Equitable access to COVID-19 vaccines in Africa (ECOVA)

The COVID-19 pandemic has underscored existing disparities in the distribution and accessibility of vaccines, reigniting discussions on the need to enhance research and development capabilities for vaccines, in Zimbabwe and on the African continent. Africa possesses the potential to manufacture vaccines, vaccine raw materials, diagnostics, and other medical supplies. However, realising this potential requires a strategic realignment of Africa's investment decisions and the promotion of public-private partnerships or product development collaborations. These measures are essential to expanding research and development capacities for vaccines in Zimbabwe and on the continent. Qualitative in-depth interviews were conducted with twenty Key Informants with specialised knowledge and expertise in the expanded program on immunisation (EPI) and the COVID-19 vaccination program in Zimbabwe. This study synthesizes some of the strategies and recommendations the key informants provided as solutions to enhance domestic vaccine production and address inequities, as well as promote public private partnerships for vaccine research and development in Zimbabwe.

In Mozambique, Covid-19 increased the number of poor people, made over two hundred thousand people sick, and took almost three thousand lives. Vaccinating all eligible population could help prevent death and consequently spare the health system and the economy. Although about nine in 10 people were willing to be vaccinated, only seven have been vaccinated even though COVID-19 vaccines were available in the country. We examined documents produced during 2019 to 2023 by government agencies, national and international investigators, aimed at understanding why people delayed or refused COVID-19 vaccination in Mozambique.

The COVID-19 pandemic has highlighted disparities in vaccine distribution and accessibility, particularly in Africa and more specifically in Zimbabwe. We conducted a scoping review with the aim to estimate the pooled vaccine hesitance and strategies to reduce hesitance and increase vaccine uptake in Zimbabwe. We reviewed study documents and reports produced by government agencies, national and international investigators and the media between March 2020 and January 2024 regarding COVID-19 vaccination in Zimbabwe. Although the study was inspired by Covid 19 vaccination, the study sought for documents on vaccination in general considering the shared delivery and distribution structures with the COVID-19 vaccines but filtered to human vaccines. Data was extracted from a variety of sources including journal articles, official reports and surveys. Our results for vaccine hesitancy and vaccine uptake are outlined below.

The coronavirus disease (COVID-19) is one of the largest public health threats in recent times, with significant health, economic, and social consequences globally. The Nigeria Centre for Disease Control (NCDC) in 2022 revealed that 266,057 cases with 3,155 deaths were reported. However, it is possible that these numbers do not accurately reflect the severity of COVID-19 disease in Nigeria because the country had only tested 5,160,280 people as of 2022, despite a population of around 200 million. Nigeria did not meet its 2021 vaccination target, prompting the need to identify the contextual factors affecting vaccine access and uptake as well as vaccine hesitancy in Nigeria and document the approaches that can be deployed to reduce opposition to vaccination as well as improve advocacy for vaccine equity. This scoping review, conducted using Arksey and O’Malley’s framework, aimed to explore the factors influencing COVID-19 vaccine hesitancy and uptake in Nigeria. The findings highlight the need for targeted, evidence-based strategies to address vaccine hesitancy, improve vaccine distribution, and engage diverse population groups to enhance vaccination uptake across Nigeria.

COVID-19 vaccines are crucial for preventing severe illness from the virus. Despite their effectiveness, vaccine hesitancy, unequal access, and economic disparities hinder vaccination programs in Africa, with Ethiopia facing significant challenges. A review of 34 Ethiopian studies revealed significant COVID-19 vaccine hesitancy, exceeding 50% in over 40% of the studies. The lowest hesitancy was found in adults from Addis Ababa (19.1%), while the highest rates were seen among healthcare workers in Oromia (69.7%) and pregnant women in Southwest Ethiopia (68.8%). Factors like female gender, primary education level, living in rural areas, younger age, lower knowledge about the vaccine, reduced trust in authorities, and a misperception of the virus's risk all contribute to vaccine hesitancy in Ethiopia. To address this effectively, policymakers need to focus on interventions that build trust, raise public awareness about the vaccine's benefits, and combat the spread of misinformation.