Vaccine Uptake and Effectiveness: Why Some African Countries Performed Better Than the Others?

Objective: This study examines the factors influencing vaccination rollout and its effectiveness in reducing infectious disease outbreaks in African countries. It aims to understand why some countries performed better in vaccination coverage than others and explores the impact of COVID-19 vaccinations in conjunction with the stringency index in Africa. Methods: Two data sources were utilized. Firstly, a scoping review of relevant studies and gray literature was conducted using the Arksey H & O'Malley L methodological framework. Additionally, data from the Oxford COVID-19 Government Response Tracker (OxCGRT dataset) were analysed to explore the effect of COVID-19 vaccines in Africa. Regression discontinuity in time was employed to assess the effects of COVID-19 vaccination on new COVID-19 cases, deaths, and reproduction rate. Results: The study found that the number of vaccinated individuals increased from March 2021, while the stringency index steadily declined since January 2021. Despite higher vaccination coverage, new COVID-19 cases and deaths peaked in late 2021 and early 2022, indicating the continued need for non-pharmaceutical interventions. After considering country fixed effects and other covariates, the number of new cases and deaths were negatively associated with the stringency index and vaccine introduction. Conclusion: COVID-19 vaccination was shown to be crucial in reducing new cases and deaths in Africa. However, vaccination progress in the region remains low and is influenced by factors at both structural and micro levels. Further research is required to disentangle the effects of non-pharmaceutical interventions and other measures from vaccination campaigns in the context of Africa while accounting for other contributing factors. Lay summary: This study aimed to understand why some African countries did better than others in their COVID19 vaccination efforts and how these vaccinations affected the spread of the virus. Researchers reviewed existing studies and government data along with the Oxford COVID-19 Government Response Tracker. While vaccinations increased from March 2021 and strict measures eased from January 2021, new cases and deaths remained high in late 2021 and early 2022, indicating the need for additional measures. Stricter government actions and higher vaccination rates were linked to fewer cases and deaths. In Africa, COVID-19 vaccinations are crucial, but progress is slow due to various factors at both macro and individual levels. Further research is required to understand the interplay between vaccinations, other measures, and controlling the virus.