The World Health Organization (WHO) has advised Africa against giving Covid-19 booster doses, even as some countries destroyed drugs that expired due to vaccine hesitancy among some in the population.
WHO argues that it doesn’t make sense for Sub-Saharan Africa to spend scarce Covid-19 vaccines on boosters when so many across the continent have yet to receive their first shot.
Alain Poy the Regional Immunization Monitoring and Evaluation Officer for the WHO Africa region says there are only 136 million people that have been fully vaccinated on the continent, out of a target of 1 billion people.
With so many that are yet to be vaccinated, officials say it would be unfair to start giving out booster doses when people in the same country or a neighbouring one have not yet had a chance to be fully vaccinated.
“When majority have been vaccinated, we can implement booster doses, and vaccination for children where it is needed,” says Dr. Abdou Salam Gueye the Regional Emergency Director for Sub Saharan Africa.
Dr. Gueye says at the moment, he is against giving booster doses every six months, as this isn’t the most efficient approach. The most efficient approach in dealing with Covid-19, he says, is to invest resources in reducing suffering by saving the biggest number of people.
To achieve this, Dr. Gueye says there is a need to invest in operationalizing vaccination campaigns. That way vaccines will be brought to where they are needed and when they are needed.
“Some people may believe Africans are not vaccinated because they are hesitant,” says Dr. Gueye, who adds that this would be the wrong conclusion.
“Africans are not vaccinated because they don’t have vaccines,” he says. He adds that where vaccines are available, Africans are not vaccinated because resources to operationalize campaigns and bring services to where and when they are needed but are not readily available.
Dr. Gueye cites a World Bank study that found that the majority on the continent would take an approved Covid-19 jab if it was availed to them free of charge. In the study whose data was collected between September and December 2020, Ethiopia was found to have the highest vaccine acceptance rate at 97 percent, while Uganda, Nigeria, and Malawi were at over 82 percent.
But even as WHO advises against booster doses Uganda, Nigeria and Malawi have had to destroy Covid-19 shots that expired before utilization. In Malawi and Nigeria, the governments reported not having enough time, as the vaccines were imported too close to the expiry date.
In Uganda, which announced plans to destroy 400,000 doses of Moderna and less than 300 of AstraZeneca in January 2022, Minister of Health Jane Ruth Aceng says the problem was that these vaccines were taken to a part of the country that has high hesitancy rates. Yet, the vaccines were the delicate type that needed to be used less than 30 days after they had been thawed.
Dr. Aceng says the now expired vaccines had been taken to northern Uganda, in a bid to improve vaccination rates in that part of the country, but hesitancy among members of the population made consumption difficult.
According to WHO, parts of Africa which are at war or those like northern Uganda that were previously in conflict with the government are likely to have higher cases of vaccine hesitancy.
“The level of trust with government determines whether there is hesitancy or not. People living under unreliable and corrupt governments and those that are at war are more like to resist vaccines,” says Dr. Gueye.
This could explain the high Covid-19 vaccine hesitancy in northern Uganda, where people lived in internally displaced people’s camps until 2006 when the war between the Lords’ Resistance Army (LRA) and the current Uganda government ended.
According to Dr. Aceng, the government transferred vaccines rejected by the north to western Uganda, but since Moderna is ultra-frozen, it was difficult to utilize all 500,000 doses that had been removed for thawing, from the required cold chain of -80 degrees Celsius. Only 100,000 were utilized, leaving the remaining 400,000 to expire.
Meanwhile, WHO says Africa seems to have reached the peak of the fourth Covid-19 wave, with fewer infections and deaths.
In South Africa which has provided the most data on the omicron variant, which is the driver of the fourth Covid-19 wave, Dr. Anita Graham, an Intensivist at Wits University says immunity gathered from vaccines and previous infections helped lead to fewer hospitalizations and less death.
She, however, adds that for those patients that were not vaccinated, omicron was as serious, as in earlier variants where the chances of severe illness or even death were as high for the old and immunocompromised.