Following the advent of COVID-19, World Health Organisation has listed a number of safe, effective and efficacious vaccines for emergency use to control the pandemic. As of October 11, 2021, Uganda had cumulatively received over 4 million doses of COVID-19 vaccines, including mRNA Moderna and Pfizer vaccines, AstraZeneca (AZ), Sinovac, Sinopharm, and Johnson and Johnson (J&J), all targeting priority groups, and continues to expect more (approximately 3.6 million) to be received by the end of December 2021. However, the program continues to register low vaccination rates at national and sub-national levels regardless of the available vaccines.
While the program prepares to transition from phase I prioritisation to phase II vaccination coverage, UNITAG was requested to provide guidance and recommend innovative ways to increase COVID-19 vaccine uptake in Uganda. Operational challenges in introducing different vaccines to the immunisation program prompted this request in a bid to assist the Ministry of Health in successfully implementing the Uganda COVID-19 Vaccination Implementation Plan (UCVIP), whose overall objective is to vaccinate all eligible persons (adolescents aged 12-17 years and adults aged 18 to 49 years) against COVID-19 in Uganda by the end of 2022.
UNITAG, guided by lessons learned on the issue globally and domestically, assessed current COVID-19 vaccine rollout and uptake data from phase one vaccination targeting high-risk groups in Uganda, the UCVIP and barriers to COVID-19 vaccination coverage. In addition to the program’s rollout strategic considerations, the committee further considered ethical and legal requirements and concluded that a well-functioning health system working in harmony should be built on having trained and motivated health workers and a reliable supply of vaccines, backed by adequate funding, strong health plans, and evidence-based policies.
The following approaches to urgently increase uptake as more vaccines become available were recommended;
1) Motivate the existing Health Workers (HWs) engaged in the vaccination campaign by increasing human resource capacity to alleviate the extra workload, recognising best performing HWs as champions and continuously educating them on the benefits of vaccination over cost.
2) Mobilise funding for COVID-19 Vaccination Campaign by drafting a COVID-19 Vaccination Investment Case document supported by a budget focusing on the various COVID-19 vaccination challenges.
3) Strengthen vaccination delivery by borrowing lessons learned from the concluded immunisation campaigns to showcase the impact of vaccination and facilitate a successful COVID-19 campaign.
4) Increase access to vaccines by increasing vaccination sites, including private health facilities, and engaging other sectors to utilise their ongoing programs.
5) Use evidence-based policies to present a strong case for whether to mandate COVID-19 vaccination or not.