India: ACVIP Guidelines on Immunizations during COVID 19 Pandemic

The WHO declared COVID 19 as a Global Health Emergency in January 2020. It was

declared a “Pandemic” on March 11, 2020. The Government of India declared a

lockdown on March 22, 2020, which was initially for 21 days, ending on April 14,

2020, but was extended up to May 3, 2020. The Ministry of Home Affairs has

released guidelines to be followed during the lockdown on April 15, 2020. Since

March 22, 2020 effective primary, secondary and tertiary care facilities have been

almost paralyzed. The primary focus of public health has been in preparedness and

containment of COVID 19 pandemic in the country and all other preventive health

activities have been relegated to the background. A decreased demand for

vaccination may also occur because of physical distancing requirements or

community reluctance. The likelihood of outbreaks of vaccine preventable diseases

(VPDs) such as measles may increase as a result of disruption of immunization

services, even for brief periods. The importance of continued immunization

activities is further emphasized by the observation that during the 2014-2015

Ebola outbreak, the increased number of deaths caused by measles, malaria,

HIV/AIDS and tuberculosis attributable to health system failures, exceeded deaths

from Ebola itself. A modelling study done by the scientists at the London School of

Hygiene and Tropical Medicine on the impact of suspending routine immunization

sessions to prevent the spread of COVID 19 and further deaths due to COVID 19 in

Africa, has shown that for each COVID 19 death prevented, there would be as

many as 34 - 1274 future deaths due to diseases including measles, yellow fever,

polio, meningitis, pneumonia and diarrhea.

Any flare of VPD will additionally burden the already stressed health care

systems.

The ministry of Home affairs in its guidelines dated April 15, 2020, has

mentioned that Essential Medical Services be maintained during the

lockdown. Clinics and Hospitals must continue providing Essential Medical

services to non-COVID 19 patients.