This article is part of our special report Transparency in the race for a COVID vaccine.
A real commitment from all stakeholders and policymakers is needed to support a catch-up immunisation campaign and overcome the difficulties routine vaccination programmes have experienced during the pandemic, according to a key vaccine stakeholder.
In an interview with EURACTIV, the new executive director of Vaccines Europe, Sibilia Quilici, said that while everyone is rightly focusing on the rollout of COVID-19 vaccination, there is also a concrete risk that other vaccination programmes might end up overlooked.
“Significant healthcare system resources are allocated to COVID-19 vaccination and little, if any, attention is given to routine immunisation to ensure continuity,” she said.
Routine national immunisation programmes are intended to protect the population against vaccine-preventable diseases such as measles, human papillomavirus-related diseases and cancers, influenza or pneumococcal infections, to name but a few. Such programmes are widely recognised as one of the world’s most successful and cost-effective health interventions.
“Lockdown and social distancing measures created a change in the behaviour of the population with regards to access to healthcare in general, including primary prevention such as routine vaccination,” Quilici said.
Temporary interruptions of routine immunisation services have been reported as people tended to avoid health services in order not to get infected with COVID-19. In some cases, national governments have even suspended immunisation programmes to prevent such a risk.
According to Quilici, this leads to misleading communication about the importance of vaccination, ending up in a significant reduction in appointments and up-take of routine vaccination.
In France, there have been 57% of postponements or cancellations of routine immunisation affecting children, and 49% for adults.
“We know that population today is not at the level of protection they should have,” Quilici stressed.
At the peak of the first wave of the pandemic, the World Health Organisation and UNICEF released a joint statement stating that the COVID-19 pandemic is a “stark reminder that infectious diseases know no borders. All countries are vulnerable, regardless of income levels or the strength of their health care systems.”
“The current offer for routine immunisation includes protection at all stages of life, depending on the individual’s health status, age, lifestyle and occupation,” Quilici said.
“It includes not only kids or the elderly but also adult people such as young parents, travellers or people with occupation requiring adequate protection against infectious diseases such as military or healthcare professionals,” she added.
Complete life-course immunisation programmes are in force all across Europe, with the Italian ones offering one of the most complete protections against 18 infectious diseases.
COVID, a double-edged sword
On the positive side, lockdown measures and protective masks have been an efficient way to avoid an outbreak of influenza and other epidemics this year.
“But what will happen once people are vaccinated for COVID-19 and go out again?” asked Quilici.
The risk of outbreaks for the next season is high as people may not have the right level of protection, she added.
At the same time, people being locked down have had the tendency of not checking whether they are up to date with their vaccination, which affected the overall vaccination coverage.
“And when you have a decrease in vaccine uptake, going back to the protective level of vaccine coverage rates becomes really hard,” Quilici said.
The process of catching up might also require time, which is why Quilici calls for a commitment in this sense by all relevant stakeholders and policymakers.
The silver lining of the COVID pandemic is that now people are much more aware of vaccines as they have understood what harm a single virus can do at the global level in terms of social and economic burden.
“Thanks to COVID-19, people start realising the value of vaccines and vaccination,” she said.
“However, it is part of the story of vaccines: you have a disease, people want to be protected and like vaccines; once there’s no disease anymore, they forget about vaccines and their importance.”
She pointed out that Europe is the most vaccine-hesitant continent in the world. “And COVID will not change that.”
For her, COVID-19 is going to create artificial vaccine confidence simply because people have grown tired of the lockdowns and travel restrictions.
“They want to have a solution to fix that. And today vaccines is the only solution that is proposed to them,” she said.
Quilici did not exclude the possibility that COVID vaccination could become a routine in the likely case that it becomes endemic within Europe.
“We keep updating the influenza vaccines every season with strains that are changing and circulating: something similar could be done for handling COVID-19 too,” she concluded.
[Edited by Zoran Radosavljevic]