ABSTRACT
Coverage of COVID-19 vaccines in Somalia remains low, including among health workers. This study aimed to identify factors associated with COVID-19 vaccine hesitancy among health workers. In this cross-sectional, questionnaire-based study, 1476 health workers in government and private health facilities in Somalia's federal member states were interviewed face-to-face about their perceptions of and attitudes toward COVID-19 vaccines. Both vaccinated and unvaccinated health workers were included. Factors associated with vaccine hesitancy were evaluated in a multivariable logistic regression analysis. Participants were evenly distributed by sex, and their mean age was 34 (standard deviation 11.8) years. The overall prevalence of vaccine hesitancy was 38.2%. Of the 564 unvaccinated participants, 39.0% remained hesitant. The factors associated with vaccine hesitancy were: being a primary health care worker (adjusted odds ratio (aOR) = 2.37, 95% confidence interval (CI): 1.15-4.90) or a nurse (aOR = 2.12, 95% CI: 1.05-4.25); having a master's degree (aOR = 5.32, 95% CI: 1.28-22.23); living in Hirshabelle State (aOR = 3.23, 95% CI: 1.68-6.20); not having had COVID-19 (aOR = 1.96, 95% CI: 1.15-3.32); and having received no training on COVID-19 (aOR = 1.54, 95% CI: 1.02-2.32). Despite the availability of COVID-19 vaccines in Somalia, a large proportion of unvaccinated health workers remain hesitant about being vaccinated, potentially influencing the public's willingness to take the vaccine. This study provides vital information to inform future vaccination strategies to achieve optimal coverage.
ABSTRACT
INTRODUCTION: Nigeria has adopted the African Regional measles elimination targets and is implementing the recommended strategies. Nigeria provides routine measles vaccination for children aged 9 months. In addition, since 2006, Nigeria has been conducting nationwide measles supplemental Immunisation activities (SIAs) or mass vaccination campaigns every 2 years, and has established measles case-based surveillance. METHODS: We reviewed routine and supplemental measles immunization coverage data, as well as measles case-based surveillance data from Nigeria for the years 2012 - 2016, in an attempt to determine the country's progress towards these elimination targets. RESULTS: The first dose measles vaccination coverage in Nigeria ranged from 42% and 54% between 2012 and 2015, according to the WHO UNICEF national coverage estimates. Nigeria achieved 84.5% coverage by survey following the 2015 nationwide measles supplemental immunisation activities (SIAs). During this period, the incidence of confirmed measles ranged from 25 - 300 confirmed cases per million population per year, with the Northern States having significantly higher incidence as compared to the Southern States. At the same time, the pattern of confirmed cases indicated a consistent shift in epidemiological susceptibility including older age children. CONCLUSIONS: In order to accelerate its progress towards the measles elimination targets, Nigeria should build population immunity on a sustainable basis by addressing systemic issues in order to scale up routine immunisation coverage, especially in the Northern half of the country; tailoring the target age for measles SIAs so as to sharply reduce measles incidence in age groups heavily affected by the disease; effectively mobilising resources and improving the quality of planning and coverage outcome of SIAs.
ABSTRACT
Nine polio areas of expertise were applied to broader immunization and mother, newborn and child health goals in ten focus countries of the Polio Eradication Endgame Strategic Plan: policy & strategy development, planning, management and oversight (accountability framework), implementation & service delivery, monitoring, communications & community engagement, disease surveillance & data analysis, technical quality & capacity building, and partnerships. Although coverage improvements depend on multiple factors and increased coverage cannot be attributed to the use of polio assets alone, 6 out of the 10 focus countries improved coverage in three doses of diphtheria tetanus pertussis containing vaccine between 2013 and 2015. Government leadership, evidence-based programming, country-driven comprehensive operational annual plans, community partnership and strong accountability systems are critical for all programs and polio eradication has illustrated these can be leveraged to increase immunization coverage and equity and enhance global health security in the focus countries.