The number of vaccines being delivered to Africa has started to rise in recent weeks through both COVAX deliveries and bilateral deals. The continent has received a total of 113 million doses of which 68 per cent have been administered. While this increase and commitments to future deliveries give grounds for optimism, the past year has shown that immunisation goes beyond just delivery. A critical part of the process is getting jabs into arms, which requires efficient settings and supply chains; staff and equipment; systemisation and data; and strategic communications and community engagement. There are numerous challenges in the administration of vaccines from lack of funding to cold-chain logistics and storage management, all of which are discussed extensively in our Absorption-Capacity Challenge paper.
These challenges are exacerbated when countries have limited time to administer vaccines, a particular problem with donated doses that have short shelf lives. AstraZeneca, which is used most often in Africa, can be stored safely in refrigerated conditions for up to six months. Sinopharm and Sinovac, the next most widely used, have a shelf life of two years.
When given large amounts with a short shelf life, countries struggle to administer vaccines in time. We witnessed this in February when South Africa redistributed one million doses of AstraZeneca because of its lower efficacy against the Beta variant compared to other vaccines. These doses were passed on to other African countries through the African Union but with very little shelf life left. Two of the recipients, Nigeria and South Sudan, reported they were unable to administer them due to the expiry dates, so some were reassigned to neighbouring Togo and Ghana. In May, Malawi destroyed almost 20,000 doses of the AstraZeneca vaccine because they only had a two-week shelf life by the time they arrived in the country.
There is concern once more about waste as Britain begins to deliver nine million AstraZeneca shots as part of its broader pledge to donate 100 million surplus vaccines by June 2022. The bulk of these nine million doses will expire at the end of this September. Roughly five million will be sent to COVAX while the remainder will be given directly to countries – including 817,000 to Kenya.
Kenya, like COVAX, has a minimum two-month requirement on shelf life when accepting vaccines. Looking at Kenya’s absorptive capacity, there are reasons to be optimistic about the country’s ability to administer. So far, a total of 2,053,717 people have been vaccinated with 20 per cent of this figure achieved in the past two weeks following the UK donations. Kenya administers an average of more than 35,000 doses per day and has the potential of absorbing these vaccines before their expiry date if it keeps up the current pace.
Figure 1 - Number of vaccine doses administered in Kenya
Number of vaccine doses administered in Kenya
In addition to doses from the UK, Kenya is set to receive approximately 24 million doses from COVAX and another 11 million from other sources including the African Union. In order to fully exhaust its available supply of doses, the Health Ministry has unofficially opened up vaccination to all Kenyans aged 18 years and above.
Donating doses with short shelf lives leads not only to the risk of having vaccines destroyed but also to increased costs incurred through redistributing to countries already stretched on resources. Growing vaccine inequality and supply shortages means that countries should keep donating but they should also recognise the need for support to improve absorptive capacity – taking a more holistic approach.
Still, governments in Africa need to be prepared for vaccines with short shelf lives. They can do this by following the rollout example in Kenya and reconsidering distribution strategies, including the amendment of eligibility requirements to accommodate greater vaccine supply.