ABSTRACT
Background After SARS-CoV-2 vaccines become available, they will be deployed to many countries with limited immunization systems.
Methods We conducted a cold chain capacity assessment of a simulated country in the WHO African Region. We combined region-specific data regarding immunization, population, healthcare workforce, and cold storage capacity (upper and lower range and quartile values for national and subnational levels). We used seasonal influenza vaccines as proxies for SARS-CoV-2 vaccines. We evaluated the increase in vaccine doses to be administered, doses administered per vaccinator, and cold storage volumes for SARS-CoV-2 campaigns targeting risk groups compared to routine immunization baselines.
Findings Compared to routine immunization, a SARS-CoV-2 vaccination campaign would increase monthly doses administered when targeting risk groups: ≥65 years (29.9%), chronic diseases patients (101.5%), and healthcare workers (1.2%). SARS-CoV-2 vaccination campaigns would increase doses administered per vaccinator for risk groups: ≥65 years (32.5%), chronic diseases patients (110.4%), or healthcare workers (1.4%). Routine vaccine volumes already exceed national level storage capacity for at least 75% of African Region countries, but subnational levels would have sufficient storage capacity for SARS-CoV-2 vaccines in all but the lower 25% of African Region countries.
Interpretation SARS-CoV-2 vaccination campaigns would substantially increase doses per vaccinator and cold chain capacity requirements over routine immunization baselines. Pandemic vaccination campaigns would add volume to national level stores already at their limits, but substantial capacity exists at subnational levels for SARS-CoV-2 vaccines. Immediate attention to strengthening delivery systems is essential to support pandemic vaccine responses in the African Region.
Funding None
Competing Interest Statement
Justin R. Ortiz reports that his institution has received grants from Pfizer and NIH for trials of COVID vaccines. Joanie Robertson reports that her organization has received grants from the Bill & Melinda Gates Foundation and from Gavi, the Vaccine Alliance for supply chain research and technical assistance. Jui-Shan Hsu reports that her organization has received grants from the Bill & Melinda Gates Foundation and from Gavi, the Vaccine Alliance for supply chain research and technical assistance. Stephen L. Yu reports no interests. Amanda J. Driscoll reports no interests. Sarah R. Williams reports no interests. Wilbur H. Chen reports he has received research grants from GlaxoSmithKline, Emergent BioSolutions, Institut Pasteur, PATH, Wellcome Trust, and National Institutes of Health for non-SARS-CoV-2 vaccine research. He has received fees from FluGen, Inc., MassBiologics, Pharmaron, Sanaria, Inc., Lumen Bioscience, Inc., and Sequiris for non-SARS-CoV-2 consulting. Meagan Fitzpatrick reports that her institution has received research funding from the National Institutes of Health, PATH, and the Bill & Melinda Gates Foundation, and that she has received consulting fees from Sanofi Pasteur, unrelated to SARS-CoV-2 vaccines. Samba Sow reports no interests. Robin J. Biellik reports no interests. Jean-Marie Okwo-Bele reports no interests. Kathleen M. Neuzil reports that she has received grants from Pfizer and NIH for trials of COVID vaccines.
Funding Statement
This work had no specific funding support.
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Data Availability
Our analysis can be replicated fully with methods and data from the study manuscript and supplement and other publicly available data which we have cited. No individual participant data were used. Other study data or documents are not available.