COVID-19 Vaccine Rollout in Somalia: Experiences and Challenges in Fragile Context

The first case of the Novel Coronavirus (SARS Cov-2) in Somalia was confirmed on the 16th of March 2020, five days after the World Health Organization (WHO) declared the disease “a global pandemic”. As of 16 June 2021, Somalia reported 14,841 confirmed cases and 775 deaths. The first wave of the infection lasted almost four months between mid-March 2020 and July 2020, with a weekly average of 173 confirmed cases and 5 deaths. The infection rate has risen sharply in the second wave between February 2021 and May 2021, with a weekly average of 553 confirmed cases and 36 deaths, an ominous signifier of more rapid spread of the infection and the loss of more lives than the previous wave in 2020. On the 15th March 2021, Somalia become one of the first 12 African countries to receive COVID-19 vaccine supply through the COVID-19 Vaccine Global Access (COVAX) Facility. COVAX initiative is supported by WHO, GAVI, and the Coalition for Epidemic Preparedness Innovations (CEPI) to improve equitable access and distribution of COVID-19 vaccines around the world. It procures a supply of COVID-19 vaccines for low- and middle-income countries under the pooled procurement mechanism equivalent to inoculate twenty percent (20%) of their population. UNICEF, WHO, GAVI and other partners worked together to develop guidance, tools and training resources to support countries in assessing their readiness and planning to introduce and roll out COVID-19 vaccination. Somalia received 300,000 doses of Oxford/AstraZeneca COVID-19 vaccine to inoculate at risk groups i.e., pre-existing social and medical vulnerabilities such as frontline health workers –older adults and people with underlying clinical conditions. It also received additional 200,000 Sinopharm and 2,000 Sputnik vaccine doses donated by China and the United Arab Emirates respectively. The vaccination programme for COVID-19 was launched on 16th March 2021 amid national election impasse which eclipsed this important occasion to mark the start of the COVID-19 vaccination campaign in Somalia. Since then, the rollout has faced a daunting list of challenges most importantly operational and logistical constraints due to limited funding, and vaccine hesitancy in the wake of the news about rare side effects from Oxford/AstraZeneca vaccine. Hence, this study on the status of COVID-19 vaccine rollout in Somalia, assesses the existing opportunities and challenges to the COVID-19 mass vaccination and proposes policy options and recommendations to address the identified rollout gaps for COVID-19 immunization.