Global diversity of policy, coverage, and demand of COVID-19 vaccines: a descriptive study

Summary Background Hundreds of millions of doses of COVID-19 vaccines have been administered globally, but progress in vaccination varies considerably between countries. We aim to provide an overall picture of COVID-19 vaccination campaigns, including policy, coverage, and demand of COVID-19 vaccines. Methods We conducted a descriptive study of vaccination policy and doses administered data obtained from multiple public sources as of 23 October 2021. We used these data to develop coverage indicators and explore associations of vaccine coverage with socioeconomic and healthcare-related factors. We estimated vaccine demand as numbers of doses required to complete vaccination of target populations of countries according to their national immunization program policies. Findings Use of both mRNA and adenovirus vectored vaccines was the most commonly used COVID-19 vaccines formulary in high-income countries, while adenovirus vectored vaccines were the most widely used vaccines worldwide (176 countries). Almost all countries (98.3%, 173/176) have authorized vaccines for the general public, with 53.4% (94/176) targeting individuals over 12 years and 33.0% (58/176) targeting those ≥18 years. Forty-one and sixty-seven countries have started additional-dose and booster-dose vaccination programs, respectively. Globally, there have been 116.5 doses administered per 100 target population, although with marked inter-region and inter-country heterogeneity. Completed vaccination series coverage ranged from 0% to more than 95.0% of country target populations, and numbers of doses administered ranged from 0 to 239.6 per 100 target population. Doses administered per 100 total population correlated with healthcare access and quality index (R2 = 0.58), socio-demographic index (R2 = 0.56), and GDP per capita (R2 = 0.65). At least 5.54 billion doses will be required to complete interim vaccination programs: 4.65 billion for primary immunization and 0.89 billion for additional/booster programs. Globally, 0.84 and 0.96 dose per individual in the target population are needed for primary immunization and additional/booster programs, respectively. Interpretation There is wide country-level disparity and inequity in COVID-19 vaccines rollout, suggesting large gaps in immunity, especially in low-income countries.

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The acceptance of covid-19 vaccines in Sub-Saharan Africa: Evidence from 6 national phone surveys

10.1101/2021.06.28.21259320 ◽

2021 ◽

Author(s):

Shelton Kanyanda ◽

Yannick Markhof ◽

Philip Wollburg ◽

Alberto Zezza

Keyword(s):

Side Effects ◽

Low Income ◽

Urban Areas ◽

Vaccine Coverage ◽

Sub Saharan Africa ◽

Low Income Countries ◽

Vaccine Hesitancy ◽

African Countries ◽

Representative Sampling ◽

Sub Saharan

Introduction Recent debates surrounding the lagging covid-19 vaccination campaigns in low-income countries center around vaccine supply and financing. Yet, relatively little is known about attitudes towards covid-19 vaccines in these countries and in Africa in particular. In this paper, we provide cross-country comparable estimates of the willingness to accept a covid-19 vaccine in six Sub-Saharan African countries. Methods We use data from six national high-frequency phone surveys from countries representing 38% of the Sub-Saharan African population (Burkina Faso, Ethiopia, Malawi, Mali, Nigeria, and Uganda). Samples are drawn from large, nationally representative sampling frames providing a rich set of demographic and socio-economic characteristics by which we disaggregate our analysis. Using a set of re-calibrated survey weights, our analysis adjusts for the selection biases common in remote surveys. Results Acceptance rates in the six Sub-Saharan African countries studied are generally high, with at least four in five people willing to be vaccinated in all but one country. Vaccine acceptance ranges from nearly universal in Ethiopia (97.9%, 97.2% to 98.6%) to below what would likely be required for herd immunity in Mali (64.5%, 61.3% to 67.8%). We find little evidence for systematic differences in vaccine hesitancy by sex or age but some clusters of hesitancy in urban areas, among the better educated, and in richer households. Safety concerns about the vaccine in general and its side effects emerge as the primary reservations toward a covid-19 vaccine across countries. Conclusions Our findings suggest that limited supply, not inadequate demand, likely presents the key bottleneck to reaching high covid-19 vaccine coverage in Sub-Saharan Africa. To turn intent into effective demand, targeted communication campaigns bolstering confidence in the safety of approved vaccines and reducing concerns about side effects will be crucial to safeguard the swift progression of vaccine rollout in one of the world's poorest regions.

