{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:33:51Z","timestamp":1791203631090,"version":"4.2.0"},"reference-count":94,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001125","name":"GAVI Alliance","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001125","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-009125"],"award-info":[{"award-number":["INV-009125"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-034281"],"award-info":[{"award-number":["INV-034281"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,7,19]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We conducted a rapid review to determine the extent that immunisation services in low-income and middle-income countries (LMICs) were disrupted by the COVID-19 pandemic and synthesised the factors that can be used to build resilience in future.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Rapid review reported in accordance with the Preferred reporting for Systematic reviews and Meta-Analyses (PRISMA) guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>PubMed and Web of Science were searched through 6 October 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria for selecting studies<\/jats:title>\n                    <jats:p>We included studies that focused on disruption to immunisation activities due to the COVID-19 pandemic in LMICs. Outcomes included routine vaccine coverage, supplementary immunisation activities, vaccine doses, timing of vaccination, supply chain changes, and factors contributing to disruption or resilience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Two independent reviewers used standardised methods to search, screen and code studies. Quality assessment was performed using a modified version of the Critical Appraisal Skills Programme for qualitative research. Findings were summarised qualitatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 4978 identified studies, 85 met the eligibility criteria. Included studies showed declines in immunisation activities across LMICs related to the COVID-19 pandemic. These included reductions in achieved routine coverage, cancellation or postponement of campaigns and underimmunised cohorts. Immunisation was most disrupted in the early months of the pandemic; however, recovery varied by country, age-group and vaccine. Though many countries observed partial recovery in 2020, disruption in many countries continued into 2021. It has also been noted that clinician staff shortages and vaccine stock-outs caused by supply chain disruptions contributed to immunisation delays, but that concern over COVID-19 transmission was a leading factor. Key resiliency factors included community outreach and healthcare worker support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is limited information on whether reductions in vaccination coverage or delays have persisted beyond 2021. Further research is needed to assess ongoing disruptions and identify missed vaccine cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-076607","type":"journal-article","created":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T20:11:02Z","timestamp":1722975062000},"page":"e076607","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["COVID-19 related disruption and resilience in immunisation activities in LMICs: a rapid review"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8502-9915","authenticated-orcid":false,"given":"Anna-Maria","family":"Hartner","sequence":"first","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK"},{"name":"Centre for Artificial Intelligence in Public Health Research, Robert Koch Institute, Wildau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Gaythorpe","sequence":"additional","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"2025121600532854000_14.8.e076607.1","unstructured":"Centers for disease control prevention . CDC museum COVID-19 timeline. 2022."},{"key":"2025121600532854000_14.8.e076607.2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-01750-1"},{"key":"2025121600532854000_14.8.e076607.3","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/S1473-3099(18)30478-X","article-title":"Vaccine-preventable diseases in lower-middle-income countries","volume":"18","author":"Turner","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2025121600532854000_14.8.e076607.4","unstructured":"OHCHR . 48th session of the human rights council: deepening inequalities exacer bated by the COVID-19 pandemic. Available: https:\/\/www.ohchr.org\/en\/2021\/09\/48th-session-human-rights-councildeepening-inequalities-exacerbated-covid-19-pandemic [Accessed 26 Apr 2023]."},{"key":"2025121600532854000_14.8.e076607.5","unstructured":"United Nations Children\u2019s Fund . The state of the World\u2019s children 2023: for every child, vaccina tion. 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