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Volume 9
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COVID-19 and the Gaping Wounds of South Africa’s Suboptimal Immunisation Coverage: An Implementation Research Imperative for Assessing and Addressing Missed Opportunities for Vaccination

by
Chukwudi A. Nnaji
1,2,*,
Charles S. Wiysonge
1,2,3,
Maia Lesosky
1,
Hassan Mahomed
4,5 and
Duduzile Ndwandwe
2
1
Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
2
Cochrane South Africa, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town 7501, South Africa
3
Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
4
Western Cape Provincial Department of Health, 8 Riebeeck Street, Cape Town 8001, South Africa
5
Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
*
Author to whom correspondence should be addressed.
Vaccines 2021, 9(7), 691; https://doi.org/10.3390/vaccines9070691
Submission received: 20 May 2021 / Revised: 21 June 2021 / Accepted: 21 June 2021 / Published: 23 June 2021
(This article belongs to the Special Issue Vaccination and Public Health Version II: COVID-19 Vaccination)
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Abstract

Despite South Africa’s substantial investments in and efforts at ensuring universal access to immunisation services, progress has stalled and remains suboptimal across provinces and districts. An additional challenge is posed by the ongoing coronavirus disease 2019 (COVID-19) pandemic, which has disrupted immunisation services globally, including in South Africa. While there is growing evidence that missed opportunities for vaccination (MOV) are a major contributor to suboptimal immunisation progress globally, not much is known about the burden and determinants of MOV in the South African context. Herein, we make a case for assessing MOV as a strategy to address current immunisation coverage gaps while mitigating the adverse impacts of the COVID-19 pandemic on immunisation services. We illustrate a practical implementation research approach to assessing the burden of MOV among children in primary care settings; for understanding the factors associated with MOV; and for designing, implementing, and evaluating context-appropriate quality improvement interventions for addressing missed opportunities. Such efforts are vital for building health system resilience and maintaining immunisation programme capacity to optimally deliver essential health services such as routine childhood immunisation, even during pandemics.
Keywords: missed opportunities for vaccination; immunisation coverage; COVID-19; implementation research; quality improvement; South Africa missed opportunities for vaccination; immunisation coverage; COVID-19; implementation research; quality improvement; South Africa

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MDPI and ACS Style

Nnaji, C.A.; Wiysonge, C.S.; Lesosky, M.; Mahomed, H.; Ndwandwe, D. COVID-19 and the Gaping Wounds of South Africa’s Suboptimal Immunisation Coverage: An Implementation Research Imperative for Assessing and Addressing Missed Opportunities for Vaccination. Vaccines 2021, 9, 691. https://doi.org/10.3390/vaccines9070691

AMA Style

Nnaji CA, Wiysonge CS, Lesosky M, Mahomed H, Ndwandwe D. COVID-19 and the Gaping Wounds of South Africa’s Suboptimal Immunisation Coverage: An Implementation Research Imperative for Assessing and Addressing Missed Opportunities for Vaccination. Vaccines. 2021; 9(7):691. https://doi.org/10.3390/vaccines9070691

Chicago/Turabian Style

Nnaji, Chukwudi A., Charles S. Wiysonge, Maia Lesosky, Hassan Mahomed, and Duduzile Ndwandwe. 2021. "COVID-19 and the Gaping Wounds of South Africa’s Suboptimal Immunisation Coverage: An Implementation Research Imperative for Assessing and Addressing Missed Opportunities for Vaccination" Vaccines 9, no. 7: 691. https://doi.org/10.3390/vaccines9070691

APA Style

Nnaji, C. A., Wiysonge, C. S., Lesosky, M., Mahomed, H., & Ndwandwe, D. (2021). COVID-19 and the Gaping Wounds of South Africa’s Suboptimal Immunisation Coverage: An Implementation Research Imperative for Assessing and Addressing Missed Opportunities for Vaccination. Vaccines, 9(7), 691. https://doi.org/10.3390/vaccines9070691

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