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Global, regional, and national estimates of target population sizes for covid-19 vaccination: descriptive study

BMJ ◽

10.1136/bmj.m4704 ◽

2020 ◽

pp. m4704 ◽

Cited By ~ 4

Author(s):

Wei Wang ◽

Qianhui Wu ◽

Juan Yang ◽

Kaige Dong ◽

Xinghui Chen ◽

...

Keyword(s):

Confidence Interval ◽

Adult Population ◽

Target Population ◽

Descriptive Study ◽

World Health ◽

Vaccine Hesitancy ◽

Target Populations ◽

Population Sizes ◽

National Estimates ◽

Country Specific

AbstractObjectiveTo provide global, regional, and national estimates of target population sizes for coronavirus disease 2019 (covid-19) vaccination to inform country specific immunisation strategies on a global scale.DesignDescriptive study.Setting194 member states of the World Health Organization.PopulationTarget populations for covid-19 vaccination based on country specific characteristics and vaccine objectives (maintaining essential core societal services; reducing severe covid-19; reducing symptomatic infections and stopping virus transmission).Main outcome measureSize of target populations for covid-19 vaccination. Estimates use country specific data on population sizes stratified by occupation, age, risk factors for covid-19 severity, vaccine acceptance, and global vaccine production. These data were derived from a multipronged search of official websites, media sources, and academic journal articles.ResultsTarget population sizes for covid-19 vaccination vary markedly by vaccination goal and geographical region. Differences in demographic structure, presence of underlying conditions, and number of essential workers lead to highly variable estimates of target populations at regional and country levels. In particular, Europe has the highest share of essential workers (63.0 million, 8.9%) and people with underlying conditions (265.9 million, 37.4%); these two categories are essential in maintaining societal functions and reducing severe covid-19, respectively. In contrast, South East Asia has the highest share of healthy adults (777.5 million, 58.9%), a key target for reducing community transmission. Vaccine hesitancy will probably impact future covid-19 vaccination programmes; based on a literature review, 68.4% (95% confidence interval 64.2% to 72.6%) of the global population is willing to receive covid-19 vaccination. Therefore, the adult population willing to be vaccinated is estimated at 3.7 billion (95% confidence interval 3.2 to 4.1 billion).ConclusionsThe distribution of target groups at country and regional levels highlights the importance of designing an equitable and efficient plan for vaccine prioritisation and allocation. Each country should evaluate different strategies and allocation schemes based on local epidemiology, underlying population health, projections of available vaccine doses, and preference for vaccination strategies that favour direct or indirect benefits.

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Use of Simple Mobile Technology to Create an Electronic Vaccination Registry in Kenya

TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH ◽

10.21522/tijph.2013.09.04.art012 ◽

2021 ◽

Vol 9 (4) ◽

pp. 130-143

Author(s):

Samuel Juma

Keyword(s):

