Experiences of Parents and Healthcare Workers on Childhood Vaccination Coverage during the COVID-19 pandemic in the Western Urban Area of Sierra Leone

Abstract Background Childhood immunisation is crucial for preventing disease outbreaks. The COVID-19 pandemic is believed to have disrupted vaccination services, increasing the risk of vaccine-preventable diseases. This study explores the impact of COVID-19 on childhood vaccination in Sierra Leone’s Western Urban Area. Methods A mixed-methods approach was used to assess immunisation coverage among children aged 0–23 months, comparing pre-pandemic and pandemic periods. The quantitative component employed an interrupted time series design using data from Sierra Leone's District Health Information System (DHIS2). The qualitative aspect involved interviews with 40 caregivers of children with delayed vaccinations and 10 healthcare providers. Data was analyzed using thematic analysis. Results Most vaccine antigens analysed showed a significant decline in vaccination coverage coinciding with the emergence of COVID-19 (P < 0.05), except BCG vaccine. A statistically significant association was found between the COVID-19 pandemic and a drop in vaccination coverage for Pentavalent 1, 2, 3, and MR 1 & 2 vaccines; [OR = 0.52, 95% CI: 0.30–0.92], [OR = 0.41, 95% CI: 0.24–0.69], (OR = 0.35, 95% CI: 0.19–0.64), [OR = 0.31, 95% CI: 0.17–0.54], and (OR = 0.40, 95% CI: 0.26–0.62) respectively. The identified barriers to vaccination during the pandemic included caregivers' fear of contracting or being tested for COVID-19 and denial of vaccination services by healthcare workers, among others. Conclusion The COVID-19 pandemic caused a notable decline in vaccination coverage in Sierra Leone, primarily due to fear of COVID-19. However, mitigation measures such as Personal Protective Equipment usage and outreach programs improved coverage.