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  <journal-meta>
   <journal-id journal-id-type="nlm-ta">Ulutas Med J</journal-id>
   <journal-title-group>
    <journal-title>The Ulutas Medical Journal</journal-title>
    <abbrev-journal-title>Ulutas Med J</abbrev-journal-title>
   </journal-title-group>
   <issn pub-type="ppub">2149-0430</issn>
   <issn pub-type="epub">2149-388X</issn>
   <publisher>
    <publisher-name>Hayriye Zehra Ulutaş</publisher-name>
   </publisher>
  </journal-meta>
  <article-meta>
   <article-id pub-id-type="doi">10.5455/umj.20211129125134</article-id>
   <article-id pub-id-type="publisher-id">30582</article-id>
   <article-categories>
    <subj-group subj-group-type="heading">
     <subject>Review Article</subject>
    </subj-group>
    <subj-group subj-group-type="subject">
     <subject>Virology</subject>
    </subj-group>
   </article-categories>
   <title-group>
    <article-title>The Slow Pace of COVID-19 Vaccination Despite Availability in Africa: A Global Health Security Issue</article-title>
   </title-group>
   <contrib-group>
    <contrib contrib-type="author" corresp="yes">
     <contrib-id contrib-id-type="orcid" authenticated="false">https://orcid.org/0000-0001-5473-1034</contrib-id>
     <name name-style="western">
      <surname>Onigbinde</surname>
      <given-names>Oluwanisola Akanji</given-names>
     </name>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Conceptualization" vocab-term-identifier="https://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Data curation" vocab-term-identifier="https://credit.niso.org/contributor-roles/data-curation/">Data curation</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Formal analysis" vocab-term-identifier="https://credit.niso.org/contributor-roles/formal-analysis/">Formal analysis</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Funding acquisition" vocab-term-identifier="https://credit.niso.org/contributor-roles/funding-acquisition/">Funding acquisition</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Investigation" vocab-term-identifier="https://credit.niso.org/contributor-roles/investigation/">Investigation</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Methodology" vocab-term-identifier="https://credit.niso.org/contributor-roles/methodology/">Methodology</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Project administration" vocab-term-identifier="https://credit.niso.org/contributor-roles/project-administration/">Project administration</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Resources" vocab-term-identifier="https://credit.niso.org/contributor-roles/resources/">Resources</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Software" vocab-term-identifier="https://credit.niso.org/contributor-roles/software/">Software</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Supervision" vocab-term-identifier="https://credit.niso.org/contributor-roles/supervision/">Supervision</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Validation" vocab-term-identifier="https://credit.niso.org/contributor-roles/validation/">Validation</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Visualization" vocab-term-identifier="https://credit.niso.org/contributor-roles/visualization/">Visualization</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing – original draft" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-original-draft/">Writing – original draft</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing – review &amp; editing" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review &amp; editing</role>
     <xref ref-type="aff" rid="aff1">1</xref>
    </contrib>
    <aff id="aff1">
     <label>1</label>
     <institution-wrap>
      <institution-id institution-id-type="ror">https://ror.org/05saqv884</institution-id>
      <institution>Anatomy Department, Faculty of Basic Medical Sciences, College of Health Sciences Nile University of Nigeria, Abuja. Nigeria</institution>
     </institution-wrap>
    </aff>
   </contrib-group>
   <pub-date publication-format="electronic" date-type="pub" iso-8601-date="2022-03-09">
    <day>09</day>
    <month>03</month>
    <year>2022</year>
   </pub-date>
   <pub-date publication-format="print" date-type="collection">
    <year>2022</year>
   </pub-date>
   <volume>8</volume>
   <issue>1</issue>
   <fpage>1</fpage>
   <lpage>4</lpage>
   <history>
    <date date-type="received" iso-8601-date="2021-11-14">
     <day>14</day>
     <month>11</month>
     <year>2021</year>
    </date>
    <date date-type="rev-recd" iso-8601-date="2021-12-16">
     <day>16</day>
     <month>12</month>
     <year>2021</year>
    </date>
    <date date-type="accepted" iso-8601-date="2022-01-06">
     <day>06</day>
     <month>01</month>
     <year>2022</year>
    </date>
   </history>
   <permissions>
    <copyright-statement>© 2022 The Author(s)</copyright-statement>
    <copyright-year>2022</copyright-year>
    <license>
     <ali:license_ref>https://creativecommons.org/licenses/by-nc/4.0/</ali:license_ref>
     <license-p>This is an open access article distributed under the CC BY-NC 4.0 licence.</license-p>
