Panorama de la cobertura de vacunación infantil y oportunidades perdidas en América Latina tras la pandemia de covid-19

Abstract

In Latin America, childhood vaccination coverage showed a downward trend before the COVID-19 pandemic, which worsened during the pandemic. This review aimed to analyze changes in coverage, completion of vaccination schedules, and missed opportunities for vaccination in children aged up to five years during and after the pandemic, compared with the pre-pandemic period. A descriptive and analytical systematic review with narrative synthesis was conducted and reported in accordance with the PRISMA 2020 guidelines. The search covered studies published between 2020 and 2025 in PubMed, Scopus, Web of Science, SciELO, and Taylor & Francis. Forty studies were included in the main synthesis, and their methodological quality and risk of bias were assessed using tools developed by the Joanna Briggs Institute (JBI). The results showed varying declines across countries, vaccines, doses, and time periods, with a greater impact on later doses and booster doses. Missed opportunities were related to inadequate checking of the vaccination card, stock-outs, false contraindications, and inappropriate decisions during health care encounters, although specific evidence on this phenomenon was limited. Microplanning, active case-finding, follow-up of incomplete vaccination schedules, and outreach activities were associated with improvements in vaccination indicators, but recovery was uneven. The evidence showed that the pandemic worsened the pre-existing decline in childhood vaccination. These findings support the need to strengthen the completion of vaccination schedules, reduce missed opportunities, and improve nursing follow-up to restore and sustain vaccination coverage.

Keywords: Childhood vaccination; COVID-19; Vaccination delay; Latin America.