An overwhelming majority of people in Africa – 78% of people surveyed across 19 countries in the African Union – are willing to get vaccinated, according to new research from the Partnership for Evidence-Based Response to COVID-19 (PERC).

PERC – a public-private partnership consisting of organizations and institutions such as the African Union, Africa Centres for Disease Control and Prevention (CDC), Vital Strategies, the World Health Organization, and others – polled approximately 23,000 people across 19 African Union Member States. 

The 19 countries surveyed included South Africa, Kenya, the Democratic Republic of Congo, and Morocco – representing countries with wider access to vaccines and almost none at all.  

That is despite the fact that as of November 2021  less than 7% of the African continent has been vaccinated. 

The report, released on Thursday, highlights that vaccine hesitancy is not the top challenge in Africa. 

Despite efforts of the African Vaccine Acquisition Trust (AVAT) and the COVAX facility to expand vaccine access, only three African countries – Egypt, Morocco, and Zimbabwe – have reached the end-of-year WHO vaccination coverage target of 40%, according to the report. 

This demonstrates a substantial unmet need between acceptance and coverage, and underscores even further the importance of consistent vaccine supply and support for vaccination programmes in Africa. 

“We must work urgently towards equitable access to safe and effective vaccines on the African continent,” said Dr John Nkengasong, Director of the Africa Centres for Disease Control and Prevention. 

“The PERC data show that demand for vaccines is substantially higher than supply.”

The PERC report considers the inequity surrounding global vaccination efforts and the logistical challenges to vaccinating the African continent. It also further outlines several preventative measures critical to mitigating COVID-19 transmission in the wake of new, more transmissible variants, such as Omicron. 

High vaccine acceptance contradicts media reports about hesitancy 

The high vaccine acceptance rates of the African continent, higher now at 78% when compared to a previous PERC survey conducted earlier in the year (67%), contradicts media reports that low vaccination rates across Africa are due to hesitancy.

Five surveyed countries – Guinea, Morocco, Mozambique, Tunisia, and Zimbabwe, even had acceptance at 90% or higher. Acceptance rates were influenced by trust in governments and their handling of the pandemic; perceived risk of COVID-19; availability of information; as well as trust in the vaccines.

Among the 20% of respondents who did express vaccine hesitancy, top reasons included low risk perception, not having enough information about vaccines, and lack of trust in government. 

Misinformation has also been shown to influence decision-making regarding vaccines.

The global reaction to adverse events associated with AstraZeneca’s vaccine at the beginning of Africa’s rollout campaign likely had a lasting impact on vaccine acceptance and product choice in many member states. 

Vaccine production fails to reach global targets 

An insufficient number of vaccine doses have been promised to low- and middle-income countries, with the supply delivered even lower than expected.

Global production targets totaled 20.8 billion doses, but manufacturers’ project that only about 12 billion will be produced by the end of the year. 

In addition, less than 15% of donated doses were actually delivered to LMICs. 

Unpredictable and inconsistent supply act as logistical bottlenecks that threaten countries’ ability to meet demand. 

In its report, PERC called on numerous stakeholders – manufacturers, donor countries, AVAT and COVAX to work collaboratively with recipient governments to ensure advance vaccination campaign planning and rollout.

“As vaccine supply increases in many countries, efforts to identify and address barriers to getting shots into arms are critical,” the report read.

“WIthout immediate, coordinated support to address these bottlenecks, the pace of vaccination will remain slow, in spite of the great demand for COVID-19 vaccination.” 

Recommendations point towards global support and public health measures 

The report makes several calls to action, noting that in addition to scaling-up public health infrastructure and implementing preventative measures, the global community would need to support and supply AU Member States with vaccines for more effective and equitable distribution.

Notably, while individual public health measures – handwashing, mask-wearing, and social distancing – all garnered support from at least 90% of survey respondents, preventative measures that restricted gathering received less support. Unemployment and food security made it difficult to adhere to restrictive community measures.

Specifically, the report recommends: 

• Governments should prioritize strengthening surveillance structures and health data systems.
• Though reliable supply of safe and effective COVID-19 vaccines is necessary, it is not sufficient. The global community should support vaccine delivery with resources and expertise to ensure coverage.
• Public health and social measures are critical tools for mitigating COVID-19 transmission, especially as more transmissible variants emerge in under-vaccinated populations. 
• To the fullest extent possible, the global community and national governments should invest in public health infrastructure and social protection programs. 

“The PERC data enable policymakers to both save lives and minimize impacts on livelihoods,” said Tom Frieden, President and CEO of Resolve to Save Lives, an initiative of Vital Strategies. 

“The global community has an opportunity to invest in health care workers and public health infrastructure to support vaccine delivery and COVID-19 care and prevention in the near term, and also repair and restore health service delivery disrupted by COVID-19 for the long term.”

Image Credits: World Bank/Flickr, PERC , PERC, UNICEF.