Africa’s COVID-19 rollout is anticipated for Spring 2021, despite the continent’s low vaccine preparedness, multiple health leaders in Africa have said, as policy advisory groups flag the importance that other successful immunization campaigns will have on COVID recovery.

At a press briefing on Thursday, Dr. John Nkengasong, Director of Africa CDC, said: “Africa may have to wait until the second quarter of 2021 to roll-out COVID-19 vaccines. I have seen how Africa is neglected when drugs are available in the past.” The sentiment was echoed by WHO Regional Director for Africa Matshidiso Moeti, who specified an anticipated March roll-out.

The statements follow calls made by the African Regional Immunization Technical Advisory Group (RITAG) for countries to urgently resume routine and catch-up immunization services, while adhering to strict COVID-19 prevention protocols.

When African countries began to lockdown at the beginning of the pandemic, critical vaccination programs for diseases like polio were suspended for several months. Since the countries began reopening, governments have taken steps to undo the impact the pandemic has had on these campaigns, but the months-long interlude to routine immunizations has left its mark. While Africa was declared wild polio-free in August 2020, vaccine-derived polio cases have increased.

“Collective action to strengthen immunization is needed, now more than ever, as we approach the end of the Decade of Vaccines and COVID-19 limits access to essential health services across Africa,” said Professor Helen Rees, Chair of the RITAG, which is the principal advisory group to the WHO on regional immunization policies and programmes

Currently, African vaccine preparedness appears to be low, warned a WHO group on Thursday – which evaluated self-assessment of vaccine readiness levels in 40 of the region’s 47 countries, only to find that average readiness was only about 33% – in comparison to the WHO benchmark of 80%.

Through COVAX – a program aiming to accelerate the development of COVID-19 vaccines – Africa will be able to access vaccines for up to 20% of its population but at the outset, early dose will only reach about 3% of the population : namely, health workers and the elderly.

Nkengasong added that the continent needs to provide vaccine access to up to 60% of its population before it can achieve herd immunity indicating that additional funding needs to be arranged to extend COVID-19 vaccine coverage in Africa beyond what the continent would get through COVAX. He put the cost at up to US$12 billion.

How COVID-19 has impacted immunisation in Africa

Africa has a regional immunization target of 90% but in 2019, immunization coverage in the region stagnated at 74% for the third dose of the diphtheria-tetanus-pertussis containing-vaccine (DTP3), and at 69% for the first dose of the measles vaccine. WHO and its partners had hoped there would be improvement in 2020.

Moeti stressed that pre-existing gaps in immunisation coverage have been exacerbated in 2020 by the COVID-19 pandemic, putting millions of children at risk for deadly diseases.

An additional 1.37 million children across the African region missed the Bacille Calmette-Guerin (BCG) vaccine which protects against tuberculosis, and an extra 1.32 million children below the age of one missed their first dose of measles vaccine between January and August 2020, when compared with the same period in 2019, WHO said in a statement.

Moreover, immunization campaigns covering measles, yellow fever, polio and other diseases have been postponed in at least 15 African countries in 2020.

“Current outbreaks of vaccine-preventable diseases are an apt reminder of the work that remains to be done,” said Dr. Richard Mihigo, Programme Manager for Vaccine-Preventable Diseases at the WHO Regional Office for Africa. “How we respond to these outbreaks amid the COVID-19 pandemic will be critical to protecting children and communities, and to preventing further disease outbreaks.”

Image Credits: WHO, United Nations Photo.