{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T18:17:40Z","timestamp":1778696260618,"version":"3.51.4"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1094816"],"award-info":[{"award-number":["OPP1094816"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Implications of the COVID-19 pandemic for both populations and healthcare systems are vast. In addition to morbidity and mortality from COVID-19, the pandemic also disrupted local health systems, including reductions or delays in routine vaccination services and catch-up vaccination campaigns. These disruptions could lead to outbreaks of other infectious diseases that result in an additional burden of disease and strain on the healthcare system. We evaluated the impact of the COVID-19 pandemic on Zambia\u2019s routine childhood immunization program in 2020 using multiple sources of data. We relied on administrative vaccination data and Zambia\u2019s 2018 Demographic and Health Survey to project national disruptions to district-specific routine childhood vaccination coverage within the pandemic year 2020. Next, we leveraged a 2016 population-based serological survey to predict age-specific measles seroprevalence and assessed the impact of changes in vaccination coverage on measles outbreak risk in each district. We found minor disruptions to routine administration of measles-rubella and pentavalent vaccines in 2020. This was in part due to Zambia\u2019s Child Health Week held in June of 2020 which helped to reach children missed during the first six months of the year. We estimated that the two-month delay in a measles-rubella vaccination campaign, originally planned for September of 2020 but conducted in November of 2020 as a result of the pandemic, had little impact on modeled district-specific measles outbreak risks. This study estimated minimal increases in the number of children missed by vaccination services in Zambia during 2020. However, the ongoing SARS-CoV-2 transmission since our analysis concluded means efforts to maintain routine immunization services and minimize the risk of measles outbreaks will continue to be critical. The methodological framework developed in this analysis relied on routinely collected data to estimate disruptions of the COVID-19 pandemic to national routine vaccination program performance and its impact on children missed at the subnational level can be deployed in other countries or for other vaccines.<\/jats:p>","DOI":"10.1371\/journal.pgph.0000554","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T17:22:12Z","timestamp":1683048132000},"page":"e0000554","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["An evaluation of the early impact of the COVID-19 pandemic on Zambia\u2019s routine immunization program"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2737-7003","authenticated-orcid":true,"given":"Amy K.","family":"Winter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saki","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea C.","family":"Carcelen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9872-2313","authenticated-orcid":true,"given":"Kyla","family":"Hayford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilbroad","family":"Mutale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis D.","family":"Mwansa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nyambe","family":"Sinyange","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ngula","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6579-3513","authenticated-orcid":true,"given":"William J.","family":"Moss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Mutembo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,5,2]]},"reference":[{"key":"pgph.0000554.ref001","author":"World Health Organization","year":"2023","journal-title":"Coronavirus Disease Dashboard"},{"key":"pgph.0000554.ref002","article-title":"Estimating global and regional disruptions to routine childhood vaccine coverage during the COVID-19 pandemic in 2020: a modelling study.","author":"K Causey","year":"2021","journal-title":"The Lancet"},{"issue":"10","key":"pgph.0000554.ref003","doi-asserted-by":"crossref","first-page":"e1264","DOI":"10.1016\/S2214-109X(20)30308-9","article-title":"Routine childhood immunisation during the COVID-19 pandemic in Africa: a benefit\u2013risk analysis of health benefits versus excess risk of SARS-CoV-2 infection","volume":"8","author":"K Abbas","year":"2020","journal-title":"The Lancet Global Health"},{"issue":"6","key":"pgph.0000554.ref004","doi-asserted-by":"crossref","first-page":"e722","DOI":"10.1016\/S2214-109X(21)00098-X","article-title":"COVID-19 pandemic and health-care disruptions: count the most vulnerable","volume":"9","author":"J Kumar","year":"2021","journal-title":"The Lancet Global Health"},{"issue":"7","key":"pgph.0000554.ref005","doi-asserted-by":"crossref","first-page":"e005031","DOI":"10.1136\/bmjgh-2021-005031","article-title":"Addressing disruptions in childhood routine immunisation services during the COVID-19 pandemic: perspectives from Nepal, Senegal and Liberia.","volume":"6","author":"SM Dixit","year":"2021","journal-title":"BMJ Global Health"},{"key":"pgph.0000554.ref006","article-title":"At least 80 million children under one at risk of diseases such as diphtheria, measles and polio as COVID-19 disrupts routine vaccination efforts, warn Gavi, WHO and UNICEF","author":"World Health Organization","year":"2020"},{"key":"pgph.0000554.ref007","unstructured":"COVID-19 situation reports [Internet]. 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