The Coronavirus Disease (COVID-19) pandemic caused by the novel virus, SARS-COV-2, has considerably increased awareness and discussions among the general populace – and scientists – regarding the important roles of vaccines.
In fact, the Delta variant causes more infections and spreads faster than earlier forms of the virus that causes COVID-19. It might cause more severe illness than previous strains in unvaccinated people.
Vaccines continue to be highly effective at preventing hospitalisation and death against this variant. However, despite the desperate need for interventions from vaccines, there is still considerable apathy and hesitancy around the acceptance and use of the available, approved vaccines in many places in Africa and Nigeria, especially.
Vaccines are considered one of the greatest achievements in attaining community and global health. Vaccination represents basic public health interventions aimed to mitigate the severe epidemiological and economic burden generated by communicable disorders, thus, recognised globally as a key strategy for improving health outcomes and life expectancy.
In Africa, vaccination programmes have helped reduced mortality and morbidity due to vaccine-preventable diseases. The novel Coronavirus Disease (COVID-19) pandemic is a global threat the entire world is faced with. Since its outbreak in Wuhan City, China, in December 2019, 106,433,703 cases and 2,323,147 deaths have been recorded across 213 countries and five regions of the globe, as of 16th February 2021.
On the African continent, 3,673,181 COVID-19 cases and 95, 128 deaths have been recorded, with South Africa, Morocco (8,394), Tunisia (7,214), Egypt, and Ethiopia (2,914) taking the lead.
Since the outset of the COVID-19 pandemic, strict Standard Operating Procedure (SOP) has been imposed, such as increased emphasis on hand hygiene, social distancing, the donning of face masks and gloves by the general public, and government’s stay-at-home orders have been used to curb its spread.
At the early period of the COVID-19 pandemic, when there was no known COVID-19 vaccine or treatment, herd immunity was suggested as a possible remedy for tackling SARS-CoV-2, the COVID-19 virus. Herd immunity is the indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through a previous infection.
The World Health Organization (WHO) however, supports achieving ‘herd immunity’ through vaccination, to prevent unnecessary cases and deaths. The proportion of the population that must be vaccinated against COVID-19 to begin inducing herd immunity is not known. To stop the increasing morbidity and mortality due to COVID-19, researches have been conducted for the development of a COVID-19 vaccine, and COVID-19 vaccines are currently available in some countries.
Through the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) public-private partnership, numerous government agencies, including the National Institutes of Health (NIH), the Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC), have partnered with representatives from academia, philanthropic organisations, and more than 15 biopharmaceutical companies to develop a safe and effective COVID-19 vaccine.
Following the discovery of the COVID-19 vaccine, COVAX was established as a global initiative to accelerate the development, production, and equitable access to Covid-19 vaccines in 190 countries across the globe, irrespective of their developmental phase or level of income.
Currently, three vaccines are authorised and recommended to prevent COVID-19: Pfizer-BioNTech COVID-19 vaccine; Moderna’s COVID-19 vaccine; and Janssen’s COVID-19 vaccine. As of February 2021, large-scale (Phase 3) clinical trials of two COVID-19 vaccines are in progress in the United States: AstraZeneca’s COVID-19 vaccine and Novavax’s COVID-19 vaccine.
According to the CDC, almost 63 million doses of the COVID-19 vaccine have been distributed in the U.S. So far, more than 43.2 million doses have been administered. In the UK, a total number of 12,844,193 people have been vaccinated since vaccination for COVID-19 began.
As the global rollout of COVAX vaccines accelerates, the first COVID-19 vaccination campaigns in Africa using COVAX doses began in Ghana and Côte d’Ivoire, while Africa’s most populous country – Nigeria – has received its first batch of COVID-19 vaccines, becoming the third country in Africa to get the shots through COVAX. However, other African countries are still waiting to receive the vaccine.
Although the COVID-19 pandemic has increased awareness of the importance of vaccines for the vast majority of people who accept vaccines, research shows that newer vaccines generate more hesitancy. A poll recently conducted in the United States reported that if a vaccine against COVID-19 were to become available to the public, 49% of those surveyed plan to receive it, 31% were unsure, and 20% said they would not.
These results, combined with the fact that an increasing number of people are requesting alternative vaccination schedules or declining vaccination altogether, provide evidence that COVID-19 vaccine hesitancy has already become an issue that needs to be addressed. WHO defines vaccine hesitancy as the delay in the acceptance or blunt refusal of vaccines, despite the availability of vaccine services, and has been identified as a growing trend in global health. Vaccine hesitancy represents a threat that can seriously jeopardise the implementation and success of vaccination campaigns.
Nigeria plans to fully vaccinate 40% of its citizens against COVID-19 before the end of 2021, and 70% by the end of 2022. Nigerian government has used the Astrazeneca vaccine thus far. A full vaccination constitutes two doses, given between four to twelve weeks apart.
Currently, Nigeria has been able to vaccinate 9.5% of the target population at the first dose, which constitutes about 5% of the target. Although the data on the number of designated health facilities for receiving the vaccine in the country is not available, data from Lagos State shows that only 88 sites are available to cater for about 10 million Lagosians (based on 70% target of the Nigerian government).
To win the battle against vaccine hesitancy in Nigeria, there is an urgent need for community pharmacists to be effective in the fight against COVID-19 vaccine hesitancy. There is also the need for adequate provision of approved COVID-19 vaccines and its safe administration.
As being done in the US, the government should partner with community pharmacists to be part of the vaccine programme, to increase access to the vaccine. Also, the approved COVID-19 vaccines may present some unique logistics challenges such as the management of receiving, storing, and properly handling a vaccine at potentially ultra-cold temperatures, and a dedicated space to ensure the vaccine is prepared and administered in a safe manner.
It will be essential to equip community pharmacists with accessible and tailored information on the different COVID-19 vaccines, to support their discussion with their patients.
Pharmacists are the most accessible health care providers whose training and certifications prepare them for full participation in all aspects of community vaccination delivery. Most importantly, community pharmacists can readily connect the dots for patients; they offer medical counseling and advice and guide medication and vaccines’ safety to other healthcare providers.