Tuberculosis vaccination of young children during the COVID-19 pandemic: modern practices

BACKGROUND: Reducing population immunity to vaccine-controlled infections because of low vaccination coverage at any moment could destabilize earlier epidemiological well-being against vaccine-controlled infections in the context of the COVID-19 pandemic.

AIM: This study comprehensively assessed the completeness and timeliness of TB vaccination of young children in a maternity hospital-polyclinic stages and identified resources to improve their immunization.

MATERIALS AND METHODS: Form 063/in patients born from January 1, 2020, to December 31, 2021, (3613), Registers of newborns under the supervision of the Children’s City Polyclinic (DPP) from 2020 to 2021 were obtained (3). This article uses epidemiological (descriptive-estimative and analytical) and statistical methods of analysis using the online service StatTech. Electronic discharges from the EMIAS system were used to examine the timeliness and completeness of vaccination coverage.

RESULTS: In 2020 and 2021, because of the early discharge of newborns from the maternity hospital, a significant proportion of them were not vaccinated against tuberculosis within the timeframe prescribed by the National Immunization Prevention Calendar. In 2020, 24.8% of the causes of not contracting tuberculosis in a maternity hospital were discharged early, whereas, in 2021, it was 9.6% (p <0.05). In 2020, the chances of not vaccinating against BCG because of early withdrawal were 3.12 times higher than in 2021 (95% of confidence interval 2.09–4.7). In the structure of the causes of the lack of development, the largest proportion was medical withdrawals from BCG and parental refusals, 40.7% and 40.9%, respectively. In 2020 and 2021 their number was relatively stable, and for each of the analyzed items, more than 40%. Later on, only 32.8% of those not disabled in the maternity hospital were vaccinated against tuberculosis up to the age of 2 months. The cumulative coverage of tuberculosis vaccination for children registered with DHS was 82% by the first 12 months of life, which was not in line with the WHO target of 95% immunization coverage. The reasons for this failure were parents’ refusal to be vaccinated (48.5%), their low social responsibility (39.2%), and medical defenses (12.3%). The interruption of vaccination schedules at the maternity ward during the COVID-19 pandemic due to the early discharge of newborns resulted in a delay in scheduling subsequent vaccinations. As a result, children were born in 2020 and 2021. By 12 months, 17%, whooping cough, diphtheria, and tetanus, 20.6%, polio 20.5%, pneumococcal infection 30.2%, had not been vaccinated.

CONCLUSION: Given the high incidence of morbidity among children up to the age of two and the increase in the number of home-based cases of tuberculosis, the ambiguity of the situation makes vaccination against tuberculosis a priority in the current version of the National Immunization Service. It requires control of the regulated order of the Ministry of Health of Russia from December 6, 2021. 1122h “On approval of the national calendar of preventive vaccinations, the calendar of preventive vaccinations according to epidemic indications and the order of preventive vaccinations” calendar.