Critical prerequisites for Covid-19 vaccine acceleration: A developing economy perspective

Examining corruption risks in the procurement and distribution of COVID-19 vaccines in select states in Nigeria

BACKGROUND

Public health emergencies raise significant concerns about corruption and accountability; however, these concerns can manifest in different ways across diverse locations. For instance, more developed countries with a stronger rule of law may experience more corruption in vaccine procurement, whereas developing countries may experience more corruption at the point of distribution and delivery to end users. This research focuses on corruption concerns in Nigeria, specifically examining the procurement and distribution of COVID-19 vaccines.

METHODS

This paper utilizes a scoping review and a qualitative research approach. Key informants (n = 40) involved in the procurement and distribution of COVID-19 vaccines across two states in Nigeria were interviewed. Findings from the scoping review were summarized, and collected data were inductively coded and analysed in themes, revealing clear examples of implementation irregularities and corruption in the country's COVID-19 vaccination processes.

RESULTS

Vaccination programme budgeting processes were unclear, and payment irregularities were frequently observed, resulting in vaccinators soliciting informal payments while in the field. Recruitment and engagement of vaccination personnel was opaque, while target vaccination rates incentivized data falsification during periods of vaccine hesitancy. Accountability mechanisms, such as health worker supervision, vaccination data review, and additional technical support provided by donors were implemented but not effective at preventing corruption among frontline workers.

CONCLUSIONS

Future accountability measures should be evidence-driven based on findings from this research. Personnel recruitment, contracting, budgeting, and remuneration should focus on transparency and accountability.

Promoting COVID-19 Vaccine Acceptance through Community Engagement: An Ethnographic Study in Ghana

Introduction. To successfully manage COVID-19 and to meet the target of vaccinating 22.9 million people in Ghana, the government has adopted community engagement as one of the strategies. Yet, the Volta Region continues to record the lowest rate of vaccine acceptance in Ghana. This study explored how government institutions engaged communities on COVID-19 vaccine preparedness and acceptance in two administrative municipalities in Ghana. Methods. This qualitative study employed face-to-face in-depth interviews among thirty-six respondents comprising of government officials and community leaders and ten focus group discussions among 87 people made up of men and women most of whom were natives and some migrants in two administrative municipalities in Ghana. Data were collected from June to September 2021. Audio interviews were transcribed and uploaded to Nvivo 12 to support triangulation, coding, and thematic analysis. Ethical approval was obtained from the requisite authority, and all COVID-19 restrictions were observed. Results. Government institutions focused on informing communities of vaccines and vaccination with little input from the communities. The Ghana Health Service carried out the most extensive engagement because they had more decentralized institutions. Successful engagement activities resulted in vaccine acceptance among some community members. Challenges in community engagement included insufficient logistics and myths and misconceptions about vaccines, which accounted for some community members’ lack of trust in vaccines, resulting in their unwillingness to vaccinate. Government officials used innovative approaches such as comparing the safety of COVID-19 vaccines to vaccines designed for children under the age of five years to deal with misinformation. Conclusion. Government needs to provide more resources to institutions that are mandated to carry out engagement activities to enable them carry out their tasks. It is further recommended that government institutions should intensify community engagement in distant communities to support the country to meet the target.

The impact of the acceleration of COVID-19 vaccine deployment in two border regions in Oman

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Border regions should take priority in pandemic management for vaccine deployment.

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Public health measures remain as important as vaccine distribution in the country.

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In one border region, hospitalizations decreased by nearly 75% due to enhanced vaccination.

Background

Among the challenges to public health systems imposed by coronavirus disease 2019 (COVID-19) have been vaccine scarcity and the prioritization of high-risk groups. Countries have been prompted to accelerate the pace of immunization campaigns against COVID-19 to deploy the immunization umbrella to the largest possible number of target groups. In this paper, we share the perspective of Oman regarding the impact of accelerating the administration of the first dose of the COVID-19 vaccine in one border governorate (Musandam) by comparison to another border governorate (Al-Buraimi) where this approach was not applied.

Methods

Daily admissions data (April 10, 2020 to June 24, 2021) and vaccination data (January 1 to June 24, 2021) were collected systematically. For each governorate, the cumulative doses (first and second doses) and vaccination coverage were calculated daily.

Results

Within 1 month, first dose vaccination coverage increased from 20% to 58% in Musandam, reducing the incidence of hospital admission by 75%. In comparison, vaccination coverage plateaued at 20% in Al-Buraimi, and the incidence of hospital admission increased by 500%.

Conclusions

Given the peculiarity of the geographical location and being the first line of access for imported cases, border regions should be a priority for vaccine deployment as a preventive measure. The two different approaches reported here, implemented in broadly similar cross-border governorates, provide evidence of the significant effect of accelerating the first dose of vaccine in reducing hospitalizations.