EA states stuck with Covid vaccine doses as fight winds down

Up to 40 million Covid-19 vaccines could go to waste in East Africa as the fight against the deadly coronavirus slows down due to apathy and logistical hitches.

The region’s countries, once aggressive buyers of the vaccines as the rich West hoarded them for their populations, are now stuck with stockpiles of doses they cannot dispense because of the anti-vax sentiment and lack of support for the inoculation programmes.

The “good” problem has caught up with Uganda mainly, but it reflects the general lethargy across the East African region, where thousands died as the region struggled to purchase the vaccines from reluctant makers.

The death toll, infections and hospitalisations have gone down to manageable levels. But that means few are interested in getting the jab and those getting it are doing so because they have no choice.

Expiring in four months

Uganda’s Ministry of Health says it is stuck with a stockpile of 13.4 million vaccines which are expected to expire in four months due to an unfounded perception of the vaccines' side effects.

The country is anticipated to lose enormous sums of money if these vaccines expire before they have been used. Some are expiring in August and September, according to Dr Diana Atwine, Health Permanent Secretary.

She told the Public Accounts Committee of Parliament this week that people are no longer motivated to receive the vaccines.

Uganda is waiting for a solution to this crisis as it can neither sell nor donate the vials, as many other African countries had hoarded these as a preventative measure against the deadly virus.

“All African countries bought the Covid-19 vaccines at the same time,” Dr Atwine told MPs, citing Kenya, DR Congo and South Sudan as partner states stuck with millions of vaccines.

“Recently, we were in South Africa, and we realised that they were also stranded with vaccines,” she added.

Logistical challenges

The Ugandan government has been working hard to increase vaccination rates among its citizens, but challenges like vaccine reluctance, a shortage of vaccine supplies where they are required, and logistical challenges getting to remote areas have slowed down progress.

In Kenya, at least a million doses may be disposed of soon, as they are expected to expire in the next one month. The figure could go up to four million, if what is in the stores is not utilised.

The EastAfrican understands a downtrend in the intake of the jab is behind the possible destruction of the vaccine doses in stores across the country.

Fewer vaccinations

Kenya is currently administering fewer than 200 doses of the vaccine a day, from 2,000 a day when waves of the virus strains swept across the nation.

In fact, most of those taking the jabs are travellers to destinations abroad where visitors are required to be vaccinated. According to the World Health Organisation, in the EAC, Tanzania leads in administration of the vaccines, even in the face of an initial Covid denial and anti-vax sentiment among the population, with about 39 million doses dispensed.

Rwanda and Uganda have given out 26 million doses each, Kenya 23 million, Congo 13 million, South Sudan 3 million and Burundi 35,000.

Figures from the Kenyan Health ministry indicate that of the 23 million doses administered, over 19 million were given to adults over the age of 18 and another 3 million to children aged 12 to 18 years.

Booster doses

The number of booster doses has increased to 1.7 million and 37 percent of individuals have received all recommended doses.

Kenya purchased and received 27.8 million doses in 2021, meaning, there’s about 4 million doses in the country waiting to be utilised. In March, the Ministry of Health was compelled to destroy 840,000 AstraZeneca doses that expired.

Through donations and government purchases, Uganda acquired 48,897,520 doses by the end of December 2022. Of these, 22,615,954 are believed to be in the National Medical Stores.

Only six percent of children between the ages of 12 and 17 received at least two doses of the vaccine, compared with 59 percent of people over 18.

This coverage falls short of the nation’s goal of having 28.5 million eligible Ugandans (22 million adults and 6.5 million children) vaccinated.

Potency vs expiry

According to the WHO, the shelf life of a vaccine reflects how long it retains its potency and stability at a given storage temperature and therefore its effectiveness. The shelf life is used to establish the expiry date of each batch of the vaccine product.

Expiry dates do not affect the safety of the vaccine, however. Rather, it reflects the potency.

“Potency does not drop dramatically after the expiry date, it goes down slowly. Usually, the expiry date given is half of the storage time after which it starts losing potency,” WHO says.

Kenya Medical Practitioners and Dentists Union Deputy Secretary Dennis Miskellah said the biggest loss when destroying vaccines is not the cost of the actual destruction, but rather the price paid for a jab that will now go to waste, as well as the potential healthcare cost of someone who may now fall ill or die from complications of a disease that could have been prevented.

“We need to speedily get this vaccine. This is about you as an individual. My worry is that we may destroy what could have saved a life from a severe outcome of a disease,” Dr Miskellah said.

As part of the Africa CDC’s strategic response to the pandemic it partnered with the Mastercard Foundation to establish the Saving Lives and Livelihood programme in 2021 to rapidly scale up vaccination on the continent to achieve 70 percent coverage in three years.

Routine immunisation

The first beneficiaries of this programme were Tanzania, South Sudan, Cameroon, Namibia, Sierra Leone, Liberia, Lesotho, Morocco, and Zambia. This might explain how Tanzania, a late-comer, surpassed the other EAC partners in the number of the vaccinated.

The programme led to the setup of new vaccination centres and the strengthening of existing CVCs for increased access to vaccination sites by the population. Similarly, the logistics of supplying vaccinations from the central cold rooms to the centres, including the ancillaries needed to support their functioning, was established.

Tanzania has now passed the 50 percent mark.

In a statement on March 17, Dr Derrick Sim, acting Managing Director of the Covax Facility, said Dodoma had maintained a sustained vaccination rollout in recent months to surpass the milestone.

“Tanzania has developed some highly innovative approaches on how to roll out Covid-19 vaccines and also, catch up on routine immunisation programmes. The progress and commitment by government and partners to protect people against Covid-19 is commendable and demonstrates that countries can deal with multiple immunisation priorities at the same time,” Dr Sim said.