Article Text

Download PDFPDF

162:oral Assessment of the routine immunization program during the COVID-19 pandemic at the main health center, in UNRWA’s Baqa’a refugee camp, Jordan
  1. Ahmed Aboushady1,
  2. Khalil Abu Naqera2,
  3. Saed Atallah2,
  4. Shatha Albeik3,
  5. Dilani Logan3
  1. 1School of Public Health; Harvard University; USA
  2. 2UNRWA Jordan Field Office, Amman, Jordan
  3. 3UNRWA Headquarters, Amman, Jordan


The WHO pulse survey found that 80 out of 105 countries reported varying disruptions to their health services sector. During the COVID-19 pandemic, many governments implemented lockdowns, which subsequently affected residents’ daily lifestyles and access to essential health services. In April 2020, the Jordanian government implemented one of the world’s COVID-19’s strictest lockdown. This study assesses the effect of such measures on the routine immunizations program at the main health center in the Baqa’a refugee camp, managed by UNRWA.

Our assessment of the program’s performance quantifies the gap in service provision using the number of vaccine doses provided. The gap was compared to the COVID-19 mitigation measures quantified through the OxGRT Stringency Index. Therefore, a LOESS regression model was developed to represent the predicted values for 2020, using data from the previous years. Our model was then compared to the observed 2020 doses provided through the health center.

We found a correlation between the increase in the stringency index and the increase in the gap, where the strictest values of the index were associated with the highest gaps. Additionally, the 2020 values were much more dispersed with a wider range than our predicted model, reflecting the effect of the mitigation measures and the countering activities conducted by the health center staff. Overall, using the monthly values, a gap of 1199 doses (8.75%) in 2020 was calculated between the predicted and observed values. Furthermore, we found that the first dose of the 3-dose hexavalent vaccine showed a higher and earlier peak than the other doses after the lockdown period.

In conclusion, the implemented activities by UNRWA’s health center staff, use of a mobile application, and refugees-embracing health systems have successfully minimized the gap in service provision and provided alternative outlets to maintain an overall high coverage of routine immunizations.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: .

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.