Sustaining COVID-19 vaccine and routine immunization uptake in Ghana

When COVID-19 vaccination was introduced in Ghana, Gershon Kwame Osei, a religious leader from Ave-Dakpa Community in the Akatsi North District of Ghana’s Volta region was one of the influential voices against the vaccine due to myths and superstition. 

Now, his advocacy and social mobilization work along with many others is generating demand and driving people towards taking the COVID-19 vaccination. Osei is one of 900 community-based volunteers (CBVs) trained by the Ghana Coalition of NGOs in Health (GCNH) working in collaboration with the Ghana Health Service and the World Health Organization (WHO).

Thanks to the work of the community volunteers, over 80 000 people were vaccinated over the three-month, between 01 May to 31 July 2023,  with about half receiving their COVID-19 vaccine for the first time.

“Initially, I told my congregants not to take the vaccine because I was hearing that it is making people sick,” says Osei. “I am now well informed and happy to be helping to mobilize my people for their vaccination”.

Health authorities in the Volta region were concerned about the slow COVID-19 vaccine uptake, with fears that the declassification of COVID-19 as a public health emergency will lead to a further decline in vaccination. 

“Community members question us on why we continue to administer the COVID-19 vaccination despite the declaration of the pandemic as no more constituting a public health emergency. This is negatively impacting vaccination coverage”, says Dr Senanu Kwesi Djokoto, the Deputy Director for Public Health in the Volta Region.

The region is among low-performing regions in Ghana with only about two in every 10 of the general population completing primary series of COVID-19 vaccination compared with the national average of three in 10 as at the end of April 2023. 

As part of efforts to help Ghana sustain the vaccination drive, WHO with funding from the Government of Canada through the Canada Grant for Vaccine Equity (CanGIVE) and Gavi, the Vaccine Alliance, engaged the GCNH, a non-state actor with representation in all regions to undertake advocacy, communication, and social mobilization in all districts and communities of the Volta region. The main objective was to dispel myths and generate demand for COVID-19 vaccination and routine immunization.

“Although COVID-19 is no more a   public health event of international concern, the virus continues to circulate and could come back stronger to cause devastation as observed in previous waves of the pandemic,” says Prof Francis Kasolo, the WHO Representative to Ghana. “We need to sustain the gains, modify the approach to demand generation, and ensure those who need the vaccine, especially persons in the high-risk groups receive them”.

The trained community-based volunteers (CBVs) carried out interpersonal communication within the communities and leveraged soccer games to bring the youth together for vaccination. WHO provided technical support to vaccination teams to undertake house-to-house vaccination exercises along with the social mobilization efforts of volunteers.

“I thought the virus was no more, so I did not want to go back and take the vaccine. But my encounter with the volunteers has motivated me and I have just taken a third dose,” noted Christine Galley, a resident of Ave-Dakpa.

Health workers are confident of the impact of the intervention as COVID-19 vaccination uptake has improved by at least 20% since the rollout of the GCNH project. The intervention has also strengthened community engagement and delivery of other health services. 

“Community members are demanding other services in addition to COVID-19 vaccination. We leverage the support from this intervention to provide routine immunization, non-communicable disease screening, healthy lifestyle counselling, and distribution of family planning commodities” says Prosper Amegadzie, a disease control officer working in Ho Municipal.

Ongoing efforts are already boosting the integration of routine vaccination and other health services with COVID-19 vaccination as sustainable and cost-effective, drawing on the synergies to restore routine immunization coverages to levels before the pandemic, while sustaining the uptake of COVID-19 vaccine.