Interruption of Childhood Vaccinations in Mozambique

The vaccine is an important public health discovery. With the implementation of childhood vaccination programs, infectious and communicable diseases are significantly reduced, promoting children’s healthy growth.

Vaccination is a preventive medical service recommended for every child in the world, and vaccination schedules vary by country. According to the last census in Mozambique, there are more than 14 million children from 0 to 17 years old. The Mozambique vaccination program covers children up to 5 years old and school-age children by utilizing mobile brigades to schools.

In Mozambique, COVID-19 has not been a major health crisis when compared to other endemic diseases.

2020 was a difficult year for children around the world, in particular Mozambique. The country was rocked by tropical cyclones Idai and Kenneth – storms that devastated much of central and northern Mozambique. There were also severe issues with the armed conflict that has intensified in recent months in Cabo Delgado province. The COVID-19 pandemic was the focus of public health, and containment measures for the pandemic included implementing the World Health Organisation’s recommended restrictions, including school closures at the national level.

In Mozambique, COVID-19 has not been a major health crisis when compared to other endemic diseases. At the time of writing, fewer than 900 COVID-19 deaths have been recorded, although some believe that figure is underestimated, placing the true number at over 3000.

Even so, health professionals still believe that the primary cause of child mortality is infectious diseases, reaching far beyond COVID-19. Leading the list of culprits is malaria, followed by diarrhoea, and then respiratory infections, with malnutrition persisting as an underlying cause.

There is currently more attention and publicity on the vaccination campaign for COVID-19, while the focus on normal – life-saving – vaccination campaigns for children are being minimized.

So how was regular healthcare impacted by the restrictive measures imposed per WHO advice regarding a disease without severe local effects? Vaccination points still operated in health units, central hospitals, provinces, generals, districts, and mobile brigades to schools and communities. But school closures limited access, and people were afraid to leave their homes for vaccination due to both COVID-19 and the outbreaks of war. This caused the number of vaccines given to children for existing endemic diseases (measles, TB, yellow fever) to drop exponentially, both for the initial jab and the booster shot.

There is currently more attention and publicity on the vaccination campaign for COVID-19, while the focus on normal – life-saving — vaccination campaigns for children are being minimized. This is a serious concern in a country with a high prevalence of malnutrition and infectious diseases in early childhood. In Mozambique, malnutrition is a significant trigger for death caused by vaccine-preventable illnesses, and those vaccination campaigns have stalled. 

Beyond fears of violence and COVID, serious infrastructural problems emerged, impacting both vaccine uptake and routine healthcare. Most drugs have fallen into short supply. There is a particular shortage of antipsychotic medications across the country, which presents a serious concern given the mental health repercussions of the response to the COVID-19 pandemic. Mobile healthcare brigades ceased to function despite available human resources. A fuel shortage spurred by the economic crisis associated with the COVID-19 response remains an unabating problem. For example, the district now has to wait to accumulate enough patients to initiate a hospital transfer to minimize fuel expenditures. This process can delay necessary medical treatment for many patients.

The world’s COVID-19 focus of the past year has made it difficult for health professionals in Mozambique to maintain the vaccination of young children for the diseases from which they are most at risk: and there have been considerable, if undocumented, increases in child mortality as a result.

The interruption of the vaccination brigades from school closures illustrates how the main health-related challenges in Mozambique reach far beyond COVID-19, especially in child health, awareness of child care, and strengthening of child health. Given the centrality of vaccination to prevent childhood diseases, these interruptions are a great concern to Mozambican health professionals.

It is still essential to maintain advertising and vaccination campaigns for greater parental adherence because vaccines are necessary to prevent disease, reduce disease transmission, reduce infant mortality and reduce child hospitalizations due to infectious diseases, as children have low immunity.

However, the world’s COVID-19 focus of the past year has made it difficult for health professionals in Mozambique to maintain the vaccination of young children for the diseases from which they are most at risk: and there have been considerable, if undocumented, increases in child mortality as a result.

This article was written by a physician in Central Mozambique with firsthand knowledge of the current healthcare and vaccination situation in Mozambique, whose identity is known to the organization.

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