key: cord-0717253-y40fjjpi authors: Muhammad, Ameer; Ahmad, Daniyaal; Tariq, Eleze; Shafiq, Yasir title: Rebuilding Trust on Routine Immunization in Era of COVID-19 Fear–Role that Civil Society Organizations can Play Hands-in-Hand with Immunization Program date: 2021-06-02 journal: Public Health Rev DOI: 10.3389/phrs.2021.1603989 sha: 19dd990694b462d5a72742d6c224136ad8e4d5f0 doc_id: 717253 cord_uid: y40fjjpi nan vaccination-playing major roles at both the supply-as well as the demand-side [16] . The role of these organizations in the response is integral as they are the last-mile players to reach the community's needs, playing a pivotal role in containing endemic illnesses at the community level, averting cases through community mobilization and awareness, and acting at the front line in case detection and referrals. They also advocate with and hold the government, private sector, and development partners accountable for delivering to the most vulnerable [17, 18] . CSOs are thus potential frontline community players to delivering key messages related to COVID-19 and the emerging risk of VPDs in communities [19] . CSOs can fill the current gaps created in service provision and help in reconstructing the trust which vaccination services may have lost in terms of demand in hard-to-reach, vulnerable, and marginalized populations [20, 21] . They usually operate as an independent entity, granting them adjustable and contextual flexibility when working for the communities during the COVID-19 crisis. With having appropriate institutional support and already being trusted partners of the communities through cross sectoral intervention and integrated approaches, they harbor incredible potential in fulfilling this role [22] [23] [24] . The COVID-19 pandemic is an extreme condition and warrants the need of a supportive system for routine immunizations across the globe. The synergy between CSOs and the government needs to be established through the recognition of the contribution which these players can provide during this critical time and help the EPI programs to cover its losses. There are platforms available such as "Pakistan CSOs Coalition for Health and Immunization (PCCHI)"-a network of around 80 organizations working together on health and immunization in Pakistan. This forum has great power to aid in community mobilization, research, advocacy, awareness raising, demand generation, monitoring, and service delivery [25] . This unified action of formal CSO engagement and cohesive approach can help us reach those children who were missed, and supply them with the appropriate dose of vaccine, possibly preventing a lot of non-COVID-19 deaths which are attributable to VPDs. Data has suggested that; "For every one excess Covid-19 death attributable to SARS-CoV-2 infections acquired during routine vaccination clinic visits could be around 140 (37-549) and these deaths in children may be prevented by sustaining routine childhood immunization in Africa" [26] . Due to the significant impact in saving lives, there is a strong and urgent need for building these engagements and taking CSOs onboard who can work with the EPI program hand-in-hand, for the betterment of our communities and our children. YS and AM conceptualized, analyzed, and prepared the manuscript. ET and DA helped in the preparation of the manuscript. All authors read and approved the final manuscript. The Socio-Economic Implications of the Coronavirus Pandemic (COVID-19): A Review COVID-19 Coronavirus Pandemic The Potential Impact of COVID-19 on GDP and Trade: A Preliminary Assessment World Health Organization. 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