The COVID-19 era, a threat to rotavirus immunization in Africa
Cape Town | Despite a substantial increase in evidence showing the impact of rotavirus vaccine introduction, rotavirus remains the leading cause of severe diarrhea and a threat to the health of young children in Africa and globally – and the COVID-19 era has dramatically set back prevention and control of this life-threatening disease.
This was a stern warning from rotavirus researchers, policymakers, clinicians, public health practitioners and health officials who attended the 13th African Rotavirus Symposium held virtually on 3 and 4 November 2021. Organised under the auspices of the African Rotavirus Network (AfrRN), the symposium was hosted by the University of Nairobi, Kenya in partnership with Ministry of Health, Kenya, Kenya Paediatric Association, the World Health Organization Regional Office for Africa (WHO AFRO), the Bill & Melinda Gates Foundation and the South African Medical Research Council (SAMRC).
This year’s gathering primarily sought to tackle ways of maintaining the momentum for rotavirus vaccination and reflect on the challenges and progress made in rotavirus vaccine introduction in Africa in the context of the COVID-19 pandemic. It also created a platform for sharing ideas, expertise and learnings across organizations and countries in the areas of rotavirus vaccine introduction, vaccine impact, and diarrheal disease prevention and control in Africa. Other key discussion topics included an evaluation by PATH of the potential economic and health impact of rotavirus vaccination in 63 middle-income countries not eligible for support from Gavi, the Vaccine Alliance, as well as an update on the latest rotavirus research undertaken, particularly during the COVID-19 pandemic.
In his welcome remarks, Symposium Chair, Professor Frederick Were from the University of Nairobi, Kenya, said that to help keep the momentum for rotavirus immunization going, valuable lessons could be drawn from efforts made by the global health community in minimizing COVID-19 risks – particularly where new vaccines are gradually being introduced and made available. “During this period, vaccine-preventable childhood diseases such as rotavirus still exist and, therefore, it is essential to continue introducing vaccines in African countries to prevent an increase in mortality of children from this virus,” said Were.
Presenting on the impact of COVID-19 on essential immunization services, Dr Antionette Ba from UNICEF said globally, infant immunization coverage dropped to 83% in 2020, back to the 2009 level. “The number of children receiving no vaccines through the routine immunization programme— “zero-dose” children—increased from 13.6 to 17.1m,” said Dr Ba.
On progress and the challenges of rotavirus vaccine introduction in Africa in the COVID-19 era, Prof Jason Mwenda of WHO AFRO said the pace of new and underutilized rotavirus vaccine introduction slowed down noticeably in 2020. “The slowdown is likely to continue as countries focus on ongoing efforts to control the COVID-19 pandemic, and with the introduction of COVID-19 vaccines,” he said.
Presentations from officials in Benin and Ghana shared lessons learned from their countries’ recent experience switching to new, more affordable rotavirus vaccine products. Both of these product switches took place in the COVID-19 era, which resulted in unique and unexpected opportunities and challenges.
The symposium closed with remarks from Veronica Denti of Gavi who shared that Gavi has supported the immunization of more than 159m children from 2008 to 2020 in 51 countries. She stated that countries have more rotavirus vaccine choices than ever before, noting how important it is for more evidence to become available to help country decision-making. On a positive note, Ms Denti shared that Nigeria aims to introduce rotavirus vaccine in 2022, which is expected to reach a large number of children not yet protected against rotavirus in Africa. Demonstrating that, despite the immense threat that COVID-19 has been to the momentum of rotavirus vaccination in Africa, there are brighter moments on the horizon.
NOTE TO THE EDITOR
The 13th African Rotavirus Symposium (ARS) was organised under the auspices of the African Rotavirus Network (AfrRN). The AfrRN is a regional network of countries and institutions conducting research on paediatric diarrheal diseases. It was established in 1998 to address diarrheal disease in Africa; to determine the rotavirus burden of disease; examine the diversity of circulating strains; and to increase awareness around rotavirus disease in Africa.