Ouestafnews (in collaboration with Daily Guide – Ghana) –Seventy-year-old Adjeley Ny3 sits on a wooden bench in the far-left corner of a compound house in Mamprobi, an indigenous Ga community located about 2.3 kilometres from the central business district of Accra.
Wearing a cloth wrap strapped around her chest, she chews on her sponge as the morning sun rises from the East.“As you can see, I am strong and I can do many things on my own with little support,” she says in Ga, smiling broadly. “Ny3” is an honorific for “mother” (nye) or female elder in the Ga language.
Adjeley Ny3 believes her healthy lifestyle has contributed to her current state of wellbeing. For her, local herbs, fruits and vegetables have been her go-to-remedy for ailments. It’s a recipe for staying healthy that definitely excludes the taking of vaccines to protect against diseases, like COVID-19.
“I don’t believe in foreigners bringing medications for us to take,” she says firmly. “You never know what really is in the medicine and the intention behind it. “I have not taken and will not take the COVID-19 vaccine today or tomorrow,” she says.
The COVID-19 virus was first identified in central China in December 2019. By March 2020, cases had been found in nearly every country in the world and the outbreak was declared by the World Health Organization (WHO) a global pandemic.
In Ghana, the first two COVID-19 cases were registered on March 13, 2020. The government quickly implemented a number of measures aimed at preventing the spread of the virus such as frequent hand washing, social distancing, masking, etc. It then implemented more severe restrictions including barring foreign nationals from entering the country, closing its land borders, and imposing a partial lockdown in several major cities that lasted more than three weeks.
In February 2021, Ghana became the first country to have received the potentially life-saving COVID-19 vaccine under the COVAX Facility initiative. Ghana’s government then began a massive vaccination promotion campaign aimed at getting as many people vaccinated, as quickly as possible, specifically targeting those deemed ‘high risk’ which included persons age 60 and older, those living in long-term care facilities, and those with underlying health conditions such as hypertension, diabetes, cardio and chronic respiratory ailments and weakened immune systems.
The rollout of the vaccination campaign did indeed help stem the spread of the virus and reduce the number of deaths and hospitalizations caused by COVID-19. However, while many people did ‘take the jab’ as the public health messages urged, many others, for various reasons, still have not and as a result, Ghana has fallen short of its herd immunity goals even though it has had enough vaccine on hand.
Ghana Health Service (GHS) has received over 30 million donations of COVID-19 vaccine doses. GHS data from July 2022, when this interview was conducted, show that 20,152,826 vaccine doses had been administered. Of that number, only 8.67 million people were fully vaccinated, representing 27.9% of the total targeted population.As of December 2022, that number had increased slightly, according to GHS, with 21,400,539 doses administered out of 30,571,918 vaccine doses.
Despite the widespread public health education and sensitization campaigns undertaken in her community and the repeated pronouncements about the benefits of getting the COVID-19 vaccine, Adjeley Ny3 remains unperturbed. That she is holding fast to her resistance is very worrying to those in charge of Ghana’s public health sector who keep driving home the point that even if the COVID-19 infection rates have fallen significantly, the virus has not gone away, and, as a result, the population still vulnerable given the low vaccination rates.
This continued resistance to getting vaccinated comes at a time when Ghana is gearing up to become one of the few African countries that will soon be producing its own COVID-19 vaccines.
When the initial COVID-19 vaccines were made available, Africa countries received them later than other parts of the world and even then in a limited supply. The new vaccine manufacturing plant that Ghana is planning to build is a response to this situation.
The construction of Ghana’s first vaccine manufacturing plant for fill, finish, and packaging of COVID-19 vaccine was started in July 2022. The plant is being built with funding support of 5 million Euros from the German Development Cooperation (GIZ) and seed money of 25 million dollars from Ghana’s government. It is expected to be fully operational by January 2024 to produce the country’s first COVID-19 vaccines.
Professor Kwabena Frimpong-Boateng, chairman of the Presidential Vaccine Manufacturing Committee (PVMC), said the creation of the National Vaccine Institute will help to make Ghana self-sufficient in producing vaccines to meet national and regional needs. This is a private-sector led project, he said. “If there is anything the COVID-19 pandemic has taught us,” he said, “it is the fact that we must look within ourselves and leverage on expertise within to achieve equal health for present and future generations.”
However, this effort by the government to ramp up vaccine availability and access could well be derailed given that a good part of the older population is impervious to getting vaccinated.
Dr. Yaw Bediako, a Research Fellow at the West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), says misinformation and conspiracy theories about COVID-19 have spread with the help of social media finding believers at all levels of society.
