impairment of routine childhood vaccination during covid-19 pandemic in southeast iran

Background: the covid-19 pandemic has disrupted childhood immunization coverage and increased vaccine misinformation worldwide. objectives: this study compared on-time vaccination rates among children under five before and during the covid-19 pandemic in southeast iran, a region near two polio-endemic countries. methods: a cross-sectional study was conducted, comparing data from six months before and six months after the onset of the pandemic. the study included all children under five in zahedan, covering both urban and rural areas. sampling was performed by census. percentages of on-time and delayed or missed vaccinations were assessed by vaccine type and residence. results: data from 75,863 children were analyzed. the findings showed significant reductions in on-time vaccination, particularly at birth, in both urban and rural areas. the most affected vaccines were the pentavalent, trivalent, and oral polio vaccines. rural areas experienced lower on-time vaccination rates compared to urban areas, both before and after the pandemic. conclusions: the covid-19 pandemic severely disrupted childhood vaccination programs, leading to delays and missed doses, especially for critical vaccines and in rural areas. these findings emphasize the need for targeted interventions to address vaccination gaps and improve coverage in both urban and rural settings.