COVID-19 vaccine access in Africa: Global distribution, vaccine platforms, and challenges ahead

Abstract

Development COVID-19 vaccines in a record time has been an unprecedented global scientific achievement. However, the world has failed to ensure equitable access to what should have been a global public good. What options remain available to African countries to ensure immunization of their populations and ultimately overcome the pandemic?Introduction: vaccine access globally, a tale of two worlds? By the end of April, as the world just passed the one-year mark since the COVID-19 pandemic was declared, more than 150 million cases and 3 million deaths have been reported worldwide (https://covid19.who.int/), including 4,5 million cases (3%) and 120, 000 deaths (4%) in Africa (https://africacdc.org/ covid-19/). Though the continent, home to 17% of the world population, shares a relatively smaller fraction of this global toll, the impact of COVID-19 has been devastating. Africa bears a disproportionate burden of infectious diseases in the face of chronic shortages in its healthcare workforce: any disruption to essential health services, any health care worker (HCW) infected, magnifies the impact of the pandemic. Health services for HIV, tuberculosis, and malaria on the continent have been severely hit by COVID-19 as access has been curtailed due to COVID-19 related movement restrictions. According to a survey by the Global Fund (The Global Fund, 2021), HIV testing has fallen by 41% on average, TB referral and screening by 28%-29%, and half of health facilities have recorded COVID-19 infections among HCWs. According to the United Nations Children's Emergency Fund (UNICEF), interruptions in immunization campaigns will leave 80 million children under the age of 1 unvaccinated or under-vaccinated. Stringent measures promptly implemented to curb the pandemic have wreaked havoc on economies across the continent.

Covax-19/Spikogen® vaccine based on recombinant spike protein extracellular domain with Advax-CpG55.2 adjuvant provides single dose protection against SARS-CoV-2 infection in hamsters

“…Developing regions, e.g. Africa, continue to have limited access to COVID-19 vaccines [5] , [6] and lack the required extreme cold storage infrastructure required for mRNA vaccines. In addition, the adenovirus vector and mRNA vaccines have been associated with adverse reactions including anaphylaxis [7] , central venous thrombosis [8] and myocarditis [9] , [10] .…”

Factors Associated with COVID-19 Vaccine Intentions in Eastern Zimbabwe: A Cross-Sectional Study

“…To date, 234 million doses have been distributed through the COVAX facility [ 4 ]. Nevertheless, many low- and middle-income countries still face challenges in the equitable distribution of COVID-19 vaccines because of lack of vaccine manufacturing capacity, fragile healthcare systems, logistical challenges with transporting and storing vaccines, shortages in health care workers, and poor access to essential health services [ 5 , 6 , 7 ]. Efforts to reduce the burden of COVID-19 through vaccination are further compounded by the emerging threat of vaccine hesitancy [ 8 ].…”

Development of an Inactivated Vaccine against SARS CoV-2

“…Most of these vaccines are based on viral vectors (e.g., adenovirus, University of Oxford/AstraZeneca, Gamaleya Sputnik V, and Johnson & Johnson), mRNA (Moderna and Pfizer-BioNTech), or whole inactivated (Sinovac Biotech and Sinopharm) vaccines. However, worldwide access to these vaccines is limited, particularly in low-income or developing countries, due to extreme cold-chain requirements, high costs, and an insufficient supply of the SARS CoV-2 vaccines [36,37]. Therefore, additional SARS-CoV-2 vaccines are needed to meet the global demand.…”