World Journal of Vaccines, 2021, 11, 1-6

https://www.scirp.org/journal/wjv
ISSN Online: 2160-5823
ISSN Print: 2160-5815

Impact of COVID19 on Routine Immunization:

A Cross-Sectional Study in Senegal

Amadou Sow*, Modou Gueye, Djibril Boiro, Idrissa Demba Ba, Abou Ba, Aliou Thiongane,
Papa Moctar Faye, Amadou Lamine Fall, Ousmane Ndiaye

Chair of Pediatrics, Cheikh Anta Diop University of Dakar, Fann, Senegal

How to cite this paper: Sow, A., Gueye, Abstract

M., Boiro, D., Ba, I.D., Ba, A., Thiongane,
A., Faye, P.M., Fall, A.L. and Ndiaye, O. Introduction: The COVID 19 pandemic has prompted the world to imple-
(2021) Impact of COVID19 on Routine ment drastic prevention methods based on limiting population movements
Immunization: A Cross-Sectional Study in that have an impact on public health policies such as vaccination. The objec-
Senegal. World Journal of Vaccines, 11, 1-6.
tive of this work was to evaluate the impact of these prevention measures on
https://doi.org/10.4236/wjv.2021.111001
routine vaccination in hospitals since the advent of the pandemic in Senegal.
Received: October 2, 2020 Methodology: This is a retrospective cross-sectional study carried out in
Accepted: January 12, 2021 August 2020 in the vaccination unit of the Abass NDAO hospital centre. We
Published: January 15, 2021
compared data from the vaccination unit during the period from March to
Copyright © 2021 by author(s) and August of the last three years (2018, 2019 and 2020). The parameter studied
Scientific Research Publishing Inc. was the number of vaccine doses administered for the different periods ac-
This work is licensed under the Creative cording to the expanded programme of immunization. Results: For the vac-
Commons Attribution International cines administered in the sixth week in April, the number of doses was 36 in
License (CC BY 4.0).
2018, 29 in 2019 and 15 in 2020, i.e. a 50% drop compared to March. In July
http://creativecommons.org/licenses/by/4.0/
Open Access the number of doses administered was 40 in 2018, 35 in 2019 and 15 in 2020,
a reduction of 42% compared to 2019. Conclusion: Measures to fight this
pandemic should not make us forget routine vaccination, especially in our
resource-constrained countries. It is essential to continue vaccination for
children and to identify children who have missed vaccine doses for catch-up.

Keywords
COVID19, Vaccination, Impact, Children, Senegal

1. Introduction
COVID 19 was identified in January 2020 as the cause of a pneumonia epidemic
in China [1]. It was declared a pandemic by the World Health Organization
(WHO) due to the high contagion rate [2]. As of August 28, 2020, COVID-19
has caused the death of 833,135 (3.40%) people worldwide and infected 24,532,835

DOI: 10.4236/wjv.2021.111001 Jan. 15, 2021 1 World Journal of Vaccines

A. Sow et al.

[3]. This pandemic has prompted the world to implement drastic prevention
methods based on barrier measures, isolation, quarantine and restriction of
population movements [1]. These measures had a considerable negative impact
on the economy and on public health policies such as vaccination [4]. In Seneg-
al, the Expanded Programme on Immunization or EPI (Table 1) was launched
in 1974 with vaccination coverage that has led to the eradication of several
childhood diseases and a reduction in mortality among children under 5 years of
age [5]. The objective of this work was to evaluate the impact of the COVID-19
and preventive measures on routine hospital immunization since the advent of
this pandemic in the country on 2 March 2020.

2. Methodology
This is a retrospective cross-sectional study carried out during the month of
August 2020 in the vaccination unit of the ABASS NDAO hospital center
(CHAN) in Dakar, which is a level III public hospital. The vaccination unit is
very busy because CHAN is home to one of the largest mother-child center in
the country with a maternity unit that receives an average of 5000 parturients
per year. All newborns born in the facility are directly referred to the vaccination
unit and are followed according to the vaccination calendar until the age of 15
months. The unit also receives children born outside the facility. We compared
the data from the vaccination unit for the period of March to August for the last
three years (2018, 2019 and 2020). The parameter studied was the number of
vaccine doses administered for the different periods according to the EPI: at

Table 1. Calendar of the expanded program on immunization (EPI) in Senegal.

Ages Vaccines Target diseases

Hepatitis B, Hepatitis B,
At birth BCG, tuberculosis,
OPV Poliomyelitis

OPV,
Pentavalent,
Sixth week (first dose) Diphtheria
Rotavirus
Tetanus
Anti-pneumococcal
Whooping cough
OPV Hepatitis B
Pentavalent Hemophilus B
Tenth week (second dose)
Rotavirus (Hib)infections
Anti-pneumococcal Poliomyelitis
Pneumococcal infections
IPV Rotavirus infections
Fourteenth week (third dose) Pentavalent
Anti-pneumococcal

MR Measles - Rubella
Ninth month
YF Yellow fever

15 months MR Measles - Rubella

BCG = Bacillus Calmet Guerrin, OPV = oral polio vaccine, IPV = injectable polio vaccine, FJ = yellow fever,
MR = measles-rubella, Pentavalent = Diphtheria + Tetanus + Whooping cough + Hepatitis B + Hib infec-
tions.

