Dataset Information

COVID-19 related immunization disruptions in Rajasthan, India: A retrospective observational study.

ABSTRACT:

Introduction

Governments around the world suspended immunization outreach to control COVID-19 spread. Many have since resumed services with an emphasis on catch-up vaccinations. This paper evaluated immunization disruptions during India's March-May 2020 lockdown and the extent to which subsequent catch-up efforts reversed them in Rajasthan, India.

Methods

In this retrospective observational study, we conducted phone surveys to collect immunization details for 2,144 children that turned one year old between January and October 2020. We used logistic regressions to compare differences in immunization timeliness and completed first-year immunization status among children that were due immunizations just before (unexposed), during (heavily exposed), and after (post-exposure) the lockdown.

Results

Relative to unexposed children, heavily exposed children were significantly less likely to be immunized at or before 9 months (OR 0.550; 95% CI 0.367-0.824; p = 0.004), but more likely to be immunized at 10-12 months (OR 1.761; 95% CI 1.196-2.591; p = 0.004). They were also less likely to have completed their key first-year immunizations (OR 0.624; 95% CI 0.478-0.816; p = 0.001) by the time of survey. In contrast, post-exposure children showed no difference in timeliness or completed first-year immunizations relative to unexposed children, despite their younger age. First-year immunization coverage among heavily exposed children decreased by 6.9 pp to 10.4 pp (9.7% to 14.0%). Declines in immunization coverage were larger among children in households that were poorer, less educated, lower caste, and residing in COVID red zones, although subgroup comparisons were not statistically significant.

Conclusion

Disruptions to immunization services resulted in children missing immunization during the lockdown, but catch-up efforts after it was eased ensured many children were reached at later ages. Nevertheless, catch-up was incomplete and children due their immunizations during the lockdown remained less likely to be fully immunized 4-5 months after it lifted, even as younger cohorts due immunizations in June or later returned to pre-lockdown schedules.

SUBMITTER: Jain R

PROVIDER: S-EPMC8196298 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundThe COVID-19 pandemic has become a global public health event, which has raised concerns regarding individuals' health. Individuals need to cope with the COVID-19 pandemic with guidelines on symptom recognition, home isolation, and maintain mental health. Besides routine use of mobile health (mHealth) such as accessing information to keep healthy, individuals can use mHealth services in situations requiring urgent medical care, which is defined as mHealth emergency use. It is not known whether individuals have increased their daily mHealth services emergency use as a result of disruptions caused by the COVID-19 pandemic.ObjectiveThe purpose of this diary analysis study is to assess the influences of daily disruptions related to the COVID-19 pandemic on individuals' mHealth emergency use. The secondary purpose of this study is to explore the mediating role of COVID-19-induced strain and the moderating role of promotion regulatory focus in the relationship between daily disruptions of COVID-19 and mHealth emergency use. Drawing from the cognitive activation theory of stress, we investigated the underlying mechanism and boundary condition of the influence of COVID-19-related disruptions on daily mHealth emergency use.MethodsTo test the proposed model, this study adopts the experience sampling method to collect daily data. The experience sampling method helps researchers to capture participants' fluctuations in emotions, mental engagement in an activity, and experienced stress. This study collected 550 cases nested in 110 samples in mainland China to test the conceptual model. In addition, we employed hierarchical linear modeling analysis to test the effect of COVID-19-related disruptions on mHealth emergency use.ResultsWe found that COVID-19-related disruptions increased COVID-19-induced strain (γ=0.24, P<.001) and mHealth emergency use on a daily basis (γ=0.28, P<.001). COVID-19-induced daily strain mediated this relationship (effect=0.09, 95% CI 0.05-0.14). Promotion regulatory focus moderated the relationship between COVID-19-induced strain and mHealth emergency use (γ=0.35, P=.02). In addition, the indirect relationship between disruptions and mHealth emergency use intentions through COVID-19-induced strain is contingent upon promotion regulatory focus: this relationship was stronger in those with high promotion regulatory focus (effect=0.12, 95% CI 0.06-0.19) than in those with low promotion regulatory focus (effect=0.06, 95% CI 0.02-0.11).ConclusionsEvent disruption of the COVID-19 pandemic induced mHealth emergency use intention through increased psychological strain. Furthermore, individuals' promotion regulatory focus amplified this indirect relationship. Our findings extend our understanding of the factors underlying mHealth emergency use intention and illustrate the potential contingent role of promotion regulatory focus in the cognitive activation theory of stress. This study also opens avenues for future research on mHealth emergency use intention in other countries and cultural settings.