Fatal Outcomes for Two Confirmed Ebola Cases in DRC as Africa Strives to Reboot Immunization Strategies for COVID and Beyond
ebola
Ebola vaccination campaign in Mbandaka, Équateur Province (DRC) in 2020

In DR Congo’s latest Ebola outbreak, the two people with confirmed cases are dead and response is focusing on identifying and vaccinating contacts – because of insufficient doses to conduct a mass vaccination campaign in the outbreak area. Meanwhile, public health officials are trying to reboot Africa’s mainstream immunization programmes, which saw setbacks during the COVID pandemic. 

A targeted Ebola vaccination campaign aimed at tracing and immunizing contacts is underway in Mbandaka, a city in DR Congo’s north-western Equateur Province where two people with confirmed cases of Ebola have both died, according to the World Health Organization (WHO) on Thursday.

Addressing a press briefing on Thursday, Dr Mory Keita, Incident Manager for Ebola outbreak response in the DRC, confirmed the deaths of the two people with confirmed cases since the country’s latest outbreak was declared on April 23.

“So far, 78 direct contacts have been vaccinated and we are using the method of identifying contacts to vaccinate, because it has proven to be an effective means of quickly stopping outbreaks. And we do not have enough doses to vaccinate everyone in the country,” Keita said.

Dr Mory Keita, Incident Manager for Ebola outbreak response in the DRC

The vaccination exercise is commencing while DRC joins the rest of the world in marking the African Immunization Week, part of the larger World Immunization Week observance. For this year, attention is being drawn to what the WHO described as a surge in outbreaks of vaccine-preventable diseases over the past year.

Between January and March 2022 alone, WHO almost 17,500 cases of measles were recorded in the African region and this represents a 400% increase compared with the same period in 2021, WHO’s Africa Regional Office noted: 

“20 African countries reported measles outbreaks in the first quarter of this year, eight more than that in the first three months of 2021.” 

In 2021, 24 countries in WHO’s Africa region also confirmed outbreaks of a polio variant.  New yellow fever outbreaks were reported in 13 countries. as compared to nine  in 2020 and three in 2019. The agency has not yet reported on 2022 data. 

WHO noted that inequalities in accessing vaccines, disruptions by the COVID-19 pandemic including a huge strain on health system capacities impaired routine immunization services in many  countries and forced the suspension of other more routine vaccination drives.

“The rise in outbreaks of other vaccine-preventable diseases is a warning sign. As Africa works hard to defeat COVID-19, we must not forget other health threats. Health systems could be severely strained not only by COVID-19 but by other diseases,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa. “Vaccines are at the heart of a successful public health response, and as countries restore services, routine immunization must be at the core of revived and resilient health systems.”

Lessons from COVID about vaccination in Africa

Professor Helen Rees, Executive Director, Wits Reproductive Health and HIV Institute, University of Witwatersrand, South Africa

As of April 28, only about 16% of the African population has been fully vaccinated against COVID. Even though this is still far from the 70% vaccination goal, it has been an enormous task for the continent’s public health stakeholders, as well as an eye-opener to the issues that influence and direct impact vaccination on the continent.

Delays in COVID vaccination in Africa – as rich countries hoarded vaccines – damaged overall uptake of COVID vaccines on the continent, said Professor Helen Rees, Executive Director, Wits Reproductive Health and HIV Institute, University of Witwatersrand, South Africa.

Africans, having already lived through two years of the pandemic without the vaccines, are now no longer very keen on getting the shots, she observed.

“The delay in accessing vaccines allowed misinformation and disinformation to come in. But it also allowed questions to be raised at the population level about “well, is this disease really as bad for us as we see in the northern hemisphere?

“And people don’t necessarily understand that we have different demographics, we have younger populations, we’re going to see more asymptomatic mild infections,” she said.

Dr Benido Impouma, Director of Communicable and Noncommunicable Diseases Cluster at WHO Regional Office for Africa

The perception of a reduced risk now presents a conundrum, necessitating a combination of strategies to scale up COVID-19 vaccination, Dr Benido Impouma, Director of Communicable and Noncommunicable Diseases Cluster at WHO Regional Office for Africa. 

“We are trying to diversify. In fact, our strategy is to ensure that we can first of all achieve high coverage in priority groups, and then as time goes on, we now go to the lower priority groups,” he said.  That has included running public service ads in social media in countries with a history of vaccine hesitancy during African Immunization Week, urging the general public to speak to their health care workers about the benefits of COVID vaccination. 

https://twitter.com/WHO_Tanzania/status/1520032402462158855

Image Credits: WHO/Junior D. Kannah.

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