Journal
VACCINES
Volume 9, Issue 11, Pages -Publisher
MDPI
DOI: 10.3390/vaccines9111228
Keywords
BCG; immunization; mathematical model; paediatric mortality; COVID-19; tuberculosis
Categories
Funding
- TB Modelling Group at LSHTM
- Wellcome Trust [218261/Z/19/Z]
- NIH [1R01AI147321-01]
- EDTCP [RIA208D-2505B]
- UK MRC [CCF17-7779]
- ESRC [ES/P008011/1]
- BMGF [OPP1084276, OPP1135288, INV-001754]
- WHO [2020/985800-0]
- Wellcome Trust [218261/Z/19/Z] Funding Source: Wellcome Trust
- ESRC [ES/P008011/1] Funding Source: UKRI
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The COVID-19 disruptions resulted in a 25% reduction in global BCG coverage and could lead to additional paediatric TB deaths if catch-up vaccinations are not implemented. Catch-up vaccination is crucial in minimizing excess paediatric TB mortality.
The impact of COVID-19 disruptions on global Bacillus Calmette-Guerin (BCG) coverage and paediatric tuberculosis (TB) mortality is still unknown. To fill this evidence-gap and guide mitigation measures, we estimated the impact of COVID-19 disruptions on global BCG coverage and paediatric TB mortality. First, we used data from multiple sources to estimate COVID-19-disrupted BCG vaccination coverage. Second, using a static mathematical model, we estimated the number of additional paediatric TB deaths in the first 15 years of life due to delayed/missed vaccinations in 14 scenarios-varying in duration of disruption, and magnitude and timing of catch-up. We estimated a 25% reduction in global BCG coverage within the disruption period. The best-case scenario (3-month disruption, 100% catch-up within 3 months) resulted in an additional 886 (0.5%) paediatric TB deaths, and the worst-case scenario (6-month disruption with no catch-up) resulted in an additional 33,074 (17%) deaths. The magnitude of catch-up was found to be the most influential variable in minimising excess paediatric TB mortality. Our results show that ensuring catch-up vaccination of missed children is a critical priority, and delivery of BCG alongside other routine vaccines may be a feasible way to achieve catch-up. Urgent action is required to support countries with recovering vaccination coverages to minimise paediatric deaths.
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