By Joseph Maina
Despite public willingness and a steady increase in the number of vaccines shipped to the continent, access to COVID-19 vaccines remains a challenge in many regions in Africa.
Up to 67 percent of adults in the country would “definitely or probably” take a vaccine if available, according to a 2021 study by the University of Johannesburg and the Human Sciences Research Council.
But a combination of factors, ranging from an inability to quickly distribute highly perishable vaccines to limited accessibility to vaccine sites, are contributing to the slow roll out. Only 11 percent of the African population has been fully vaccinated, despite a surge in new supplies, according to a February report by the World Health Organization (WHO).
The study found the primary reasons preventing people from getting the jab are difficulty accessing vaccination sites, high vaccination costs and not having the time. Other reasons cited included the need to be accommodated due to having a disability, administrative barriers such as not having an identity document, concerns about getting a vaccine while pregnant or breastfeeding, underlying health issues and caregiving responsibilities.
The COVID-19 pandemic has also exposed Africa’s vulnerabilities in ensuring access to vital drugs, vaccines and health technologies, contributing to vaccine inequity and hesitancy among a cross-section of the population.
A joint study conducted by the Academy of Science of South Africa (ASSAf) and the Uganda National Academy of Sciences (UNAS) identified lack of information and misinformation, mistrust in healthcare systems, inconvenience and various political variables as the root causes of hesitancy.
Success in vaccine deployment could also be tied to people’s unique social-economic situations.
Pundits have urged creative approaches to supply the vaccines to far-flung populations and attend to some of the hiccups that have aggravated vaccine hesitancy on the continent. A key element in addressing vaccine hesitancy lies in agility, according to Dr. Mercy Mwangangi, chief administrative secretary in Kenya’s health ministry. Vaccination initiatives must also keep in mind different people’s circumstances.
“If a Kenyan has to spend Ksh100 (about USD 1) to get to a health facility to access a jab, perhaps then we are contributing to the hesitancy, because if I only have Ksh200(USD 2) that I made that day, I’m not sure that I want to spend my Ksh200 travelling to get a jab, when I have my other daily needs,” Mwangangi said.
To address the challenge, she noted that it might be necessary to look at the wider mechanisms of deploying the vaccines.
“It may be useful to look at outreach services. It may also be useful to look at non-conformist mechanisms of deploying this vaccine, such as going to churches on a Sunday and capturing the people where they are,” she said.
Supply constraints, particularly at national levels, have also hampered vaccine availability to populations in the continent.
According to Folorunso Oludayo Fasina, a professor in the Department of Veterinary Tropical Diseases in the University of Pretori, Africa has yet to achieve optimal delivery levels for COVID-19 vaccines, a fact he attributed to delays in arrival of supplies.
In Nigeria, for instance, up to 1 million vaccines were estimated to have expired in November 2021 before they could be used, due in part to a surge in supply that was not commensurate with local capacity to manage the shots. The WHO reportedly conceded to Reuters that vaccines with “very short” shelf lives were a problem.
Another factor is risk perception among some populations. As noted by Yap Boum of Epicentre of Doctors Without Borders in an interview with France24, the less risk people perceive, the less they feel the need to get vaccinated.
Cameroon perfectly epitomizes this phenomenon.
As with many African countries, Cameroon’s death rate since the onset of the pandemic has been relatively low despite infection rates that are comparable to Europe. As Boum suggests, this contributes to perceptions of lower risk that consequently result in vaccine hesitancy.
Vaccination campaigns have also been inordinately focused on urban environments, Boum said. Access to remote regions is further hampered by poor infrastructure and financial limitations.
Countries could get around this challenge by piggybacking COVID-19 vaccination drives on existing logistical frameworks. Kenya offers one such example.
“One of the things I am very proud of is the Kenya national immunization program,” stated Dr. Githinji Gitahi, group chief executive officer of AMREF Health Africa in a 2021 TV interview. “Kenya does vaccinate children every year, on normal under-5 vaccines. This infrastructure and logistical capacity has enabled us to have 99.6 percent absorption of the vaccines. That’s because the distribution channels for the COVID-19 vaccines and their administration processes are not any different from the ones we use for under-5 vaccination.”
Experts have agreed that in addition to measures aimed at addressing structural challenges, they need to bolster community outreach programs to thaw negative attitudes towards the vaccines.