Objective To assess the impact of the COVID-19 pandemic on routine childhood vaccination coverage in Colombia by age group, rural/urban residence, state and vaccine type. Design Ecological study of official monthly vaccination records. Setting Vaccination records from the Colombian Ministry of Health (March-October 2019 and 2020). Participants Aggregated data for Colombian children (<12 months, n=676 153; 12-23 months, n=700 319; and 5 years, n=734 295) participating in the Expanded Program on Immunization. Main outcome measures Proportion of eligible population receiving vaccination. Results Vaccination coverage showed an overall decline of approximately 14.4 from 2019 to 2020 (2019 coverage=76.0, 2020 coverage=61.6). The greatest reduction in proportion vaccinated was observed in children <12 months of age for pneumococcal vaccine (second dose) (2019 coverage=81.4; 2020 coverage=62.2; 2019-2020 absolute difference, 19.2; 95 CI 14.8 to 23.7). For children aged 1223 months, the proportion vaccinated for yellow fever declined by 16.4 (12.4 to 20.9) from 78.3 in 2019 to 61.8 in 2020. Among children 5 years of age, the biggest decrease occurred for the oral polio vaccine (second dose), with a difference of 11.4 (7.1 to 15.7) between 2019 and 2020 (73.1 and 61.7 for 2019 and 2020). We observed a statistically significant effect on vaccine coverage in rural versus urban areas for children <12 months and 5 years of age. Conclusions Reduced uptake of immunisations during the COVID-19 pandemic poses a serious risk of vaccine-preventable disease outbreaks. Colombia and other middle-income countries need to continue to monitor immunisation programme coverage and disease outbreaks at the national and subnational levels and undertake catch-up vaccination activities.
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