Synthesis

Vaccines have been in use for over 200 years, and improvements in medical research and health care delivery infrastructure have led to dramatic improvements in patient outcomes against some of the world’s most lethal pathogens. There are lessons to be learned from this history that may inform the successful delivery of vaccines to control COVID-19, as well as future epidemics. The recent use of the ring vaccination methodology during Ebola vaccine trials in West Africa, drawn from smallpox eradication methods used 50 years earlier, highlights the value in learning from history., As COVID-19 vaccination campaigns gathered momentum in low- and middle-income countries, this project sought to identify transferable lessons from previous rollouts of vaccines with similar characteristics.

The information provided below is drawn from the published article titled 'Learn from the Lessons and Don’t Forget Them’: Identifying Transferable Lessons for COVID-19 from Meningitis A, Yellow Fever and Ebola Virus Disease Vaccination Campaigns,” which is available at BMJ Global Health at https://gh.bmj.com/content/6/9/e006951.

Click here to see key milestones in the development and delivery of the selected vaccines.

This project included a rapid literature review, followed by 24 semistructured interviews with technical experts who had direct implementation experience with the selected vaccines in Africa and South America. Barriers, enablers, and key lessons were identified from the literature and from participants’ experiences. Data were analyzed thematically according to seven implementation domains.

The thematic framework was developed using existing vaccine readiness assessment tools and gap analyses developed for implementing Ebola virus disease vaccines, and COVID-19 vaccination guidelines developed by the World Health Organization.

Following are the key recommendations for the implementation of COVID-19 vaccines in low- and middle-income countries, based on lessons from meningitis A, yellow fever, and Ebola virus disease vaccination campaigns.

The key lessons from previous vaccination campaigns are shown according to the domains in the thematic framework developed for this research. These domains align with the Exemplars in Global Health vaccine delivery framework, which has been used to understand the drivers of routine immunization.

The key recommendations generated from this research include prioritizing resources for operational activities and community engagement, identifying effective and sustainable training strategies for improved service delivery to upskill vaccination teams, streamlining response coordination and vaccination monitoring functions, and exploring opportunities for health service integration.

These recommendations rely on low- and middle-income countries having sufficient vaccine supply to conduct vaccination campaigns for COVID-19, which has not been the case in most settings. We implore the global community to prioritize COVID-19 vaccine supply for low- and middle-income countries.