Low Income ◽

Vaccine Coverage ◽

Dropout Rate ◽

Developed Countries ◽

World Health ◽

Low Income Countries ◽

Short Message ◽

Poor Access ◽

Health Organization ◽

Low Coverage

Vaccination is one of the high-impact public health interventions against the spread of disease. Over time, developed countries have been able to reduce the burden of disease through improving access to vaccination and achieving high vaccine coverage. In low-income countries, the situation is different as most countries still report low coverages of less than 90%, which is the global target recommended by the World Health Organization. The main reasons for this low coverage include poor access to vaccination, stock-outs, and poor documentation and targeting for vaccination services. To address these problems, we developed an electronic vaccine registry using Unstructured Supplementary Service Data (USSD) technology that registered births, vaccines administered and sent short message reminders to mothers about their clinic dates. The study was conducted in Nyandarua County, Kenya, between June 2018 to March 2019. To participate in the study, mothers had to reside within the jurisdiction of the study site. Mothers who moved into the study site also had their children registered and previous vaccines updated. A total of 4,823 births and 20,515 vaccines administered were captured into the system. The system sent 12,554 short message reminders to mothers; 3 days before the due day and on the due day. Additionally, it generated a birth register, vaccination register, defaulter list, dropout rate report, vaccine coverage, and timeliness reports. The intervention improved vaccination coverage and timeliness of vaccination by up to 8.7%.

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Epidemiology and determinant factors of neural tube defect: Narrative review

Surgical Neurology International ◽

10.25259/sni_84_2020 ◽

2020 ◽

Vol 11 ◽

pp. 81

Author(s):

Melese Linger Endalifer ◽

Gedefaw Diress

Keyword(s):

Neural Tube ◽

Neural Tube Defect ◽

Low Income ◽

Low Income Countries ◽

Medical Illness ◽

Related Factors ◽

Mortality And Morbidity ◽

Determinant Factors ◽

Geographical Regions ◽

Behavioral Nutrition

Background: The epidemiology of neural tube defect (NTD) is face ignorance from the global community. However, the problem is complex and it is a cause for child mortality and morbidity. We provide the latest insights with respect to determinant factors of NTD. Methods: Google Scholar and PubMed were systematically searched to identify potential research articles concerning the epidemiology and its determinant factors of NTD. Results: The epidemiology of Neural tube defects increased in some countries. The epidemiology and determinant factors were varies across countries,geographical regions and socioeconomic status of the populations. In general, the determinant factors of NTD were summarized as behavioral, nutrition-related, environmental, medical illness, and health service-related factors. Conclusion: Birth defect is fatal which affects the new generation; specifically, NTD is the problem of middle- and low-income countries. It is a direct cause for neonatal and perinatal mortality rate globally. Even if little factors identified, yet conducting experimental and clinical trial researches are a better approach to slow down the progress.

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Postscript Evolutionary ecology to reconcile public health, ethics and politics for infectious diseases control in low-income countries: time to move forward!

10.1093/oso/9780198789833.003.0025 ◽

2018 ◽

Author(s):

Awa Marie Coll Seck ◽

Ibrahima Seck

Keyword(s):

Public Health ◽

Infectious Diseases ◽

Low Income ◽

Evolutionary Ecology ◽

Childhood Vaccination ◽

Low Income Countries ◽

Vaccination Programs ◽

Guinea Worm ◽

High Profile ◽

Public Health Challenge

Infectious diseases (IDs) remain a major public health challenge in low-income countries (LICs) despite several striking successes and improvements in their control during the last decades. This includes the eradication of smallpox and rinderpest, and several other pathogens are on the edge of eradication, such as polio or guinea worm. It also concerns other high-profile pathogens that are increasingly more controlled, such as malaria, which has strongly diminished in several regions or measles for which transmission has been strongly impacted by childhood vaccination programs....

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Parents’ Decision-making for Childhood Immunization and Prevention of Childhood Diseases – A Cross-Sectional Survey

10.21203/rs.3.rs-1047244/v1 ◽

2021 ◽

Author(s):

Jonas KEMEUGNI NGANDJON ◽

Alfred Laengler ◽

Thomas Ostermann ◽

Virgile Kenmoue

Keyword(s):

Decision Making ◽

Low Income ◽

Childhood Vaccination ◽

World Health ◽

Low Income Countries ◽

Health Seeking ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccination Programs ◽