    </license>
   </permissions>
   <self-uri xlink:href="https://www.ulutasmedicaljournal.com/?mno=30582"/>
   <self-uri content-type="pdf" xlink:href="https://www.ulutasmedicaljournal.com/pdf/30582.pdf"/>
   <abstract>
    <p>Following the pop-up of the COVID-19 pandemic in December 2019, the World Health Organization and other major stake holders have been working tirelessly in curbing the spread of this virus. Pending the availability of vaccines, the world was shutdown with different lockdown measures to prevent its spread. However, following the availability of vaccines, many nations swung to action for massive vaccination, unfortunately, the rate of such vaccination is very slow in Africa as at the time of this research. This paper torchlight the available figures of COVID-19 vaccination in Africa and its implication on the global health security.</p>
   </abstract>
   <kwd-group kwd-group-type="author">
    <kwd>COVID-19</kwd>
    <kwd>Health Security</kwd>
    <kwd>Africa</kwd>
    <kwd>COVID-19 Vaccination</kwd>
    <kwd>Global Health</kwd>
   </kwd-group>
   <funding-group>
    <funding-statement>Funding information was not reported in the published version of this article.</funding-statement>
   </funding-group>
  </article-meta>
 </front>
 <body>
  <sec id="sec-1">
   <title>Introduction</title>
   <p id="b-1">Toward the close of the year 2019, the world was thrown into chaos due to the coronavirus disease 2019 (COVID-19) pandemic and the most dreaded part of it was the lack of a vaccine to combat it in its early stage. The whole world was on a partial shutdown and within the first 6 months, over 8 million people were infected with over 400 thousand deaths recorded (    <xref ref-type="bibr" rid="ref1">1</xref>
). Following the discoveries of the COVID-19 vaccines, the World Health Organization (WHO) approved the vaccines trial and the first African country started its trial around June 2020 in South Africa (    <xref ref-type="bibr" rid="ref2">2</xref>
). After the full approval of the COVID-19 vaccination, there was a delay in the onset of the vaccination in Africa as they depend on supplies from other continents and international bodies. The earliest vaccination started between January and March 2021 in a few African countries following supply by COVAX facility, however, African countries still have thousands and millions of doses of the COVID-19 vaccines that are yet to be administered as of the time of this research (    <xref ref-type="bibr" rid="ref3">3</xref>
). According to the WHO, only 43 out of about 54 African countries have so far joined the COVAX facility that was aimed to give about 600millionCOVID-19vaccine doses to vaccinate at least 20% of the African population by the end of 2021 (    <xref ref-type="bibr" rid="ref4">4</xref>
). The first 90 million doses will be targeted at health workers and other vulnerable groups that are in dire need of protection. By implication, these 600 million doses will immunize just 3% of the entire Africans by the first half of 2021 (    <xref ref-type="bibr" rid="ref4">4</xref>
). Going by this pace, the big question is, how many years will it take Africa to vaccinate 50% of its population? What is the fate of Africans pending vaccination? Despite the delay in the onset of vaccination and the low quantity of COVID-19 vaccines received, most African countries seem to be hoarding between hundreds to millions of the COVID-19 vaccine doses, why?</p>
   <p id="b-2">The table below shows some African countries and COVID-19 vaccination records according to the African Center for Disease Control and Prevention as of mid-August 2021 (    <xref ref-type="bibr" rid="ref3">3</xref>
,    <xref ref-type="bibr" rid="ref5">5</xref>
).</p>
   <p id="b-3">With all indications, the pace of the COVID-19 vaccination in Africa is too slow for a continent ready for the fight against the pandemic. Again, the record shows a country like the Sahrawi republic who received about 20,000 COVID-19 vaccines that could cater for almost 1.67% of her population but there was no record of any vaccination yet as of mid-august 2021. Similarly, countries like Burundi and Eritrea have no record of neither receiving the COVID-19 vaccine nor vaccination statistics despite joining the COVAX facility (    <xref ref-type="bibr" rid="ref3">3</xref>
).</p>
   <p id="b-4">Moreover, the record also revealed that only 8 out of the 43 African countries that joined COVAX received a COVID-19 vaccine supply that can cater to at least 20% of the population. These countries are Morocco, 43.51%; South Africa, 24.30%; Mauritius, 80.27%; Djibouti, 23.76%; Comoros, 22.89%; Seychelles, 95%; Equatorial Guinea, 21.43%; Eswatini (Swaziland), 21.33%. Unfortunately, only 2 out of these 8 countries (Mauritius and Seychelles) have fully vaccinated above 50% of their population while Morocco has about 33.45% population being fully vaccinated. The remaining 5 of these 8 countries have below 10% population being fully vaccinated. About 33 out of the 43 African countries have COVID-19 vaccine supplies that can cater to just 5% of their population. However, none has fully vaccinated their citizens up to the percentages of the vaccines received. Conclusively, as of mid-September 2021, only 3.18% of the entire African population has been fully vaccinated (    <xref ref-type="bibr" rid="ref3">3</xref>
