PESHAWAR: The lockdown enforced by government as part of preventive strategy against spread of Covid-19 has been affecting adversely immunisation of children in the province, according to sources.

Despite the closure of OPDs, there are about 1,230 centres of expanded programme on immunisation (EPI) but their 2,880 technicians have been deputed to either track the travellers to foreign countries or have been made part of the rapid response teams during multiple shifts.

The Pakistan Paediatric Association is concerned over the situation with regard to child health and wants the government to ensure immunisation of children against 10 vaccine-preventable childhood ailments.

It said that the annual target of the province for the year 2020 was to fully immunise 1.2 million children but the lockdown was obstructing vaccination.

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The association said that in the absence of immunisation, children would be exposed to deadly preventable diseases like measles, diarrhoea, pneumonia, tuberculosis, pertussis etc. It has request the government to restore routine immunisation services, observing all necessary precautions.

At the end of 2019, the coverage of the fully immunised children was 78 per cent, up from 69 per cent at the end 2018, which is likely to drop if the immunisation activities remain suspended or stayed low.

Before the lockdown, the health department had planned to further scale up coverage of children up to 90 per cent by end of 2020 but it seemed a far dream now, according to paediatricians.

They said that EPI centres remained opened but workers were busy in Covid-19 related assignments and very few children were being vaccinated due to lockdown.

They said that it was not that good but not too bad in the prevailing circumstances.

There are some reports that the polio staff, including employees of WHO and Unicef, are engaged in immunisation activities but in fact most of them work from home and attend offices either through teleconference or video-conference.

Sources said that they were just collecting data about Covid-19 from the districts and communicating the same to the federal government.

However, the EPI staff is making all out efforts against spread of infection.

Experts said that government should have deployed the polio staff for routine immunisation as it was more important to safeguard children against the preventable diseases.

Senior officials in health department told Dawn that the government was likely to issue directives regarding withdrawal of notification of non-provision of other health services in the hospitals to pave way for resumption of full immunisation activities.

There have been no outreach sessions for one month. During the outreach activities, the vaccinators cover children. Routinely, the children are brought to EPI centres located at the hospitals, which has been stopped since enforcement of lockdown.

The overall EPI coverage varies from district to district but it has dropped everywhere in March 2020 compared to February 2020.

PPA provincial president Prof Afzal Khan said that although they endorsed the “social distancing measures” yet due to closure of all OPDs and private clinics, parents were constrained to get treatment for the routine and at times severe illnesses of their children.

He said that it would further add to the already very high infant and under five mortality rates.

He said that there was anecdotal evidence that in such circumstances, quackery and self-medication were on the rise that may have dire consequences for child health.

“It is therefore requested that limited and controlled non-Covid-19 child health services should be allowed in secondary and tertiary health care facilities. While providing these services, the hospital authorities should take necessary steps to ensure social distancing and avoid spread of coronavirus,” said Dr Afzal Khan.

He said that It was also noted with concern, that immunisation services in the hospitals were suspended while they already had a very low immunisation coverage.

He added that suspension of services would lead to drop outs and further deterioration of the situation.

Published in Dawn, April 8th, 2020