JMIRx Med
PubMed-indexed overlay journal for preprints with post-review manuscript marketplace (What is JMIRx?).
                        Editor-in-Chief:
                      Edward Meinert, MA (Oxon), MSc, MBA, MPA, MPH, PhD, CEng, FBCS, EUR ING, Professor of Digital Health and Clinical Artificial Intelligence, Newcastle University, United Kingdom
  
Recent Articles

Background: The COVID-19 pandemic caused global disruptions to essential healthcare services, particularly affecting routine childhood immunization programs. Low- and middle-income countries (LMICs) were disproportionately impacted. In Ecuador, the national immunization program faced pre-existing challenges with coverage disparities across different geographical regions and socioeconomic groups before the pandemic. Objective: To analyze the impact of the COVID-19 pandemic on routine childhood vaccination coverage in Ecuador by comparing data from the pre-pandemic year (2019) with the pandemic period (2020-2021) and to identify geographical disparities in vaccination access. Methods: This retrospective observational study analyzed vaccination data from the Ministry of Public Health of Ecuador and demographic data from the National Institute of Statistics and Censuses (INEC). The study examined routine vaccination coverage for children under 24 months across all 24 provinces. A comparative analysis of coverage rates between the pre-pandemic and pandemic periods was conducted using descriptive statistics. Results: A significant decline in routine childhood vaccination coverage was observed between 2019 and 2021. Coverage for the BCG vaccine decreased from 86.4% in 2019 to 75.3% in 2021. Third-dose coverage for the pentavalent vaccine dropped from 85.0% to 68.0% over the same period. The most pronounced decline occurred in the second dose of the MMR vaccine, with coverage falling from 75.7% in 2019 to 58.4% in 2021. The most severe reductions were concentrated in the Coastal and Highland provinces. Conclusions: The COVID-19 pandemic significantly impacted routine childhood vaccination coverage in Ecuador, with sustained declines through 2021 that exacerbated existing regional disparities. The resulting coverage gaps place children at an increased risk of vaccine-preventable disease outbreaks. Urgent interventions, including targeted catch-up campaigns and health system strengthening, are necessary to restore coverage levels and enhance resilience against future health emergencies.
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