Unanswered Questions about COVID-19 Vaccine in South Sudan with Paul Ocieng

It is three years since the first case of COVID-19 was first discovered in South Sudan and two years since the first batch of COVID-19 vaccine arrived in the country. Africa’s response, led by the Africa Centres for Disease Control and Prevention (Africa CDC) as well as the Ministry of Health in South Sudan has been commendable. However, more still needs to be done to reach 100% vaccine coverage in the world’s youngest nation.

Our Media and External Lead, Maureen Cherongis had a chat with Paul Ocieng, Project Manager for SLL – Africa CDC Amref Health Africa in South Sudan to discuss pressing questions about vaccine uptake, progress and challenges experienced  in  South-Sudan

How is the vaccination status in South Sudan?  

COVID-19 vaccination status is at 66.6 % in South Sudan by March 2023. Largely achieved through COVID–19 national campaigns (41.15%) and regular (static and outreach) contributed to 26.45%.

Can you describe how the public perceives COVID-19 vaccines in South Sudan?  

When the COVID-19 vaccine was introduced to communities, there were mixed perceptions as a result of misinformation. The majority of the population believed the vaccine would cause impotence in men, miscarriage among pregnant women and that the vaccine was demonic. In addition, some people assumed that COVID–19 is a disease for those in the city and towns, thus no need for vaccine for those in the village. In spite of the misconceptions, we run awareness programs through Risk Communication and Community Engagement (RCCE) that turned around the early perception with many appreciating the vaccines as observed by increased uptake.

What are the barriers to the country surpassing the target of 70% target set by WHO?

Myths and negative beliefs about COVID–19 vaccines especially by religious denominations that still consider the COVID – 19 as demonic and local belief that COVID–19 is a disease for those in cities and towns, thus taking vaccines is never a priority.

Another hindrance is the inaccurate data on the population as a result of rampant population movement across counties and across Borders. There is no recent data that can guide proper planning since the country still uses the old 2018 population census.  

Furthermore, there has been logistics issues with limited cold chain equipment across supported health facilities, which are located in remote areas. Lastly, catastrophic effects of climate change such as severe flooding cause population displacement which hinders access to hard-to-reach areas.

What are the risks that can face people who have not received COVID-19?

Delaying uptake of vaccines puts people at risk of increasing upstage of COVID – 19 disease and complications when infected with COVID – 19 virus.

What are the challenges faced during the vaccine rollout, especially in hard-to-reach communities? 

Amref Health Africa in South Sudan is at the centre of providing the COVID-19 vaccine to the people of South Sudan through its Saving Lives and Livelihoods project supported by the Africa Centers for Disease Control and Prevention (ACDC). The programme usually faced the following challenges:

• Vaccine delivery delays in states mainly due to bad weather, roads and insecurity.
• Lack of existing cold chain equipment in some of the hard-to-reach locations, thus poses a risk to vaccine spoilage in the process of vaccine transportation as only vaccine carriers are mostly used to rollout outreach vaccination services.
• Mobilization challenges due to dispatched population in some hard-to-reach communities, thus low coverage.
• Increase logistic cost i.e. increase cost of boat hire/vehicle locally to reach hard/far-end communities

How do health emergencies, natural disasters and disease outbreaks affect routine immunization in South Sudan?

Access to routine immunization has become more difficult due to:

• Limited funding to immunization with priority given to interventions aimed at addressing emergencies/disease outbreaks i.e. personnel and logistics.

• Shift in routine coordination focus to emergencies/disease outbreaks.
• Shift in community health concern and response to emergencies/disease outbreaks, thus resulting in reduced uptake of routine immunization.

What solutions would you propose to ensure continuous vaccination at community- and state-levels? 

We need to develop a business continuity plan during emergencies to safeguard continuity at all levels of emergencies and disease outbreaks. There is also a need to coordinate and integrate services with other emergency responders looking at human resources, demand generation/ Risk Communication and Community Engagement as well as Infection, Prevention and Control (IPC)

What other possible alternative vaccine rollout strategies should programmes consider in future? 

For a successful vaccine rollout, programmes should consider establishing cold chain and establish an outreach team linked to proxy cold chain facility for static operation at far end/hard to reach facilities and locations. Moreover, it will be vital to consider using portable solar – powered refrigeration equipment that will keep vaccines viable for a longer period. Lastly, coordination and integration with other partners during rollout is key.

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