Almost exactly 100 years after the Spanish flu, another pandemic has struck the world. Once again, as in 1918,[1], attention has turned to China to seek its origin. This time, it is not from Canton but from the Wuhan region and its seafood market that the scourge is believed to have originated [2].  With over 520 million cases and more than 6 million deaths worldwide in a pandemic that began in 2019, Coronavirus Type 2 (SARS-CoV-2) has left its mark on the times. By bringing economic activity and the social life of 7 billion people to a standstill, and by sparking a range of behaviours and innovations, the pandemic has had multiple effects, some of which have yet to be analysed [3].

Africa has been relatively spared, but has nonetheless seen waves of the virus with uneven geographical distribution. Initially designated as the 2019-novel coronavirus (2019-nCoV) on January 12, 2020, Covid-19, as renamed by the WHO on February 11, 2020, had not even been recognized for a year when global logistics were already in motion for the first vaccination campaigns. However, while the advent of vaccines could be celebrated as good news, there was still much to be done at the level of African populations, both in terms of disease recognition, acceptance of preventive measures, and commitment to vaccination.

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The controversies surrounding COVID-19 vaccination in Africa took various forms even before vaccines became available. Sensitivities were expressed and the controversy was exacerbated when, in response to a biased question from journalists on April 1, 2020, , scientists Camille Locht and Jean-Paul Mira admitted the hypothesis and relevance of a BCG vaccine test in Africa during an interview on LCI  [4]. This idea sparked a wave of indignation from both ordinary citizens and prominent figures, including the Director-General of the WHO. The Covid-19 vaccines were therefore born in this climate of mistrust and even distrust, foreshadowing perceptual hurdles that would undoubtedly affect vaccination programs for COVID-19 in Africa. 

The first reactions to Covid-19 were denial of the disease by the population and subsequently stigmatisation of people using the services offered as part of the response. Vaccines were criticised for being ineffective, dangerous, irrelevant and unnecessary. According to some, these vaccines were seen as tools for population control. Similarly, there was a great deal of mistrust in the official discourse. Clearly, the speed of vaccine development has reinforced existing susceptibilities some people have towards vaccines and vaccination. The information that the new vaccines under evaluation, pre-positioning, and administration were based on a new technology of vaccine engineering transformed certain suspicions into certainties that they are dangerous. The main fear raised is that the technology using messenger RNA could interact with and modify the recipient's DNA, potentially turning them into a genetically modified human. The consequences of such a process on health are entirely unknown.

            

Perceptions appear to have evolved; however, acceptance of vaccines has not changed much for the better. Given the epidemiological cycle of COVID-19 and, more specifically, its waves of varying severity, it is impossible and, above all, risky to consider populations as naturally protected unless there is clear evidence of acquired immunity (from the disease) or conferred immunity (from vaccination).[5]. In this context, vaccination becomes the most reassuring protective approach to break the transmission chain, prevent the convergence of waves, and mitigate the harmful effects of the pandemic. As already mentioned, at the individual level, all concerns about vaccination are legitimate. As far as side-effects are concerned, vaccine refusal holds the same value as acceptance. Confidence in vaccination cannot come spontaneously, given the mistrust, desensitisation and misinformation about vaccines against COVID-19. This misinformation is spread not only through social networks but especially in public spaces and interpersonal relationships. The use of baseless arguments to discourage demand and systematic opposition in principle are the most damaging obstacles to vaccination. There is a need for effective communication, carried out on an ongoing basis using appropriate and, where possible, tried and tested strategies. In some cases, this may require the development of new curricula [6]. Only such approaches will promote the general population's adherence to vaccination and, in particular, the target population in Africa, with the aim of achieving the desired coverage objectives.

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The efforts made in the development and implementation of response plans are beginning to yield results, although the outcomes are still far from expectations. Much remains to be done to achieve the goal of the global community's strategy to vaccinate 70% of the population against COVID-19 by June 30, 2022. Although by 15 June 2022, 17 countries in the Americas region had achieved this objective  [7] the same cannot be said for African countries, where reaching the critical threshold of 10% primary vaccination coverage in a few countries is celebrated as a victory [8]. The use of the introduction of the COVID-19 vaccine to improve routine vaccination is a perspective to be promoted. Indeed, taking advantage of vaccination campaigns, some teams engage in advocacy and communication for children's vaccination. This was the case in Chad, where a UNICEF team, in collaboration with the country's health services, opted for integration. These players used the immunisation campaign as an opportunity to advance the Covid-19 immunisation agenda and to relaunch routine immunisation, which had nearly come to a halt in some remote areas. Covid-19 has had a fairly negative impact on vaccination services and health services in general. It is time to capitalize on the effort for COVID-19 vaccination to resume and strengthen the work of health services.

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Suggested quote:

Pluts (2022). Vaccination against Covid-19 in Africa: Bleak hopes. Platform for the Use of sciences.

 

[1] McGinnis J. P. D. (1977). The Impact of Epidemic Influenza: Canada, 1918-1919. Historical Papers / Communications historiques, 12(1), 120–140. https://doi.org/10.7202/030824ar

[2] Guo Y-R, Cao Q-D,, Hong Z-S,, Tan Y-Y.  et al. (2020). The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Military Medical Research, 7:11 https://doi.org/10.1186/s40779-020-00240-0.

[3] Barouki R., Kogevinas M., Audouze K. et al. (2021). The COVID-19 pandemic and global environmental change: Emerging research needs. Environment International, 146, 106272.

[4] RFI (2020). Test d'un vaccin en Afrique: le médecin et le chercheur présentent leurs excuses. https://www.rfi.fr/fr/france/20200404-test-vaccin-bcg-en-afrique-le-médecin-et-le-chercheur-français-présentent-leurs-excu.

[5] Randolph H. E. & Barreiro L. B. (2020). Herd Immunity: Understanding COVID-19. Immunity 52,737-741. https://doi.org/10.1016/j.immuni.2020.04.012.

[6] Wang H., Cleary P. D., Little J., Auffray C. (2020). Communicating in a public health crisis. The Lancet Digital Health 2(10) E503. https://doi.org/10.1016/ S2589-7500(20)30197-7

[7] OMS (2022). Objectif mondial de l’OMS concernant le taux de couverture vaccinale contre la COVID-19. https://www.paho.org/fr/nouvelles/24-6-2022-objectif-mondial-loms-concernant-le-taux-couverture-vaccinale-contre-covid-19.

[8] OMS (2022). La vaccination anti-COVID-19 en Afrique a augmenté de près de trois quarts en juin 2022. https://www.afro.who.int/fr/news/la-vaccination-anti-covid-19-en-afrique-augmente-de-pres-de-trois-quarts-en-juin-2022