Early effect of the Covid-19 epidemic on vaccine coverage of major antigens in Guinea: an analysis of the interrupted time series of national immunization coverage

IntroductionSince the declaration of the first case of Covid-19 on March 12, 2020, in Guinea, the number of COVID-19 cases has been increasing day by day despite the state of health emergency and the barrier measures decreed by the Guinean government. This present study aimed to assess the early impact of COVID-19 on vaccine activities by comparing current trends to trends over the past year when vaccine coverage of major antigens (BCG, OPV, DTP-HepB-Hib, MMR, IPV, and Td) had improved considerably. MethodsThe study was carried out at the Expanded Vaccination Program (EPI) of the Republic of Guinea from February 2020 to June 2020. It was a comparative retrospective cohort study on the trends in administrative coverage of the different antigens used in the framework of vaccination. We performed interrupted time series (STI) analysis using the delayed dependent variable model ANCOVA type II Sum Squares with significance for a p-value less than 0.05 to confirm the link between the occurrence of Covid-19 and the collapse of vaccine coverage. These analyzes were performed on global vaccine-preventable disease surveillance data extracted from the District Immunization Data Management Tool (DVD-MT) designed by WHO. Estimates of the target population were obtained from the National Health Information System (SNIS), and surveillance data for Covid-19 patients were obtained from the National Health Security Agency (ANSS). ResultsOverall, the EPI recorded a median vaccination coverage of less than 80% for all the vaccines introduced and the analysis of the interrupted time series shows that the interruption of the vaccination program was significant for all the vaccines. This finding is factual at both the national and district levels. However, there are disparities at this level, even though some districts have yet to report cases of COVID-19 but have experienced drop-in vaccination coverage. The comparison of vaccination coverage for DTP3, for example, shows a sharp drop in the prefectures of Yomou, NNzerekore, Macenta, Kankan, Mandiana, Dinguiraye, Mamou, Koubia, Mali, and Conakry, where it varies between 0 and 80% compared to 2019 where it was above 80%. ConclusionOur results demonstrate the need for a resilient health system that could adapt quickly and effectively to pandemics and which in turn makes it possible to strengthen EPI activities in Guinea during this period of a health crisis, in particular for children.