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 A. Sow et al.

birth (BCG, poliomyelitis), at 6 weeks then at 10 weeks (pentavalent, pneumo-

coccal, rotavirus and polio vaccine), at 14 weeks and at 9 months (measles, ru-
bella and yellow fever). The data were collected from the vaccination register
and collected on a pre-established survey form. Data analysis was done with ver-
sion 9.4 of the SAS software.

3. Results
For vaccines administered at birth (tuberculosis, oral polio), the number of dos-
es administered at the vaccination unit level was 80 for March 2018, 32 for
March 2019 and 40 for March 2020. The same trends are observed when com-
paring the months of April, May, June, July and August of the year 2020 with the
last two years (2018, 2019). The number of doses administered for birth vaccines
by month and year are shown in Figure 1. For vaccines administered at week 6
according to the EPI, there are 36 doses administered in March 2018, 41 doses in
2019 and 30 doses in 2020. In April, the number of doses was 36 in 2018, 29 in
2019 and 15 in 2020, a decrease of 50% compared to March. In July the number
of doses administered was 40 in 2018, 35 in 2019 and 15 in 2020, a reduction of
37% compared to 2018 and 42% compared to 2019. The numbers of doses ad-
ministered for the sixth, tenth and fourteenth week vaccines are shown in Fig-
ures 2-4. For yellow fever, measles and rubella vaccines administered at month
9, the number of doses administered was 10 in 2018, 24 in 2019 and 20 in 2020.
In April, the number of doses administered in 2020 fell to 5 compared to 5 in
2020, a drop of 20.8% compared to March. The numbers of doses administered
for the ninth month vaccines by month and year are shown in Figure 5.

4. Discussion
In Senegal, the first case of COVID 19 was declared on 2 March 2020 and a few
weeks after the state of emergency was declared in the country, limiting the mo-
bility of the population. The number of doses administered for tuberculosis and
polio vaccines at birth in March 2020 was not impacted by VIDC 19. This could
be explained by the fact that the pandemic had no impact on births during this

Figure 1. Number of doses administered for vaccines at birth against tuberculosis (BCG) and
oral poliomyelitis according to the month from 2018 to 2020.

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A. Sow et al.

Figure 2. Number of doses administered for the vaccines of the sixth week according to the
month from 2018 to 2020.

Figure 3. Number of doses administered for the tenth week vaccines according to the
month from 2018 to 2020.

Figure 4. Number of doses administered for the 14th week vaccines according to the month
from 2018 to 2020.

DOI: 10.4236/wjv.2021.111001 4 World Journal of Vaccines

 A. Sow et al.

Figure 5. Number of doses administered for the ninth month vaccines according to the
month from 2018 to 2020.

period and that isolation measures were still limited at the individual level.
There was a marked decrease in the number of doses administered for the sixth,
tenth and fourteenth week vaccines during the period April to August 2020.
Similar results were observed in developed countries [6] [7] [8]. This period
corresponds to a steady increase in the number of cases reached and coincides
with the implementation of physical distancing measures such as curfews, clo-
sure of steps and places of worship, and reduction in the number of passengers
on public transport [9]. This impact could also be explained by the fact that the
message about staying at home initially overwhelmed the message that the vac-
cination programme should continue to function as usual and also led to disrup-
tions at the vaccination units [1]. The disruption of immunization services could
trigger secondary outbreaks of vaccine-preventable diseases and also exacerbate
the longstanding inequality in immunization coverage, especially in urban areas
[10].

5. Conclusion
COVID 19 has certainly impacted the routine vaccination of children. Measures
to combat this pandemic should not make us forget routine vaccination, espe-
cially in our resource-limited countries. It is essential to continue these vaccina-
tion programmes for children under 5 years of age and to identify children who
have missed vaccine doses for catch-up. This could prevent the reappearance of
new epidemics such as measles, which could be associated with high morbidity
and mortality.

Authors Contributions
- Amadou Sow, Modou Gueye, Djibril Boiro: Design, data collection and
writing.
- Idrissa Demba Ba, Abou Ba, Aliou Thiongane, Papa Moctar Faye: Read-
ing, correction.

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A. Sow et al.

- Amadou Lamine Fall, Assane Sylla, Ousmane Ndiaye: Validation.

Acknowledgements
We would like to thank the staff of the vaccination unit, in particular Mrs. Fall
Awa Touré and the management of the ABASS NDAO hospital center in Dakar.

Conflicts of Interest
The authors declare no conflicts of interest regarding the publication of this pa-
per.

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