key: cord-1036330-54bunr48
authors: Awan, Usman Ayub; Haroon, Kinza; Haqqi, Aleena; Ali khattak, Aamer; Khurram, Muhammad; Ahmed, Haroon; Afzal, Muhammad Sohail
title: COVID-19 And Immunization Gap in Pakistan: Fear drives for Forthcoming Spikes
date: 2021-02-12
journal: Public Health
DOI: 10.1016/j.puhe.2021.01.024
sha: e492e3cd2dd9afcc930cf1cccd938626bbad1b66
doc_id: 1036330
cord_uid: 54bunr48

nan

Pakistan is the fifth most populous country, bearing a total population of about 200 million with a growth rate of about 2.04%. Such an abrupt increase in population rate brings immense pressure on the health care system. 8 Meanwhile, the Pakistani government was decided to suspend vaccination services to limit the local transmission of COVID-19, which has prompted an upswing of a variety of infectious diseases such as polio and measles. 9 The current pandemic causes significant distortions in Pakistan's immunization programs; thus, vaccine-preventable illnesses are becoming a snag for the health care system. Existing immunization protocols were severely affected during the implementation of COVID-19 lockdown, as illustrated in Fig 2(a) . 10 J o u r n a l P r e -p r o o f

Declining immunization campaigns were seen worldwide, particularly in developed countries, which are already facing financial constraints, lack of medical equipment, and primary health facilities. 11 According to a UNICEF report, the vaccination rate dropped to half during the pandemic lockdown. Moreover, ghettos and impoverished communities are more affected; lockout vaccination gaps lead to an extreme infant immunization burden, exacerbating global immune deficits. 9 Startlingly, territories with inadequate vaccination are at risk of wild-type poliovirus re-emergence, which will disrupt all past polio strategy policies. 12 Pakistan is still endemic to wild-type poliomyelitis (WPV) and circulating vaccine-derived poliomyelitis (c VDPV2). In 2019, as shown in Fig 2 (b) , a total of 147 cases of WPV and 22 cVDVP2 cases from Pakistan were reported. 13, 14

The pandemic hits hard and poses alarming threats to healthcare professionals regarding the severity of post-pandemic era challenges. Immunization affected by a pandemic is also of prime importance as it provokes out eradicated viral infections like measles. 11 Measles vaccination programs follow routine immunization strategies to prevent infection of children who do not have routine healthcare facilities. 15 Dreadfully, about 120 million children from 37 countries have missed measles immunization this year due to COVID-19. 16 In a third-world country like

Pakistan; measles could have fatal consequences; thus, the continuation of reporting and investigation should be mandatory for the healthcare-supporting systems. A study reported higher measles cases from January 2020 to March 2020 compared to 2019 in the COVID-19

lockdowns. 17 COVID-19 lockdown implemented by the government to protect masses against COVID-19

virus might aid widespread vaccine-preventable disease, posing a burden on a healthcare infrastructure on the verge of collapse. To resolve these vaccine-preventable diseases, urgent

Global epidemiology of coronavirus disease 2019: disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status

COVID-19 Weekly Epidemiological Update

COVID-19 and Arboviral Diseases: Another Challenge for Pakistan's Delipidated Healthcare System

COVID-19 and Influenza H1N1: A dangerous combination for Pakistan in the upcoming winter season

COVID-19 and dengue virus coepidemics in Pakistan: A dangerous combination for overburdened healthcare system

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Dengue and Zika Viruses: Epidemiological History, Potential Therapies, and Promising Vaccines

Delays in polio vaccination programs due to COVID-19 in Pakistan: a major threat to Pakistan's long war against polio virus

Impact of COVID-19 lockdown on routine immunisation in Karachi

Impact of COVID-19 pandemic response on uptake of routine immunizations in Sindh, Pakistan: an analysis of provincial electronic immunization registry data

Risk factors and short-term projections for serotype-1 poliomyelitis incidence in Pakistan: A spatiotemporal analysis

Measles vaccines: WHO position paper

More than 117 million children at risk of missing out on measles vaccines, as COVID-19 surges. Statement by the Measles & Rubella Initiative comprising of American Red Cross

Impact of COVID-19 pandemic on Measles surveillance in Pakistan

Fig 1: Status of vaccinations done in the Pakistan from year

b) Prevalence and of different vaccines-preventable diseases

Number of Vaccinations Vaccination Status in Pakistan