with communities and improving trust,12
particularly for routine vaccines that have a long, well-established, record of safety.
: Maintaining and growing confidence in vaccination is an urgent public health issue; crucial
to preventing the spread of disease, recovering vaccination coverage rates following the
COVID-19 pandemic, and ensuring that vaccination continues to protect and enhance the
health and well-being of the public.


We urge governments and all global and regional stakeholders to:
Safeguard immunization budgets that cover adolescent and all appropriate adult populations to preserve the full benefits of country investments in disease prevention, and where feasible to progressively invest in life-course immunization.
:: Governments should allocate appropriate budgets for immunization of adolescents and
adults. Insufficient targeted budget allocations have been identified as one of the main
barriers to the implementation of life-course immunization.13 Immunization may save the
health system 10 times more than it costs14 but prevention and immunizations represent
a fraction of total health spending and may be particularly susceptible to cuts in times of
economic crisis.
:: The economic fallout from the COVID-19 pandemic will make it even more critical
for governments to protect or expand immunization budgets to include life-course
immunization as a means to strengthen the resilience of the health system.
:: Adults with chronic conditions and older adults are disproportionately affected by the COVID-19 pandemic. It is critical that they have access to vaccination, a cornerstone of primary health care, not just to emergency care,15 during the COVID-19 pandemic. Access to life-course immunization, including against influenza, pneumococcal and other epidemic pathogens, will help to prevent further detrimental impacts of COVID-19 on healthcare systems.16
:: Life-course immunization will help governments to ensure parity in immunization coverage
at all stages of life and enhance the ability of governments to deliver immunization services,
both during and outside of pandemics.


We urge governments and all global and regional stakeholders to:
Encourage catch-up campaigns for all interrupted vaccine schedules (adolescent, college, travel, adults
and the elderly) not just childhood schedules.
:: Emphasis is often placed on pediatric immunization coverage; however, vaccination can prevent
an overall great number of deaths in older adults and is essential to living healthier lives.17
:: Healthcare workers should assess the vaccination status of all persons at each contact with
the healthcare system, and ensure that all age-appropriate recommended vaccines, including
influenza vaccine, are administered, as long as vaccine is available, to reduce the burden on
health systems and healthcare workers.5
:: Governments should provide healthcare providers with emergency guidance on how to maintain
routine immunization coverage, conduct catch-up campaigns, and expand immunization access
during the COVID-19 pandemic,5 other future pandemics or major disruptive events.
:: Many countries are making concerted efforts to resume disrupted immunization programs with
precautionary measures in place.7 Governments should exchange frequently on best practices
for the management of immunization catch-up campaigns to ensure that immunization services
are delivered safely with minimum disruption during the COVID-19 pandemic.