The first year of COVID-19 vaccine roll-out in Africa: challenges and lessons learned

Introduction: in the first year following the introduction of COVID-19 vaccines, only 6.8% of the total population in the 47 countries in the WHO African Region have received full vaccination. In an emergency context, the intra-action review helps countries to assess their progress and document what has worked and not worked. Methods: we reviewed and identified the key lessons and challenges documented in the reports from intra-action review of COVID vaccine roll out in 22 African countries. Results: all countries documented high level political commitment, but a serious shortage of COVID-19 vaccines and funding. Seven countries identified gaps in microplanning because of lack of funding or due to the unpredictability in the type and volume of vaccine supplies. The shortage of operational funding also affected training of health workers and hampered the expansion of service delivery. The countries implemented multi-channel communications and social mobilisation activities, alongside social media engagement and social listening. However, country capacity was limited in terms of timely responding to infodemics. Hesitancy among health workers and the general population was a challenge in most of the countries. Conclusion: countries have gained valuable experiences exploring various COVID-19 vaccination delivery models, including implementing the integration of COVID-19 vaccination within routine health care programs. There is a need to regularly monitor or do studies measuring public perceptions towards COVID-19 vaccination in order to drive the demand generation efforts, as well as use evidence in addressing hesitancy

Challenges in the logistics management of vaccine cold chain system in Ile-Ife, Osun State, Nigeria

Background: The success of national immunization programmes depends largely on effective logistics management of the vaccine cold chain system. This study assessed cold chain equipment functionality, healthcare workers' knowledge and practice of the logistics management of vaccine cold chain system in Ile-Ife, Nigeria. Methods: A descriptive study was conducted in immunization clinics of 35 health facilities in Ife East and Central Local Government Areas (LGA) in Ile-Ife. There were 100 immunization service providers in the (LGAs) and they were all recruited into the study. Information was obtained with the aid of an interviewer-administered, structured questionnaire. Cold chain equipment functionality was assessed using a checklist. Data were analyzed using SPSS version 20.0. Results: Eleven (31.4%) of the facilities had functional refrigerators for storing vaccines, 16 (45.7%) had cold boxes while 13 (37.1%) had thermometers for vaccine temperature monitoring. Fifty-four (54.0%) of the healthcare workers were aware of the "shake test" and 19 (19.0%) could correctly interpret colour changes on a vaccine vial monitor. Consumption record was considered by 69 (69.0%) of healthcare workers when making vaccine requisitions while the required lead time was considered by 24 (24.0%) of them. Only 29 (29.0%) of healthcare workers kept records of vaccines stock-on-hand.Conclusion: Adequate training and supportive supervision is essential to improve healthcare workers' knowledge and cold chain practices. Relevant cold chain equipment should be provided to boost storage capacity across health facilities

Cold chain facility status and the potency of animal rabies vaccine used in Nigeria

Rabies vaccine failures were reported in literature. Realising that rabies vaccine is sensitive to temperature change; there is need to assess the storage condition of rabies vaccine from distribution centres to veterinary clinics where they are used. This is to establish the sustained potency from source to use. Cold-Chain facilities were assessed and ampoules of rabies vaccine were collected from the distribution centres and veterinary clinics where they are used. The state of rabies vaccine before collection was noted and recorded. Laboratory assay for the potency of rabies vaccine collected was carried out using mice neutralisation test. Rabies vaccine collected from distribution centres had high virus titre ranging between log 10-2;4 and log10-2;5. The Cold-Chain facilities at these centres were adequate and functioning. However at the clinics; the storage condition deteriorated and the virus titres of vaccine tested ranged between log10-1;4 and log10-1;7. The Cold-Chain facilities were either non-functional or partially functional when they are present. Again there were no generator backups for power supply. The study showed that problem created by non-functional or partially functional Cold-Chain facilities resulted in the potency deterioration of rabies vaccine. It is therefore recommended that Cold-Chain facilities should be overhauled and backup generators be provided. Also recommended is the use of oral rabies vaccine that can stand the room temperature to vaccinate dogs

A report of a mission to Malawi; 7 - 25 November; 1983

The purpose of the mission was to assess the need for spare parts and cold chain training and make recommendations on any further equipment required

A preliminary investigation into the cold-chain being operated by the Ministry of Health in the Republic of Malawi

The report summary states that the cold chain operates reasonably well and all health staff seem to be aware of the different storage needs of different vaccines; however new equipment and better monitoring of refrigeration performance and maintenance of equipment is necessary at all levels

A report of a mission to Malawi 7th - 25th November; 1983

The purpose of the visit was to asses the need for spare parts and cold chain training; investigate availability of gas as a fuel for the cold chain and make recommendations on any further equipment that is needed