African countries are running out of supplies of Covid-19 vaccines, and there is concern over the availability of further doses. So far, seven countries have already exhausted the vaccines they received from the UN-backed Covax scheme. And some countries have not been able to use AstraZeneca vaccines before their advertised expiry date (UN).
Ghana and Rwanda have administered nearly all of the shots received to date through the global Covax distribution Scheme, but it is unclear when further doses will arrive – raising fears that people will miss out on their second vaccine. Like many countries, Covax’s initial delivery projections have been hit by supply problems.
The move – although similar to the actions of several wealthy countries – largely cut off supply from the Serum Institute India (SII), which had been set to manufacture two thirds of vaccines delivered by Covax by June. Shortages due to India’s export restrictions have been felt in 60 countries across the globe, but the most acute impact has been in Africa – which was set to receive almost all its Covax deliveries via the SII. The continent has so far administered roughly 17.5 million vaccines – less than two percent of global rollout – for a population of 1.2 billion people.
Countries using up supplies:
Deliveries of vaccines supplies under the Covax programme started in February, and most countries in Africa have signed up and received vaccine doses. Some countries are also getting donations from China, Russia, the United Arab Emirates and India. The Covax initiative has so far delivered 18 million vaccine doses to 41 African countries, according to the WHO. A few countries have not joined in. But the WHO says Rwanda, Senegal, Ghana, Togo, Tunisia, eSwatini, and Botswana have already exhausted their initial supplies from Covax and will need to wait until early May to mid-June for more.
Expiry of Vaccines:
South Africa changed its mind against using AstraZeneca and very quickly switched to Johnson and Johnson vaccine which they decided had more efficacy at fighting their Covid-19 variant.
But several other countries who were given these AstraZeneca doses did not manage to use them before they expired on 13th April 2021. Malawi was left with about 16,000 of doses out of 102,000, while South Sudan was left 59,000 doses of the vaccine. Ghana and Sierra Leone were also left with some doses. The WHO has now advised those countries to store the vaccines pending further guidance, rather than dispose of them. The manufacturer, the Serum Institute of India, says the vaccines could still be used for three months after the listed expiry date, although the WHO has yet to endorse this.
Vaccine Safety Concerns:
The WHO advised African nations to continue to use the AstraZeneca vaccine, which makes up the majority of doses supplied under the Covax scheme. Health authorities in the United Kingdom and in Europe have been looking into unusual blood clots which have appeared in a handful of people given the jab. A few African countries put the rollout of the AstraZeneca vaccine on hold as a precaution. However, currently only Chad and Zimbabwe declined to use the AstraZeneca vaccine.
A study commissioned by Africa CDC on Covid-19 vaccine perceptions in 15 countries found a significant proportion of people had concerns around vaccine safety. About 20 percent of the respondents said they would not take the vaccine, with the number of varying considerably across countries. Across most of the countries featured in the study, respondents tended to view Covid-19 vaccines as less safe than vaccines in general.
Slow uptake of the available doses:
This could be caused partly by issues around distributing the vaccines and the lack of health workers to administer them.
Vaccine Hesitancy and Skepticism:
But there are fears vaccine hesitancy and skepticism could be playing a role like the case in Sierra Leone and Malawi.
Africa’s Other Hurdles in the Vaccination journey:
- Limited stocks and supply bottlenecks
- Operational and financial hurdles
- Difficulties reaching remote locations
- Africa playing Covid-19 vaccination catch-up.
- Lack of supply chain infrastructures to store, transport and deliver vaccines effectively.
- Not meeting the requirement of maintaining a cold chain ranging from 2 degrees Celsius to -80 degrees Celsius.
- Equitable distribution of the vaccine to the population most at risk is a substantial challenge to many countries.
- Identifying the priority populations and vaccinating them is not as straightforward in LMICs as it is in many high income countries due to a lack of centralized data to identify those most at risk.
- Limitations for estimating targets for Covid-19.
- Systemic obstacles to distribution
In Somalia, the challenge is not simply obtaining Covid-19 vaccines but also persuading the population to accept it. The people have little confidence in the vaccines and they hate needles. The country has no way to handle a vaccine like the Pfizer one that requires being kept at a temperature of minus 70 degrees Celsius. Somalia recommends a vaccine that could be kept between minus 10 and minus 20 and that could adapt to high temperatures. Somalia received in March 2021, 300,000 doses, only 40% of the doses have been administered which is an indication of low uptake mainly related to conspiracies and fear of vaccine presumption.
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