New report on COVID-19 in Africa shows widespread willingness to get vaccinated, underscoring need for consistent supply and additional logistical support

16 Dec 2021 (NEW YORK, NY)—As the Omicron variant dominates the COVID-19 news cycle, new research from the Partnership for Evidence-Based Response to COVID-19 (PERC) indicates that people in African Union Member States are overwhelmingly willing to get vaccinated. Across 19 countries, 78% of people surveyed by PERC indicated that they had been or were willing to get vaccinated.

However, as of November 2021, less than 7% of the African continent has been vaccinated. This gap between acceptance and coverage demonstrates a substantial unmet need and underscores the importance of consistent and predictable vaccine supply as well as increased support for vaccination programs in Africa. The latest PERC report considers why global vaccination efforts have been plagued by inequity, as well as the logistical challenges to vaccinating the African continent. The report further outlines the continued importance of preventive measures—particularly individual measures such as masking and social distancing—that minimize the social or economic harm that can occur when mobility, economic and social gathering restrictions are imposed.

“We must work urgently toward equitable access to safe and effective vaccines on the African continent,” said Dr. John Nkengasong, Director of the Africa Centres for Disease Control and Prevention. “The PERC data show that demand for vaccines is substantially higher than supply.”

At 78%, vaccine acceptance was higher than in the previous PERC survey fielded earlier this year (67%), which may indicate the success of risk communication campaigns. In five surveyed countries—Guinea, Morocco, Mozambique, Tunisia and Zimbabwe—acceptance was 90% or higher. Vaccine acceptance was high among both those who trusted their government’s pandemic response and those who felt COVID-19 posed a personal risk to them or to their country. Such high acceptance contradicts media reports suggesting that low vaccination rates across Africa are due to hesitancy.

Among the 20% of respondents who expressed vaccine hesitancy, the top reasons were: low risk perception (24%), not having enough information about vaccines (22%) and lack of trust in government (17%). The reasons for low risk perception are complex, but officials can take concrete action to address them. Offering more and better information to people about COVID-19 and vaccines through trusted sources, particularly health care providers, coupled with consistent and reliable vaccine supply, can further increase acceptance. Respondents’ top information sources included local health centers, television and radio.

A number of bottlenecks have contributed to the failure to achieve higher vaccination coverage. Unpredictable supply—in terms of volume, timing and shelf life—threatens countries’ ability to meet demand. When offered, vaccination is frequently inconvenient, requiring people to travel far distances or visit vaccination sites at inopportune times.

“I am heartened by the efforts of the African Vaccine Acquisition Trust (AVAT) and the COVAX facility to expand vaccine access,” said Amanda McClelland, Senior Vice President of Prevent Epidemics at Resolve to Save Lives, an initiative of Vital Strategies. “But there is still work to do. Vaccine donations sent too close to expiry dates, for example, leave countries unable to launch effective vaccination campaigns.”

COVID-19 preventive measures remain crucial to mitigate the health impact of the virus. PERC researchers analyzed what influences support for and adherence to such measures and found that individual actions—handwashing, mask-wearing and social distancing—all garnered support from at least 90% of survey respondents. Such high support suggests that these key measures can continue to be effective strategies for reducing COVID-19 transmission.

Preventive measures restricting gathering or movement received less support. Unemployment and food insecurity were widespread among survey respondents and made adherence to restrictive community measures a challenge. PERC researchers concluded that such measures should be targeted to specific, high-risk populations as needed to minimize harm.

Income loss also may have had an adverse impact on access to essential health services. Cost and affordability were cited as the primary obstacles to receiving care. Declines in the number of health visits have likely contributed to declines across key health indicators. PERC researchers advocate for urgent investment to stabilize health systems and regain progress lost during the pandemic.

“The PERC data enable policymakers to both save lives and minimize impacts on livelihoods,” said Dr. Tom Frieden, President and CEO of Resolve to Save Lives, an initiative of Vital Strategies. “The global community has an opportunity to invest in health care workers and public health infrastructure to support vaccine delivery and COVID-19 care and prevention in the near term, and also repair and restore health service delivery disrupted by COVID-19 for the long term.”

Based on their findings, PERC authors recommend:

  • The global community should support AU Member States in supplying vaccines at a better coordinated and more systematic pace to allow broader, more effective and equitable distribution. Resources and expertise to support vaccine delivery must be part of the supply machinery to ensure coverage.
  • COVID-19 preventive measures (described as public health and social measures, or PHSMs, in the report) are critical to mitigate COVID-19 transmission, particularly as new, possibly more transmissible, variants emerge in under-vaccinated populations. Promoting adherence must remain a top priority.
  • Ministries of Health have competing priorities—both maintaining longer-term investments in endemic diseases, such as HIV and tuberculosis, and preparing for and responding to immediate epidemics, such as yellow fever, Ebola and measles. Investments in preparing health security systems can be utilized both for COVID-19-specific responses and long-term priorities.
  • Strengthening health data systems to be better prepared for health threats is critical. It is important that investments prioritize epidemiological data, as well as contextual data and data on community perceptions and actions toward countermeasures for disease mitigation and prevention. Together with the data itself, timely collection, analysis and dissemination are integral to systems strengthening and emergency response.
  • The global community and national governments should invest—to the fullest extent possible—in public health infrastructure and social protection programs that build and maintain resilience, in order to improve health and economic outcomes and reduce the opportunity costs of vaccination and PHSM adherence.

