Should Africa prioritize covid-19 vaccination?

OVER THE In the summer, supply shortages were the main problem. Africans queued the covid-19 vaccine jab from dawn, but most doses went to rich countries. India, a major producer, has banned exports. The result was harsh. In Senegal, some estimates indicate that the number of funerals was seven times higher than normal. Grave digger in other African countries also worked overtime. Today, only 7% of Africans are fully vaccinated against the disease.

However, vaccine shipments to Africa have increased significantly in recent weeks. Approximately 50 million doses arrived in October, almost double the number that landed in September. In Uganda, which has been given 6 million doses so far, 21 million doses are planned by the end of this year, which is sufficient for almost all adults. The World Health Organization is calling on all countries to vaccinate 70% of the total population by mid-2022 as more shots are imminent. Some African countries have set goals accordingly.

Still, much of sub-Saharan Africa may not reach its 70% target. In sub-Saharan Africa, most people are reluctant or difficult to reach vaccination. Moreover, it may not be desirable to strive to reach it by mid-2022. The median age in the region is less than 20 years. Building herd immunity against covid is a valuable goal, but vaccination of slim young Africans with little risk of dying from illness often diverts resources from more pressing health campaigns. Means to do. For Uganda, where half of the population is children, this goal “doesn’t make much sense,” says Alfred Driware, who manages the country’s vaccine program.

African healthcare workers have already gone too far. Some of their priorities may be to provide catch-up vaccination for diseases such as measles and tetanus. Millions of children missed these jabs during the blockade. My parents couldn’t travel or were afraid of empathy at the clinic. In the Moroto district of Uganda, about 400 km from the capital Kampala, local health official Hans Locare usually says that about 10% of children do not return for follow-up. That number has doubled since the pandemic. Ghana’s Minister of Health, Kwak Agiemann Manu, says his devoted program has not distracted from other public health efforts. But that may be because only 8% of Ghanaians have received jabs since the vaccine began arriving in March.

Jab for covids and jabs for other illnesses may compete more than the time of healthcare professionals. Some African countries are already immersed in emergency stockpiles of syringes that are normally reserved for outbreaks of infectious diseases such as measles and yellow fever in order to carry out enthusiastic campaigns. UNICEF believes that it is necessary to get 25% more syringes than usual just to replenish these inventories. It doesn’t even take into account the syringes needed for billions of covid jabs that must be administered to reach the 70% goal. Exacerbating the problem is the nature of the syringes used in Africa. These are specially designed to accurately derive standard Covid vaccine doses and disable needles after a single use. Both are important features because jabs are often provided by poorly trained community health workers who can unintentionally spread the infection, including: HIV By reusing old needles.

When considering priorities, some African health authorities may find increasing evidence that covid has already swept much of the region. For example, a study in Mali found that about 60% of people were already infected by January and had some degree of innate immunity. Covid may not be so deadly in Africa. Hospitalization was rare among people with covids, even when the outbreak was the worst in Mali. One obvious reason is that few people in Mali suffer from obesity and diabetes. These are two conditions that make covid worse. Some studies suggest another reason: covid does not seem to be so severe in people who have had malaria in the past.

Whether or not the 70% target is desirable, many countries in sub-Saharan Africa will have a hard time achieving it. As of early November, most of them used less than half of the dose they received (see graph). One reason is that many doses were donated by developed countries shortly before the expiration date. “They bring a vaccine that expires in two weeks,” says Dr. Lokale. He has taken 2,000 doses that must be put into his weapons in the next two weeks. That requires almost 4% of adults in his district to get up in a hurry.

Outside Moroto’s health center, four people are sitting in the thin shade of acacia trees, waiting for more to come before they get a jab. Each vial of the vaccine listed here contains 15 doses. Once opened, it should be used that day. In some places, healthcare professionals encourage people to gather friends and come as a group. Recent deliveries of Sinovac vaccines have helped alleviate this problem as they are delivered in single dose vials.

Many in Moroto are herders who regularly travel in search of fresh pasture. It can make it difficult to track them for a second dose. Dr. Rocale wants to ship a single-dose Johnson & Johnson vaccine, which will solve that problem. As global vaccine supply increases, African countries may become more selective and choose the ones that better suit their needs, says UNICEF’s Jean Gandhi.

Jab and prayer

A more difficult problem may be to persuade people to get a jab. In a survey conducted by pollster Afrobarometer in 15 African countries, on average only 47% of respondents were likely to be vaccinated, and 39% said prayer was “much more” than a vaccine. I believed it was “effective” (although I had some questions) before the jab was available). Only half had them when the shots were offered to health care workers in Moroto’s hospital. Rumors that jabs make people infertile, and that Western countries are sending jabs to kill Africans and similar nonsense, are widespread on WhatsApp. The same message will be broadcast on the radio even in villages without internet.

Low confidence in government, a chronic situation across Africa, is part of the problem. Less than half of the respondents to the Afrobarometer survey said they trust the government to ensure that vaccines are safe. However, many people have more anxieties that can be resolved with better outreach campaigns. Sayou, a 52-year-old security guard in Dakar, the capital of Senegal, says he trusts the vaccine but is uncertain if the clinic is open on his only holiday, Sunday.

This all helps explain why the plastic chairs outside the corona vaccination room in the Dakar clinic are empty. There is no shortage of vaccines, but only about 10 people appear per day compared to more than 50 people a while ago. “There are few cases of covid, but if there is another wave, the whole world will come again,” said one nurse. Health authorities, on the other hand, need to decide how best to deploy limited resources. ■■

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This article was published in the printed Middle East and Africa section under the heading “Picking their shots”.

Should Africa prioritize covid-19 vaccination?

Source link Should Africa prioritize covid-19 vaccination?

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