• Justin R Ortiz, Joanie Robertson, Jui-Shan Hsu, Stephen L Yu, Amanda J Driscoll, Sarah R Williams, Wilbur H Chen, Meagan C Fitzpatrick, Samba Sow, Robin J Biellik, and Kathleen M Neuzil.
• Center for Vaccine Development and Global Health, 685 W. Baltimore St., University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: jortiz@som.umaryland.edu.
• Vaccine. 2021 Apr 8; 39 (15): 2165-2176.

BackgroundSARS-CoV-2 vaccines will be deployed to countries with limited immunization systems.MethodsWe assessed the effect of deploying SARS-Cov-2 vaccines on cold storage capacity and immunization workload in a simulated WHO African Region country using region-specific data on immunization, population, healthcare workers (HCWs), cold storage capacity (quartile values for national and subnational levels), and characteristics of an approved SARS-CoV-2 vaccine. We calculated monthly increases in vaccine doses, doses per vaccinator, and cold storage volumes for four-month SARS-CoV-2 vaccination campaigns targeting risk groups compared to routine immunization baselines.ResultsAdministering SARS-CoV-2 vaccines to risk groups would increase total monthly doses by 27.0% for ≥ 65 years, 91.7% for chronic diseases patients, and 1.1% for HCWs. Assuming median nurse density estimates adjusted for absenteeism and proportion providing immunization services, SARS-CoV-2 vaccination campaigns would increase total monthly doses per vaccinator by 29.3% for ≥ 65 years, 99.6% for chronic diseases patients, and 1.2% for HCWs. When we applied quartiles of actual African Region country vaccine storage capacity, routine immunization vaccine volumes exceeded national-level storage capacity for at least 75% of countries, but subnational levels had sufficient storage capacity for SARS-CoV-2 vaccines for at least 75% of countries.ConclusionsIn the WHO African Region, SARS-CoV-2 vaccination campaigns would substantially increase doses per vaccinator and cold storage capacity requirements over routine immunization baselines. Pandemic vaccination campaigns would increase storage requirements of national-level stores already at their limits, but sufficient capacity exists at subnational levels. Immediate attention to strengthening immunization systems is essential to support pandemic responses.Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

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