The PERC survey—the fourth in its “Using Data to Find a Balance” series—was fielded in September, when many countries in Africa were recovering from a third wave of COVID-19 driven by the Delta variant and before the emergence of the Omicron variant. PERC polled approximately 23,000 people across 19 African Union Member States; compiled social, economic and epidemiological data from a range of sources; and compared results from previous surveys conducted in February 2021 and August 2020. A French version of the report will be available in January 2022.

To read the full report, please visit: https://preventepidemics.org/wp-content/uploads/2021/12/PERC-Finding-the-Balance-Part-IV.pdf

Scroll down to download a factsheet summarizing the report’s key findings and calls to action.

About Resolve to Save Lives

Resolve to Save Lives, an initiative of the global health organization Vital Strategies, focuses on preventing deaths from cardiovascular disease and by preventing epidemics. It is led by Dr. Tom Frieden, former director of the U.S. Centers for Disease Control and Prevention. To find out more, visit: https://www.resolvetosavelives.org or Twitter @ResolveTSL and @DrTomFrieden.

About Vital Strategies

Vital Strategies is a global health organization that believes every person should be protected by equitable and effective public health systems. We work with governments and civil society in more than 70 countries to design and implement evidence-based strategies that tackle their most pressing public health problems. Our goal is to see governments adopt promising interventions at scale as rapidly as possible. To find out more, please visit www.vitalstrategies.org or Twitter @VitalStrat.

About NASEM

The National Academies of Sciences, Engineering, and Medicine (NASEM) are private, nonprofit institutions that provide expert advice on some of the most pressing challenges facing the nation and the world. Our work helps shape sound policies, inform public opinion, and advance the pursuit of science, engineering, and medicine. The National Academies do not receive direct appropriations from the federal government, although many of their activities are mandated and funded by Congress and federal agencies. NASEM also works with Foundations, state governments, the private sector, and philanthropy from individuals to enable them to address critical issues on behalf of the nation.

About the UK Public Health Rapid Support Team

The UK-PHRST is funded by UK aid from the Department of Health and Social Care and is a partnership between the London School of Hygiene & Tropical Medicine (LSHTM) and UK Health Security Agency (UKHSA). Through the UK Public Health Rapid Support Team (UK-PHRST), the UK has the capacity to respond rapidly to disease outbreaks in low- and middle-income countries around the world and conduct operational research into epidemic preparedness, playing an important role in global health security. The team also works to help countries to build their own capacity for an improved and rapid national response to outbreaks. The views expressed in this publication are those of the authors and not necessarily those of the Department of Health and Social Care.

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About the World Economic Forum

The World Economic Forum is the International Organization for Public-Private Cooperation. In response to the COVID-19 emergency, the World Economic Forum, acting as partner to the World Health Organization (WHO), launched the COVID Action Platform. The platform is intended to catalyse private-sector support for the global public health response to COVID-19, and to do so at the scale and speed required to protect lives and livelihoods, aiming to find ways to help end the global emergency as soon as possible. For more information, visit: https://www.weforum.org/

About the World Health Organization

WHO is working with UNICEF, Gavi and partners to support all aspects of COVID-19 immunization in Africa, including capacity assessments, planning, advising on delivery strategies, regulatory mechanisms, ensuring adequate cold chain, training and supervision, data monitoring and surveillance, and communication including raising public awareness and promoting demand for vaccination. The WHO-founded Africa Infodemic Response Alliance (AIRA), a joint platform of 12 partner organisations is working to counter misinformation and disinformation and share science-based facts on health, including vaccines.

Media Contacts:

  • James Ayodele, Principal Communication Officer, Africa Centres for Disease Control and Prevention (Africa CDC), [email protected], +251 11 551 7700
  • Collins Boakye-Agyemang, Communications Officer, WHO Regional Office for Africa, [email protected], +4724139420 or +242065206565
  • Steven Chlapecka, Resolve to Save Lives, [email protected], +1.917.623.0246
  • Christina Honeysett, Director of PR, Vital Strategies, [email protected], +1 914 424 3356
  • Amanda Russo, Head of Media Content, World Economic Forum, [email protected], +1 415 734 0589

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About Resolve to Save Lives

Resolve to Save Lives is a not-for-profit organization partnering with countries, communities and organizations to prevent 100 million deaths from cardiovascular disease and make the world safer from epidemics. To find out more, visit: resolvetosavelives.org or Twitter @ResolveTSL.