text: Impact that the COVID 19 pandemic on routine childhood vaccinations and challenges ahead A narrative review To document the decline in vaccination coverage in the first months of 2020 as an indirect effect of the COVID 19 pandemic We performed a literature review in medical databases Overall 143 articles were initially retrieved out of which 48 were selected and included in the review Our review retrieved similar data in many countries worldwide and globally preliminary data from the first 4 months of 2020 indicate a decline in diphtheria tetanus pertussis coverage generally considered the marker of vaccination coverage across countries World Health Organization recommends maintaining vaccination services prioritising primary series vaccinations especially for measles rubella or poliomyelitis but it also lets each country decide whether to maintain the immunisation services evaluating the current epidemiology of vaccine preventable diseases and the COVID 19 local transmission scenario Successively recovering of vaccinations should be planned Moreover during the pandemic influenza vaccination should be promoted as a central public health measure Future challenges will be to maintain the vaccination programmes especially in children younger than 2 years old and adolescents to plan the recovery of vaccinations for subjects who postponed them during the lockdown and to early identify any vaccine preventable disease outbreak 