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Early in the development of vaccines for Corona Virus Disease 2019 (COVID-19), World Health Organization (WHO) led the establishment of the Vaccines Pillar (COVAX) of the Access to COVID-19 Tools Accelerator (ACT-A) to ensure fair and equitable access to vaccines [1]. COVAX set a target of 2 billion doses, aiming to ensure that at least 20% of each country’s population at highest risk of severe disease, hospitalization and death could be vaccinated by the end of 2021 and a fair allocation mechanism was established for COVID-19 vaccines purchased through the COVAX Facility. This was hoped to end the acute phase of the pandemic and set the world on a path for recovery.

In December 2020, vaccination began in the United Kingdom [2]and other high income countries following Emergency Use Listing (EUL) of Pfizer vaccine. However, vaccine supply through the COVAX facility only became possible in February 2021 after EUL of AstraZeneca from the Serum Institute India. As of 28th March 2022, approximately 11.1 billion vaccine doses have been administered globally. Africa has received approximately 749 million doses (≈ 6% of global supply) and only 65% of this has been administered. At the end of February 2022, approximately 11.1% of total population of the African continent had been fully vaccinated. Majority of the countries in Africa did not attain the WHO 10% target by September 2021.

Vaccination in the IGAD region started in March 2021 with AstraZeneca from the Serum Institute India and Oxford supplied by the COVAX facility. Since then, other vaccines which include; Johnson & Johnson, Sputinik, Moderna, Pfizer, Sinovac and Sinopharm have also been delivered. As of 28th March 2022, approximately 118 million vaccine doses have been delivered in the region. This accounts for 15% of vaccines on the African continent. Most IGAD Member States fell short of the WHO 10% September 2021 target except for Kenya, Djibouti and Uganda. The percentage of total adult population vaccinated in the Member States is as of 9th March 2022 is as follows; Uganda (36.8%), Kenya (28.3%), Djibouti (19.8%), South Sudan (7.1%), Somalia (6.0%), Sudan (3.8%), Ethiopia (3.1%) and Eritrea (0.0%).

Vaccination in the IGAD region like the rest of the Low and Middle Income Countries (LMICs) has been marked by shortage of vaccine supply and logistics, cold chain challenges, misinformation/myths and vaccine hesitancy[3]. Mass campaigns, directives to deny public service to unvaccinated persons, mandatory vaccination, fines for failure to vaccinate, vaccine certificate for travellers and presidential declaration have been implemented across Member States to increase vaccine uptake [4, 5]. Continental initiatives to increase vaccine supply which include; African Vaccine Acquisition Trust (AVAT) and bilateral arrangements and Partnerships for African Vaccine Manufacture (PAVM) have been started [6].

WHO has set new targets of 40% by end of 2021 and 70% by mid-2022 in its strategy to achieve global vaccination by mid-2022 [7]. Approximately 40% of the vaccine as percentage of the regional population has been delivered. Except for Uganda and Djibouti, all other Member States have received less than 50% vaccine delivery as percentage of the population

Data from Multilateral Vaccine Task Force [8].

The journey to realisation of WHO targets in the region remains huge and renewed political commitment, program financing, policy, logistical supplies and increased vaccine production is urgently needed to accelerate the vaccine delivery, vaccination services and monitoring of Adverse Effects Following Immunisation (AEFI).


    Working for global equitable access to COVID-19 vaccines. Webpage, 2020.
  2. BBC, Covid-19 vaccine: First person receives Pfizer jab in UK. 2020.
  3. Ministry of Health, K., Ramping up COVID-19 vaccination among Kenya’s hard-to-reach communities. 2022.
  4. Yusuf, M., Kenyan Court Suspends Directive Barring Unvaccinated from Government Services. 2021.
  5. Africa news, Jail or fine for Ugandans who refuse Covid -19 vaccination. new paper article, 2021.
  6. CDC, A., Partnership for African Vaccine Manufacturing (PAVM) From Aspiration To Action. 2021.
  7. WHO, Strategy to Achieve Global Covid-19 Vaccination by mid-2022
  8. COVID-19, M.L.T.F.O., Vaccine supply and delivery. 2022.

Dr. Harriet Nabukwasi Nassy
IGAD Regional COVID-19 Team
Surveillance Expert

March 31, 2022

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