Statement from the Caribbean Immunization Technical Advisory Group (CITAG) on the stark decline in childhood immunization rates, worsened by the effects of the COVID-19 pandemic

The Caribbean Immunization Technical Advisory Group (CITAG) wishes to alert Caribbean Ministers of Health and Chief Medical Officers that routine childhood vaccination coverage in Caribbean countries has fallen significantly during the COVID-19 pandemic. In some countries as many as 3 out of 10 infants are not fully vaccinated putting them at risk of measles, polio and other diseases eliminated in the Americas that continue to circulate in other areas of the world.

It is essential that countries conduct routine vaccination campaigns targeted at children under 5 years of age to ensure that they are fully vaccinated. Countries are urged to involve their pediatricians and private doctors in this campaign and where necessary to employ retired nurses and other health providers to support the health team.

At the same time, it is important to maintain vaccine preventable disease vigilance given the increased risk of visitors to the Caribbean re-introducing polio, measles, rubella or other childhood communicable diseases to our countries. We need to improve our surveillance of acute flaccid paralysis and rash and fever surveillance.   

The CITAG wishes to commend countries for their tremendous work and dedicated response to the COVID-19 pandemic in the face of many challenges. Our health staff and frontline workers have worked extremely hard with great commitment and sacrifice. Despite these heroic efforts most of the Caribbean countries have not yet achieved the WHO goal of vaccinating 70% of our adult population with COVID-19 vaccine.  Over 50% of our most vulnerable population, persons over the age of 50 years and adults with comorbidities remain unvaccinated.

The priority for COVID-19 vaccination is to achieve high vaccine coverage among the elderly and persons with comorbidities. We can do this if we improve access by simplifying the vaccination process and increasing opportunities for vaccination including involving more doctors in the private sector. Respectful face to face education by trusted persons, such as nurses, doctors and informed grass roots leaders and pastors, is needed to address misinformation and misconceptions and convince many persons to accept vaccination.

The CITAG advises countries to first improve routine childhood vaccination coverage and adult COVID-19 vaccination of the elderly and persons with comorbid conditions before embarking on COVID-19 vaccination of children 5 – 11 years of age. Most young children do not get seriously ill from COVID-19. CITAG advises that instead of routine COVID-19 vaccination of children under 12 years, that countries should target the small number of children with severe immune disorders by having their pediatrician vaccinate them.

Every effort should be made to keep schools open so that children can attend face to face classes. Basic precautions should be maintained such as wearing of masks, hand hygiene, physical distancing and good ventilation.

The Caribbean has a significant legacy of strong national immunization programs resulting in high immunization coverage of routine childhood vaccines. Governments must continue to prioritize financial and human resources to support all aspects of the EPI Program.