Health Authorities

Abstract Background The childhood vaccination program (EPI) is claimed by the World Health Organization (WHO) to be the most cost-effective intervention to reduce child mortality. Therefore, in low-income countries governments and health authorities invest in vaccination programs to reach herd immunity. However, despite the resources allocated to the EPI, epidemics preventable through vaccines are still reported in these countries. In Cameroon, the Foumbot district in the West region has witnessed measles epidemics since 2010 and in 2013 a polio outbreak was reported. Methods The design of this study is a cross-sectional survey. A total of 160 mothers of children between the ages of 12 to 23 months were selected by simple random sampling technique. Pre-tested structured questionnaire was used for data collection. Data was analyzed using SPSS statistical software. Results The outcome of this survey shows that 60% of the children studied were completely vaccinated, 37.75% were partially vaccinated, and 1.25% had not received any vaccine. The logistic regression analysis shows that a poor knowledge of infectious diseases (OR=0.3) was a significant predictor of partial and no vaccination status in children. Conclusion Parents’ decision-making for EPI was based on the information and experiences available in the community. Therefore, parents who are poorly educated on VPDs and living in a community with missing information and misinformation about vaccination will probably not complete the EPI. Public health authorities should invest in health education programs with the goal of developing skills for health- seeking behavior in individuals and communities.

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Breaking Barriers to Healthcare Access: A Multilevel Analysis of Individual- and Community-Level Factors Affecting Women’s Access to Healthcare Services in Benin

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020750 ◽

2021 ◽

Vol 18 (2) ◽

pp. 750

Author(s):

Betregiorgis Zegeye ◽

Ziad El-Khatib ◽

Edward Kwabena Ameyaw ◽

Abdul-Aziz Seidu ◽

Bright Opoku Ahinkorah ◽

...

Keyword(s):

Low Income ◽

Economic Status ◽

Healthcare Access ◽

Healthcare Services ◽

Access To Healthcare ◽

Community Level ◽

Low Income Countries ◽

Outcome Variable ◽

National Education ◽

Individual Level

Background: In low-income countries such as Benin, most people have poor access to healthcare services. There is scarcity of evidence about barriers to accessing healthcare services in Benin. Therefore, we examined the magnitude of the problem of access to healthcare services and its associated factors. Methods: We utilized data from the 2017–2018 Benin Demographic and Health Survey (n = 15,928). We examined the associations between the demographic and socioeconomic characteristics of women using multilevel logistic regression. The outcome variable for the study was problem of access to healthcare service. Adjusted odds ratios (AORs) with 95% confidence intervals (95% CI) were estimated. Results: Overall, 60.4% of surveyed women had problems in accessing healthcare services. Partner’s education (AOR = 0.70; 95% CI; 0.55–0.89), economic status (AOR = 0.59; 95% CI; 0.47–0.73), marital status (AOR = 0.44; 95% CI; 0.39–0.51), and parity (AOR = 1.85; 95% CI; 1.45–2.35) were significant individual-level factors associated with problem of access to healthcare. Region (AOR = 5.24; 95% CI; 3.18–8.64) and community literacy level (AOR = 0.69; 95% CI; 0.51–0.94) were the main community-level risk factors. Conclusions: Enhancing husband education through adult education programs, economic empowerment of women, enhancing national education coverage, and providing priority for unmarried and multipara women need to be considered. Additionally, there is the need to ensure equity-based access to healthcare services across regions.

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Evolutionary control of infectious disease in low-income countries

10.1093/oso/9780198789833.003.0009 ◽

2018 ◽

Author(s):

Paul W. Ewald

Keyword(s):

Infectious Disease ◽

Antimicrobial Resistance ◽

Low Income ◽

Low Cost ◽

Sexual Transmission ◽

Target Population ◽

Antimicrobial Treatment ◽

Low Income Countries ◽

Asymptomatic Infections ◽

Improve Health

An evolutionary suggests that health interventions can reduce not only the frequency of infectious disease but also the harmfulness of the causal organisms. Interventions that may accomplish this dual goal include hygienic investments such as vector proofing of housing, provisioning of safe water supplies, infrastructure that blocks transmission of durable propagules, the prevention of attendant-borne transmission in hospitals and reductions in the potential for sexual transmission. Vaccines can also reduce the frequency of infection and the harmfulness of the target organisms if they are designed to inhibit selectively the harmful variants in the target population. These approaches should help suppress the evolution of antimicrobial resistance because benign variants causing mild or asymptomatic infections will be less exposed to antimicrobial treatment, reducing the strength of selection for antimicrobial resistance. The interventions should improve health at low cost, which would be especially important for low-income populations.

