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COVID-19 Vaccination 21 Times More Expensive Compared to Other Mass Campaigns

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The first phase of the vaccination targeting health workers, teachers, security personnel, the elderly, and persons above the age of 50 was budgeted to cost Shillings 1.3 trillion. The second phase that is still ongoing and targets communities reporting high infections is budgeted to cost Shillings 46 billion.
Minister of Health Jane Ruth Aceng shows off her vacciantion card after receiving her first jab of teh AstraZeneca COVID-19 Vaccine

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Despite being the most ill-planned exercise executed by the Uganda National Expanded Programme on Immunization (UNEPI), the ongoing COVID-19 vaccination is the most expensive campaign carried out in the last ten years, according to officials. 

In the past four years, Uganda has carried out at least two mass vaccination campaigns including the Measles/Rubella and Polio mass vaccination in 2018. Currently, Uganda is carrying out the COVID-19 campaign alongside the polio campaign.


The 2018 MR/Polio mass vaccination targeted over 22 million children aged six months to 15 years of age. Records from the health ministry show that the 2018 MR campaign that lasted five days cost Shillings 40.6 billion (USD 10.9million. The ongoing mass polio vaccination is estimated to cost Shillings 25bn. 

The COVID-19 vaccination plan that began in March this year and is expected to run into next year has cost the country 21 times more than the two campaigns combined. The first phase of the vaccination targeting health workers, teachers, security personnel, the elderly, and persons above the age of 50 was budgeted to cost Shillings 1.3 trillion. 

The second phase that is still ongoing and targets communities reporting high infections is budgeted to cost Shillings 46 billion. Around Shillings, 120 billion of this money went towards the procurement of the Johnson & Johnson and Sinopharm vaccines. 

The rest of the money was used to pay the allowances of health workers, transport the vaccines, and fund community engagements. Dr Immaculate Ampaire, the deputy program manager of UNEPI attributes the high costs for the COVID-19 vaccination campaign to the irregular supply of doses, which has affected proper planning.  

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She explains that due to the irregular supply of doses, the country has been forced to spend more on the delivery of vaccines and run prolonged campaigns. "In previous campaigns, a million-plus doses of one vaccine would be sent for example to East by NMS using the same logistics like fuel. 

But now that is not the case. You send 100 doses somewhere and the following week you send another 200 doses. All these are costs that add up," she explains. A statement issued by the World Health Organisation on Monday intimated that Uganda was not the only country suffering from the irregular supply of vaccines. The health agency urged donating countries and agencies to supply vaccines on time and in a more organized way to enable countries to plan better.



"The majority of the donations to date have been ad hoc, provided with little notice and short shelf lives. This has made it extremely challenging for countries to plan vaccination campaigns and increase absorptive capacity. To achieve higher coverage rates across the continent, and for donations to be a sustainable source of supply that can complement supply from AVAT and COVAX purchase agreements, this trend must change," the statement reads in part.



Despite spending this much, the uptake of the COVID-19 vaccine has remained low. So far Uganda had received more than 15 million COVID-19 vaccines. More than 13 million of these were donated through COVAX and bi-lateral agreements from countries like the U.S, Canada, India and Belgium to mention but a few.


However, records from the health ministry show that less than half of the received COVID-19 vaccine doses have been used with less than 3 million Ugandans being fully vaccinated. The country scored more than 100 percent of the target during the MR/ Polio target campaign where over 19 million children were immunized against a set target of 18 million children.

Dr Alfred Driwale, the UNEPI program manager attributes this to the demographics of the target audience. "We have had successes in our past campaigns because we targeted children. Parents are more willing to protect their children by taking them for immunization than themselves. The COVID vaccines target adults and so many adults have never heard about shots for this age group. It's a foreign concept for them," he said.




For some groups of persons like health workers, the hesitation to get vaccinated is more personal. A nurse working at the Mulago Women and Neonatal Hospital told URN that her hesitation to get the jab is based on religious grounds. 

"We have heard many stories about those vaccines. My pastor says that they are not godly. It's just a way for the white man to get dominance. I do not want to get things that I do not understand," the nurse said. 

Ampaire says due to the irregular supplies of vaccines and limited financing, key events like stakeholder meetings to educate people about the vaccine were skipped, which has affected the campaign greatly.


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To reduce the amount of money spent on COVID-19, starting next year, the UN health agency has recommended a number of measures donating countries are expected to follow. 

It recommends that countries share doses in large quantities and predictable manner to reduce transaction costs, donated doses should have a shelf life of a minimum of 10 weeks and recipient countries should be made aware of the availability of donated doses at least four weeks before tentative arrival. 

In addition to this, the donated doses should be accompanied by all essential ancillaries like syringes and diluents to enable rapid allocation and absorption of the vaccines.