While fewer than 7 percent of the African continent’s total population has received a COVID-19 vaccine, nearly eight in ten people in nineteen African Union member states are willing to be vaccinated, a report from the Partnership for Evidence-Based Response to COVID-19, a public-private partnership coordinated by Resolve to Save Lives, finds.

The fourth and final report in a series of studies conducted since March 2020, Responding to COVID-19 in Africa: Finding the Balance Part IV: Calls to Action (29 pages, PDF) found that the vaccine acceptance rate across the surveyed countries rose to 78 percent in September, from 67 percent in February, which may indicate the success of risk communication campaigns. Five countries — Guinea, Morocco, Mozambique, Tunisia, and Zimbabwe — had acceptance rates of 90 percent or higher, and rates were higher among those who trusted their government’s pandemic response and those who felt COVID-19 posed a personal risk to them or to their country. Among the 20 percent of respondents who expressed vaccine hesitancy, the top reasons were a perception that they were at low risk (24 percent), insufficient information about vaccines (22 percent), and lack of trust in government (17 percent).

According to the report, global vaccination efforts have been plagued by supply shortages and inequities in distribution. The number of vaccine doses promised to low- and middle-income countries (LMICs) is insufficient, and the actual supply delivered has been even lower than expected. Global production targets for 2021 totaled 20.8 billion doses, but manufacturers’ current projections suggest that only about twelve billion doses will be produced by the end of the year; of that limited supply, high-income countries have purchased more than five doses per person. And as of November, fewer than 15 percent of doses donated to LMICs had actually been delivered.

In this context, the report’s authors emphasize the importance of preventive measures such as handwashing, mask-wearing, and social distancing — measures that saw a slight decline in the composite acceptance rate, from 88 percent in February to 85 percent in September, while the self-reported adherence rate fell from 62 percent to 55 percent. Acceptance of measures restricting social gatherings also declined, from 84 percent to 79 percent, and the self-reported adherence rate dropped from 67 percent to 58 percent.

The report’s recommendations include supplying vaccines at a better coordinated and more systematic pace to allow broader, more effective and equitable distribution; strengthening health data systems to better prepare for health threats; and investing 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 adherence to public health and social measures.

“The PERC data enable policy makers to both save lives and minimize impacts on livelihoods,” said 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.”

(Photo credit: GettyImages/Mongkolchon Akesin)