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Impflücken und Impfnebenwirkungen – eine aktuelle Übersicht

DMW - Deutsche Medizinische Wochenschrift ◽

10.1055/a-0479-3957 ◽

2019 ◽

Vol 144 (04) ◽

pp. 244-253

Author(s):

Christian Bogdan

Keyword(s):

Adverse Effects ◽

Autoimmune Diseases ◽

Surveillance System ◽

Vaccine Coverage ◽

Medical Personnel ◽

Target Population ◽

Vaccination Programs ◽

Vaccination Rates ◽

Immunological Mechanisms ◽

Adolescents And Adults

AbstractThe success of vaccination programs is jeopardized by gaps in vaccine coverage of the target population. These are frequently due to a lack of awareness, but also result from misconceptions of adverse effects of vaccines. Subject of this article are the current vaccination rates of children, adolescents and adults as well as of medical personnel in Germany, the reporting and surveillance system for adverse effects of vaccines, the magnitude of registered permanent vaccine-induced damages and the possible immunological mechanisms underlying vaccine-triggered autoimmune diseases.

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COVID-19 Vaccination Program in China: a Subnational Descriptive Analysis on Target Population Size and Current Progress

10.21203/rs.3.rs-624719/v1 ◽

2021 ◽

Author(s):

Wen Zheng ◽

Xuemei Yan ◽

Zeyao Zhao ◽

Juan Yang ◽

Hongjie Yu

Keyword(s):

Population Size ◽

Local Governments ◽

Vaccine Coverage ◽

Descriptive Analysis ◽

Herd Immunity ◽

Target Population ◽

Vaccination Program ◽

Vaccination Programs ◽

Provincial Level ◽

Long Run

Abstract Introduction: China is facing substantial risks of imported COVID-19 cases and a domestic resurgence in the long run, and COVID-19 vaccination is expected to be the long-lasting solution to end the pandemic. We aim to estimate the size of the target population for COVID-19 vaccination at the provincial level and summarize the current progress of vaccination programs, which could support local governments in the timely determination and adjustment of vaccination policies and promotional measures.Methods: By extracting provincial-stratified data from publicly available sources, we estimated the size of priority target groups for vaccination programs and further characterized the ongoing COVID-19 vaccination program at the provincial level, including the total doses administered, the coverage rate, and the vaccination capacity needed to achieve the target coverage of 70%.Results: The size of the target population shows large differences among provinces, ranging from 3.5 million to 115.2 million. As of June 10, the speed of vaccine roll-out differs remarkably as well, with the highest coverage occurring in Beijing and Shanghai, where 69.8% and 62.3% of the population is fully vaccinated, respectively. However, in 19 of 31 provinces, less than 40% of the population was administered at least one dose, in 9 of which the proportion was even less than 30%. Compared to the routine vaccination capacity before the COVID-19 pandemic, the COVID-19 vaccination capacity has greatly improved. Nevertheless, the current vaccination capacity is far lower than the target of 70% coverage by the end of 2021 or by mid-2022 in approximately 5%-20% of provinces, particularly the Guizhou, Yunnan, Xinjiang, Fujian and Hebei provinces.Conclusions: Large disparities exist in the target population size and vaccination progress across provinces in China. Vaccine coverage is far from meeting the herd immunity threshold, and the vaccination service capacity needs to be further improved.

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