To the Editor: Restrictions and concerns associated with coronavirus disease 2019 (COVID‐19) have led to decreased routine immunisation coverage in many countries, including the United Kingdom1 and the United States.2 Australian data showing the COVID‐19 pandemic’s impact on vaccination coverage are not yet available, but it has disrupted services provided by the National Immunisation Program, which funds vaccination for children, adolescents, adults and special risk groups. In the face of ongoing COVID‐19 risk and restrictions, maintaining a resilient routine vaccination program is crucial.
The COVID‐19 pandemic has heightened barriers to vaccination. Lockdown restrictions have affected immunisation service accessibility. Specifically, some clinics reduced face‐to‐face appointments in favour of telehealth3 or closed due to insufficient space and increased staffing and other requirements.4 Patients may have rescheduled appointments to avoid COVID‐19 exposure in waiting rooms, while school‐based programs have been disrupted by closures. Reduced consultations limit not only opportunities to vaccinate but also opportunities for health care providers to address vaccine questions and concerns and reinforce trust. Employment changes related to COVID‐19 may also exacerbate cost barriers for people at risk of under‐immunisation, such as migrants, international students, asylum seekers and refugees.5
To improve access, some jurisdictions have successfully established drive‐through vaccine clinics, and pharmacists in some states have been granted expanded permission to vaccinate children against influenza. However, some families may have delayed vaccines due to the COVID‐19 pandemic, and governments may need to consider additional resources for catch‐up vaccination and extensions or grace periods for “No jab, no pay” and “No jab, no play” policies. School‐based vaccination programs should be re‐established as a priority when schools reopen.
Publicly available vaccination coverage data will not reflect COVID‐19‐related impacts until as late as December 2020. We recommend early release of more timely data to ensure service providers gain feedback on program performance. We also recommend awareness campaigns promoting timely National Immunisation Program vaccination or catch‐up. Information should be culturally and linguistically appropriate and should be developed through consultation and engagement with diverse communities, including Aboriginal and Torres Strait Islander communities. Australia’s immunisation providers are dedicated and adaptable, but we must now respond quickly to the challenges of COVID‐19 and remain vigilant to maintain routine vaccination coverage across the lifespan.
This manuscript was collectively authored in July 2020 by the Collaboration on Social Science and Immunisation (COSSI) Working Group for routine immunisation in the COVID‐19 pandemic. The COSSI Working Group members are: Jessica Kaufman, Katie Attwell, Frank Beard, Katarzyna Bolsewicz, Bianca Bullivant, Samantha Carlson, Katrina Clark, Margie Danchin, Cristyn Davies, Jane Frawley, Anita Heywood, Julie Leask, Holly Seale, Maryke Steffens, Jane Tuckerman, Natasa Veselinovic, and Kerrie Wiley.
Katie Attwell has previously been employed by the Immunisation Alliance of Western Australia to conduct social research using an unrestricted grant from Sanofi Pasteur. She has received travel, accommodation and conference registration support from GSK, and travel, accommodation and speaker fees from Merck.
COSSI Working Group: Cristyn Davies is a researcher in the Wellbeing Health and Youth National Health and Medical Research Council Centre of Research Excellence in Adolescent Health (APP 1134984). Anita Heywood has received funding from GSK for investigator‐driven grant funding related to immunisation for international travel. Holly Seale has previously received funding from drug companies for investigator‐driven research and consulting fees to present at conferences and workshops and develop resources (bio‐CSL/Sequiris, GSK and Sanofi Pasteur). She has also participated in advisory board meeting for Sanofi Pasteur. Jane Tuckerman is an investigator on a project grant sponsored by industry (GSK) for investigator‐led research; she does not receive any personal payments from industry.