Guidance on Routine Immunization Services During COVID-19 Pandemic in the WHO European Region


Understanding how WHO’s guidance around providing immunization services during the COVID-19 pandemic can be applied to countries in the European Region. 


Make decisions on whether to provide immunization services during the pandemic based on the assessed risks and characteristics of your country’s transmission, health system, and immunization resources 


Therefore, routinimmunization sessions should be maintained if COVID-19 response measures allow. Decisions related to the operation of immunization services should be taken based on a detailed assessment of the vaccine-preventable disease (VPD) epidemiology, transmission scenario of COVID-19 and corresponding mitigation measures in place, and health and immunization system resources. 

Key Points:

  • The disruption of immunization services during COVID-19 increases the risk of VPD outbreaks, which may result in deaths and increase the burden on already strained health systems. 
  • When considering whether and how to deliver immunization during the COVID-19 pandemic, countries should: 
    • Assess the potential risk of an increased VPD occurrence by reviewing population immunity and surveillance data and prioritizing epidemic-prone VPDs and the prevention of measles and polio elimination backslide. 
    • Review the COVID-19 situation to understand the transmission scenario (no cases, sporadic cases, cluster of cases, or community transition) and weigh the risk of COVID-19 against that of a VPD outbreak. 
    • Consider the healthcare delivery services required to manage COVID-19 transmission scenario(s) and whether immunization staff may by diverted. 
    • Evaluate whether routine vaccinations are available in sufficient quantities given demand and potentially altered immunization schedules. 
  • If resources for routine immunization are diverted and/or services are disrupted, countries should mobilize CSOs and NGOs to support the immunization program, enumerate missed children, and develop a catch-up plan. 
  • When administering immunization services, countries may reduce the risk of COVID-19 transmission by using administrative and environmental controls to limit people’s exposure to the health system, avoid crowding, and ensure adequate hygiene and safety measures are in place. Additionally, countries should plan for supply chain disruptions and adverse events following immunization (AEFIs). 

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