European Pediatric Societies Call for an Implementation of Regular Vaccination Programs to Contrast the Immunity Debt Associated to Coronavirus Disease-2019 Pandemic in Children

In the initial months of the coronavirus disease 2019 (COVID-19) pandemic because of the lack of effective treatments and unavailability of a vaccine, governments worldwide developed a variety of safety measures to control the spread of virus among their populations. Heterogeneous strategies variously implemented during the first year of the pandemic were often maintained after COVID-19 vaccines were made available. Public health and social measures of containment, and nonpharmaceutical interventions (NPIs) that were developed and enforced at local level worldwide proved to be effective in limiting the spread of the disease and reducing the number of deaths. Safety measures adopted to minimize possible viral contamination included frequent hand washing, wearing facemasks, and social distancing policies taken on by communities to limit the spread of a disease. To further reduce person to person transmission of the virus, most countries have introduced a combination of school and workplace closures; public event cancellations, restrictions on public gatherings, closures of public transport, and stay-at-home orders.4 The implementation of strict public health NPIs targeting COVID-19 has been credited for a reduction of many viral and bacterial infectious diseases in children.5,6 For instance, global rates of respiratory syncytial virus (RSV), the most common cause of admission to hospital for infants in high-income countries, accounting for 60%-80% of bronchiolitis hospitalizations, have been significantly low since early 2020.,7 However, the substantial decrease of protective immunity because of the extended period of low exposure to pathogens seems to have left a large part of the pediatric population susceptible to infections.6 For instance, the interseasonal circulation of RSV has been reported in different areas, including Australia during late 2020, South Africa in early 2021, southern US in June 2021, and in Europe after summer 2021. This commentary, authored by the working group on social pediatrics of the European Pediatric Association/Union of National European Pediatric Societies and Associations, briefly discusses the insurgence of infectious diseases because of the immune debt associated to the public health NPIs established to control the COVID-19 pandemic. Our aim is to raise awareness of pediatricians and public health authorities on the importance vaccination programs in children to contrast the immune debt associated to the pandemic.