).</p>
   <p id="b-5">As the COVID-19 pandemic has come to stay pending vaccination for all, hoarding vaccines is never an option for any African country. Although it is not yet clear why such hundreds and millions of vaccine doses are yet to be administered in many of these countries, however, some may be reserved probably for individuals that are yet to receive their second dose, or due to the unwillingness of the citizens to get vaccinated, lack of health personnel, and manpower to enhance vaccination processes amongst others, all of which must be quickly addressed. Besides, according to the world hospital rating 2021, by the ranking web of hospital, the best hospital in Africa is on number 598 in the world while the second best is on number 1542 in the world ranking (    <xref ref-type="bibr" rid="ref6">6</xref>
). Hence, talking about handling a spike or surge in the COVID-19 infection, no African country can manage it, even developed countries are not ready to dare such spikes when it comes to the issue of COVID-19 pandemic. Moreover, a country or continent can't live and survive in isolation without interactions with other countries, therefore, it is high time for other countries to rally around Africa and render optimum support regarding COVID-19 vaccination. Besides, many of the advanced countries have fully vaccinated over 40% of their citizens while most African countries cannot boast of 5% fully vaccinated. This has led to many countries extending their travel ban and border closure rule to prevent non-vaccinated individuals from gaining access into their countries. However, such restrictions cannot continue forever, as many migrants migrate illegally, hence, until the fight against the COVID-19 is seen as a global fight where capable or able countries and continents will come to the rescue of the incapacitated ones and bear their burdens if not, the global health is in danger. Migration or sneaking of non-vaccinated or partially vaccinated individuals into countries that are already doing well in their COVID-19 vaccination programs may bring major setback that might be catastrophic to global health. Doing all possible best by the concerned authorities both internationally and locally in curbing the spread of the COVID-19 transmission in Africa will go a long way in safeguarding the health of Africans and the world at large.</p>
   <table-wrap id="tbl-1" position="float">
    <label>Table 1</label>
    <caption>
     <title>COVID-19 Vaccination Rates in Africa</title>
    </caption>
    <graphic xlink:href="tbl-1.png">
     <alt-text>Table 1: COVID-19 Vaccination Rates in Africa</alt-text>
    </graphic>
   </table-wrap>
   <p id="b-6">Conclusively, now that new variants especially the delta variant have surfaced, going through another lockdown as a means of curbing its spread might be catastrophic in Africa. There is a need for Africa to speed up COVID-19 vaccination as fast as possible and maximally utilize the available vaccine doses rather than hoarding. The WHO and other related international should not relent in their effort in making the vaccine available in Africa and COVAX should also not stop at the level of making vaccines available but also shoulder the responsibility of the speed or pace at which vaccination is done for a larger percentage of Africans to be vaccinated as fast as possible. To date, myths, rumors, and fake news concerning the COVID-19 pandemic and vaccines are rampant in Africa, there is a dare need for more enlightenment and re-enlightenment on the pandemic and safety of its vaccine, including the continued adherence to the COVID-19 safety protocoleven after vaccination, especially the use of non-pharmacological interventions (NPIs) before and after vaccination as there is no health facility to cater for any spike of the COVID-19 transmission.</p>
   <p id="b-7">For Africa to meet up with the WHO projection of making at least 40% of the population in low and middle-income countries get COVID-19 vaccination by the end of the year 2021, then it is high time for Africa to look inward and not relying too much on external assistance. To realize the WHO vaccination projection in Africa, over 1 billion COVID-19 vaccine doses will be required, therefore, African countries should channel their resources in upgrading their healthcare delivery and funding research that will trigger mass production of such COVID-19 vaccines that can cater for at least 50% of their population before the end of the year 2021. Besides, Africa should partner with companies producing COVID-19 vaccines to establish some of their production plants in Africa. Such developments will help Africa to prepare and combat any future pandemics or disease outbreaks that are endemic in the region.</p>
  </sec>
 </body>
 <back>
  <ref-list>
   <title>References</title>
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</article>
