The ins and outs of the COVID-19 vaccine deployment plan in Kenya

With the arrival of vaccines in the country, Kenya is set to begin the rollout of COVID-19 vaccination. Catherine Kyobutungi, Executive Director of the Center for Population and Health Research in Africa, provides information on the country’s vaccine strategy against COVID-19 and the inclusion of private companies in immunization programs.

What is the deployment plan?

The first vaccines to arrive were sent through the COVID-19 Global Vaccine Access Facility – COVAX. Kenya is expected to receive 24 million doses through the facility.

The country’s strategy is comprehensive that runs until June 2023, when it expects to have received around 49 million doses, covering 30% of the population.

Health care workers in 47 counties are among those who will receive the vaccine first. Frontline officers, including security personnel and teachers, are also on the priority list.

This is only a part, though crucial, of the elaborate plan for vaccine deployment in Kenya which is to be implemented by various bodies, including the National Interagency Immunization Coordinating Committee, the National Technical Advisory Group. Kenya Vaccine Safety Advisory Committee and the National Vaccine Safety Advisory Committee.

The vaccination strategy covers nine areas:

Regulatory preparation: COVID-19 vaccines already approved by strict regulatory authorities elsewhere will be shipped for approval to Kenya within seven days of submitting an application by a manufacturing company or its agent.

Planning and coordination: this will be done under the aegis of the Ministry of Health with the support of the National COVID-19 Vaccine Deployment and Vaccination Steering Committee, the National COVID-19 Deployment and Vaccination Working Group and similar organizations at the county level.

Funding: there will be a mix for both vaccine and deployment. Gavi – a global immunization organization – through the COVAX facility will cover 20% of the population and national funds will cover 10%. The current vaccination plan covers only 30% of the population because that is what the government was able to achieve. Once additional doses and funds become available, they will expand the target.

Target populations and vaccination strategies: vaccine deployment will take place in three phases. The first concerns 1.25 million people and will take place by June 2021. The second phase will take place between July 2021 and June 2022, targeting the most vulnerable, including the elderly and people over 18 suffering from comorbidities. It targets 9.76 million people. The third phase focuses on other vulnerable groups of people aged 18 and over in congregations, hospitality and the tourism industry. The phase will take place between July 2022 and June 2023. It targets 4.9 million people.

All phases are based on vaccine availability, storage needs and administration sites that can reach priority populations. In the first phase, as much as possible will be done in hospitals.

Supply chain management: the first phase will build on the existing infrastructure. There is a plan to increase the storage capacity of vaccines at negative temperature during phase two and beyond. A detailed mapping of vaccine storage facilities or regional depots and vaccination sites across the country has been completed.

Human resources management and training: the plan is to use existing health workers in public and private facilities without new recruitments. There is planned training – virtual and face-to-face – on COVID-19 vaccines and side effects targeting hospital staff in the first phase and extended to other staff in subsequent phases. Training guides based on generic World Health Organization (WHO) training modules already exist.

Acceptance and adoption: a communication strategy is being developed and will be implemented before its deployment.

Safety monitoring: After vaccine deployment, there will be safety monitoring and programs to identify any adverse events. These programs build on existing systems and processes for reporting adverse reactions to vaccines in the country.

Monitoring and evaluation system: this will be introduced before the start of deployment. It will be developed to take into account new COVID-19 vaccine approvals as they occur.

What vaccines were purchased?

At the time of the plan’s development, only three vaccines had been approved for use by WHO. These are the Pfizer BioNTech, Moderna and Oxford / AstraZeneca. Since then, other vaccines have been cleared by strict regulatory authorities elsewhere. This means that their approval for use in Kenya will eventually be accelerated.

The first deployment in Kenya, of around one million doses, will be for the AstraZeneca-Oxford vaccine.

What is the role of private companies?

It will be some time before private companies can import enough vaccines independently of the government. Indeed, the global supply is still limited. This means that it is difficult to find enough uncommitted doses to buy, for example, outside of the COVAX facility. This may change as more vaccines are approved and manufacturing bottlenecks are resolved.

Involving private health care providers in national immunization programs is not unusual. Private facilities have been recognized as essential to achieving the goals of the Global Vaccine Action Plan, a framework to prevent millions of deaths by 2020. Indeed, successful implementation and achievement of The objectives of this plan, as well as the necessary improvements in immunization coverage rates, require the best possible interaction between the public and private health sectors (for-profit and not-for-profit).

The private sector plays an important role in Kenya’s health services. For example, a 2010 study showed that 50% of outpatient visits and 70% of hospital services were in public health facilities. This means that private establishments make a significant contribution to the provision of health care.

It is therefore common for routine immunization to take place in private facilities on behalf and with the support of the government. For example, the deployment of the human papillomavirus (HPV) vaccine in Kenya is currently taking place in public and private facilities.

What are the advantages of allowing this?

In areas with poor coverage of public facilities, private facilities may be the only option.

In addition, the COVID-19 vaccination program will be on an unprecedented scale and the government therefore needs all the help it can get. The government will need to be creative in establishing easily accessible vaccination points so that people do not have to go out of their way to get vaccinated. In addition, once the vaccine becomes widely available, the government will be able to rely on the cold chain and supply chain infrastructure of private facilities to ensure that vaccines reach every corner of the country the most. quickly possible.

What are the drawbacks and challenges?

A balance must be struck between access and equity. The goal of the COVID-19 vaccination program should be to vaccinate as many people as possible, and as quickly as possible. The private sector can contribute to this goal by improving physical access while ensuring financial access. The government must negotiate with the private sector on the basis of clearly defined roles and expectations, in particular around the cost of shooting. These need to be communicated to the general public so that people look for services knowing what to expect.

It would be a shame for people not to have access to the vaccine in public facilities due to the distance and inconvenience, and not to access it in private facilities due to the cost.

Catherine Kyobutungi receives funding from the African Academy of Sciences, Hewlett Foundation, Bill and Melinda Gates Foundation, Carnegie Corporation of New York and Sida.

By Catherine Kyobutungi, Executive Director, Center for Population and Health Research in Africa