COVID-19 vaccination and herd immunity In Africa: An incentive-based approach could be the game-changer to vaccine hesitancy

Dear Editor,

Following the discovery of the COVID-19 vaccine and the rollout of vaccination programs globally, there seems to be a great relief and a flag of victory ahead in conquering the COVID-19 pandemic, however, winning this war may take a longer time in Africa due to the low COVID-19 vaccines supply and slow pace of vaccination when compared to other continents [1]. As of mid-October 2021, there have been 8,469,428 reported cases of COVID-19 infection and 214,681 deaths in Africa while less than 4% of the entire African populace has been fully vaccinated [1,2]. Besides the low supply of COVID-19 vaccines to Africa, many Africans are also unwilling to be vaccinated as many African countries still have thousands to millions of doses that are yet to be administered [1,3]. One major factor in vaccine hesitancy in this continent is widespread rumours and myths concerning the COVID-19 pandemic and its vaccines. This ranges from denying the existence of the virus even by the so-called elites like government officials and presidents [4], to tagging the virus as the ‘virus of the rich’, fear of death from the COVID-19 vaccine as it was believed that microchips are embedded in the vaccine which can kill or turn someone to a robot. Some video clips were also circulated as proof that the site of vaccination is becoming magnetic and capable of lightning bulbs, amongst other rumours and fake news [4].

However, this kind of false perception is not limited to Africans. According to one research in France, over 60% of respondents to a questionnaire are unwilling to be vaccinated due to issues ranging from the safety of such vaccines, potential short- and long-term adverse effects, and mistrust of national and global authorities in charge of COVID-19 pandemic situations [5]. Some also believed that most of the pharmaceutical companies producing COVID-19 vaccines are solely pursuing financial interests [5]. Besides, some country leaders and presidents who had initially misled their citizens against the existence of COVID-19 and its vaccines are now pleading to them to get vaccinated [5]. This further confused the citizens, thereby making issues related to the COVID-19 pandemic more complicated.

1. Poverty rates in Africa

In Africa, it is not news that the poverty level is very high. This is basically due to bad governance and misappropriation of funds. According to a World Bank report in December 2020, about 40% of the population in Africa are living below the US$1.90-a-day poverty line in 2018 and Sub-Saharan Africa accounts for about two-thirds of the global extremely poor population [6,7]. Unfortunately, this has become a major tool by the politicians and those in power to carry out different kinds of manipulations on the citizens [8]. Owned to this, an incentive-based electioneering campaign has been a powerful tool in the hands of the political gladiators to cajole or entice people into voting for them; this has been yielding positive results over decades. In Nigeria for example, this kind of incentive-based campaign is in vogue and has been tagged ‘stomach infrastructure’. Stomach infrastructure is an approach where food items among other consumables are distributed to people to gain political popularity and confidence while meeting their high poverty needs [8]. Surprisingly, such an approach has been yielding positive results for politicians as many who have already developed apathy for voting or are unwilling to vote, often change their minds and go out en masse to vote after receiving such incentives.

2. Incentive-base approach to vaccine hesitancy

Following the high resistance of Africans to the COVID-19 vaccination, an incentive-based approach could be a game-changer in getting them vaccinated. If this kind of approach has been adopted in the advanced world and it worked or it's working, how much more Africa? [9]. Even though some African countries have been denying non-vaccinated citizens some human rights and privileges like access to their places of work, hospitals among other public facilities [[10], [11], [12], [13]], however, this is only effective in government and some high profiled private establishments [14,15]. What of other citizens forming a larger percentage of the population like farmers, traders, artisans, and youths that are autonomous or not directly depending on the government for salary or survival?

Therefore, this write-up recommends the provision of incentives like food items, snacks, beverages, soft drinks, hand bands, and T-shirts at the point of vaccination with inscriptions related to the COVID-19 pandemic and vaccination, could yield positive results for en masse vaccination. In fact, cash transfer to ease means of transportation to and fro the point of vaccination can never be out of point in this clime. Cinemas could also share popcorn, drinks, or any light refreshment with those who presented their vaccination cards [9]. An incentive-based approach will be softer and more attractive than being harsh and autocratic in getting people vaccinated.

Besides, as a larger percentage of the African population are youths with over 60% less than 25 years of age [16], and the supply of COVID-19 vaccines in Africa is low [3], hence, herd immunity is vital in this continent [17]. The likely positive outcome and the resultant en masse vaccination through an incentive-based approach will make the sufficiently large proportion of vaccinated or immuned individuals existing in a given population give indirect protection against disease to people who cannot be vaccinated like the very young individuals, immunocompromised and those below the ladder of vaccination [17]. This will go a long way in safeguarding Africa from the COVID-19 pandemic.

3. Conclusion

Rather than using force and violating or infringing human rights because of vaccine hesitancy, encouraging unwilling individuals to get vaccinated through an incentive-based approach will make more people get vaccinated and as a result, herd immunity will be provided for the larger African populace. This might be the game-changer and the only solution to the issues surrounding the COVID-19 pandemic and its vaccination in Africa. Denying people their rights and forcing them to get vaccinated might even force some citizens to provide false proof of COVID-19 vaccination. If this happened, it could result in a false representation of the true status of COVID-19 vaccination in Africa and that will be catastrophic for the entire continent and the world at large.

Conflict of interest

The author has no conflict of interest to declare.

Funding

The author has no competing financial interests concerning the work described.

AUTHOR’S contribution

OAO conceptualized the idea and designed the manuscript. OAO drafted the manuscript. AOA edited, reviewed, and made additional changes to the manuscript. All authors approved the final draft.