Kenya’s COVID-19 Vaccine Rollout: All Ready to Go, But No Doses Available
COVAX delivery of COVID-19 vaccines to Africa has been hampered by a shortage of vaccines.

NAIROBI – Kenya has developed an ambitious COVID-19 vaccination rollout plan – but it has only received enough doses for a million of its 50 million citizens, and dispensed slightly more than half of these – 565,000 – to health workers.

Kenya is currently in the third wave of the pandemic and estimates that 4 million people – healthworkers and elderly people – need to be vaccinated urgently during its first rollout phase.

At the core of the country’s rollout plan is an online registration platform known as Chanjo-Ke (Chanjo is Swahili for immunization). The platform became operational in early April and it is intended to reduce the crowd numbers in vaccination centers all over the country.

“The system will help us ensure that we are able to account for the vaccines as well as trace those who have been vaccinated and, in the end, certificates of vaccination will be issued based on data that will have been captured by the system,” explains Dr Willis Akhwale, chairperson of the Taskforce on Deployment of Vaccines in Kenya.

The taskforce was created to advise the government on the vaccine rollout, and oversee its coordination.

People seeking vaccination can register for the service in advance, choosing a day and a centre for the vaccination, then show up with a national and job ID at the station. The recipient will be reminded to come for the second dose via the system.

Given the sensitive nature of personal medical data, the ICT Authority had to be brought in to ensure protection of this data, in accordance with the laws of Kenya.

The Ministry of Health (MoH) and the National Treasury (Ministry of Finance) have asked the Africa Centers for Disease Control (CDC) for assistance in procuring more vaccines.

Expansion of Vaccination Centres

The government will also add another 1000 vaccination points to the current 658 and private healthcare facilities will add 2,500 facilities during the second phase of the vaccination exercise, set to begin in July. 

Ultimately, almost 8,000 facilities will be vaccinating people by phase three, according to Akhwale.

“These facilities have been inspected and certified to have the right infrastructure and monitoring capabilities so that we can continuously vouch for safe vaccination,” adds Dr Collins Tabu, the head of Immunization and Vaccine Programme in the Ministry of Health.

Certification of facilities is conducted by the Kenya Medical Practitioners and Dentists’ Council.

At the moment, the country has been averaging 15,000 daily vaccinations, “which could easily get over 50-60,000 vaccinations per day if 300 facilities were fully vaccinating,” says Akwale.

The whole deployment exercise is scheduled to run for 30 months and cover 60% of the adult population. The rest, including pregnant women and individuals under 18 years, are not targeted because as Akhwale explains, no vaccine for this population group exists at the moment.

Gavi, the Vaccine Alliance, is donating 20 billion Kenya Shillings ($ 188 million) whereas the Kenyan Government will contribute 14 billion Shillings ($132 million) towards these efforts. However,  Akhwale is quick to add that this will be contingent upon vaccine availability.

The vaccines have emergency use authorization, given the urgency of the pandemic. This means that the vaccine use has not gone through the usual, lengthy stringent vetting process. 

Even so, the vaccine is not exempt from the monitoring rigours that come with the introduction of such a new product into the population.

“The healthcare worker will key in the data into the Chanjo system in case of any adverse events following immunisation, and this data is channelled to the Pharmacovigilance Centre at the Pharmacy and Poisons Board,” says Dr Peter Mbuiru, acting Chief Principal Regulatory Officer at the Pharmacy and Poisons Board. 

The board has been active in both the control of the Covid-19 disease by developing key guidelines on the use of medical products and technologies including Covid-19 vaccines as well as the authorization of in vitro diagnosis used in testing the disease.

About 3,000 healthcare workers have been trained to administer Covid-19 vaccines, with an additional 700 trainer-of-trainers having received training.

Prioritisation of Target Groups

Kenya is already battling a third wave of the pandemic.

One of the biggest challenges in all this effort has been the prioritization of the target groups to receive the jab. 

The government’s initial target was to vaccinate 1.25 million frontline healthcare workers. However, Akhwale maintains that given older people were at higher risk of severe disease, this had to be expanded to include those aged 58 years and above. The population of this category of people is 2.7million in Kenya. 

This means that nearly 4 million people are most at-risk – but only 1million vaccine doses currently. 

So, given this difficult situation, can’t the government make its own bilateral arrangement to acquire doses outside the COVAX mechanism?

“Yes, we can, but you need to understand at this time there are no vaccines out there,” Akhwale told Health Policy Watch. “Secondly, COVAX and the Africa CDC have already placed massive [vaccine] orders.”

The only other option is to procure COVID-19 vaccines that are not WHO-approved, something which the country is not prepared to do.

And in any case, adds Tabu of the Immunisation Programme, “the first dose will still provide protection of more than 76% until you receive the second dose.”

The AstraZeneca vaccine, which Kenya is using, has raised some health safety concerns in some regions of the world, especially in Europe. 

“The question is, are these concerns directly related to the vaccine and are they significant enough to stop the benefits of vaccination over the risks that they may cause?” asked Dr Githinji Gitahi, CEO of Amref Health Africa, in a recent television interview, adding that the advice of the Africa CDC and WHO is that, “we should continue vaccinating.”

One of the reasons why Kenya settled on AstraZeneca as opposed to other vaccines, according to Tabu, is the guaranteed availability of the vaccine despite the current constraints in the global supply chain.

Image Credits: WHO.

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