Post-COVID Immunization Challenges, Vaccine Confidence, and Measles-Rubella Protection in Children and Vulnerable Populations: A Scoping Review

Oliver Bennett¹, Sophie Turner², Harry Collins³

Abstract

https://doi.org/10.5281/zenodo.20778447

Routine immunization is a core public health intervention for preventing childhood morbidity and mortality, but the COVID-19 pandemic disrupted vaccination services, caregiver follow-up, community trust, and disease surveillance in many settings. This scoping review mapped evidence on post-COVID immunization challenges, vaccine confidence, and measles-rubella protection among children and vulnerable populations. Searches were conducted across bibliographic databases, evidence-discovery platforms, organizational resources, and supplementary sources. The review followed a scoping review design using the PRISMA-ScR framework. Eligible evidence included observational studies, cohort studies, cross-sectional studies, outbreak reports, systematic and scoping reviews, program and policy resources, and mixed-methods studies addressing missed or delayed vaccination, incomplete vaccination, zero-dose status, vaccine hesitancy, measles-rubella vaccination, antibody persistence, immune response variability, outbreak vulnerability, and catch-up vaccination strategies among children, caregivers, displaced populations, conflict-affected groups, and low-resource communities. Searches identified 386 records. After removal of 91 duplicates, 295 records were screened, 63 full-text reports were assessed, and 12 evidence sources were included in the final synthesis. Evidence was organized by population, setting, vaccine type, post-COVID context, immunization challenge, confidence-related factors, antibody or outbreak outcomes, and public health interventions. The review shows that immunization recovery after COVID-19 depends not only on vaccine availability, but also on caregiver trust, service continuity, surveillance capacity, and targeted outreach to vulnerable communities.