This resistance is specifically directed towards the COVID-19 vaccine, he added. “When we talk about childhood vaccinations, there’s quite a bit of hesitancy in some countries. Thankfully in Ghana, we don’t really have that. Everybody accepts that their child should get vaccinated,” he said.
“Infants are being vaccinated at a very high rate but the hesitancy we are seeing with COVID-19 is because we are asking adults to get vaccinated. And I think the people are a bit susceptible to some of the misinformation that has been coming from overseas,” he explains.
To combat this resistance and encourage more people to get vaccinated for their own and the good of public health, Ghana’s health services in January 2022 launched “National Vaccination Days” to promote and increase inoculation numbers. The campaign, branded, “Operation 2.5 million does in 5 days” was aimed at reaching the over 13 million eligible persons across the country who were at the time still unvaccinated.
Dr. Kwame Amponsa-Achiano, Programme Manager for the Expanded Programme on Immunization (EPI) at the Ghana Health Servic (GHS), said 600,000 vaccination teams were deployed with 1,500 supervisors simultaneously across the country using various with strategies including static, intensified outreach, mobile and out campsto get the unvaccinated to take the jab.
For example, static teams were stationed at walk-in sites. The mobile teams were out walking in the community, entering one house after another speaking with residents, and the out camp teams were sent out to the hard to reach, remote areas. This intensive out-reach campaign was done in conjunction with increased awareness raising efforts to ensure visibility of the various teams. The teams were given the goal of vaccinating at least 85 people a day.
To support this effort, prior to the campaign launch, GHS also did a number of advocacy, communication, and social mobilization activities, to raise awareness and ramp up demand for the vaccine.
These activities included radio and TV talk shows and, with the collaboration of religious leaders, having information about the campaign shared at churches and mosques.The campaign was successful, said Dr. Amponsa-Achiano.
In the ensuing months, the National Vaccination campaigns recorded some impressive vaccination figures from May to November, 2022.
Data from the GHS EPI immunization program show that in May 2022 approximately 834,603 vaccines were administered while in June, 2022, 1,912,153 vaccines were administered. The following month, July 2022, had the highest number for the campaign with 1,111,064 vaccines being administered. In the months that followed, the numbers varied: In August 2022, 534,604 vaccines were administered; September 2022, 1,026,785; October 2022, 440,450 and November 2022, 657,047.
Even though the campaign has racked up some significant vaccination numbers, Ghana still falls short of its heard immunity target of 30 million.
Dr. Amponsah-Achiano speaking at a press briefing on the National Vaccination Days in December said that misinformation and disinformation about vaccines coupled with pockets of hesitancy are still challenges hindering the EPI from reaching its targeted population.
Perpetual Nyarko, a nurse at Mamprobi Hospital,and her colleagues have been actively engaging in COVID-19 community sensitization to debunk misinformation and help address vaccine hesitancy.
“On our weekly routine, we ensure that we have a message about COVID-19 for the community members. It has not been easy but gradually people are getting used to COVID-19 vaccination,” she notes.
Nurse Nyarko says it took a lot of effort to convince people living in Mamprobi that COVID-19 is real and the vaccine is safe.
She notes that the national COVID-19 vaccination days helped to boost sensitization and education efforts. “With the support that we got from the GHS it made it easier for people to listen to us because we were saying the same thing as was on TV and radio they listen to.”
As far as the messaging, more work is still to be done, said Dr. Bediako. He said there’s been a lack of clarity and consistency in the messaging.
“I think attempts have been made, probably for economic reasons, to reassure people and help them think everything is under control, he said, adding, “ But at the same time, if you do that too much then they question themselves why they need to be vaccinated.”
For this reason, he said, GHS continues to face difficulties getting people to take the vaccine even though there are vaccines available, he said.
What is the solution? Dr. Bediako recommends that the approach to COVID-19 education be modified from relying on fear and from just being COVID-19 specific to a general health message that addresses vaccinating in general.
“As I said,” he continued, “A lot of people are used to vaccinating their children against the childhood killer diseases, as we used to call them.” What’s needed, he said is this: “We have to make the education less COVID-19- specific and try to link that (general message) to the current COVID-19 vaccination drive.”
“We have to do better to make people realize that vaccination is nothing new, nothing mysterious or dangerous. And if we can do that then we can achieve high rates of vaccination,” he said.”
This is why breaking the myths and misconceptions about COVID-19 vaccines and along with convincing people like elder Adjeley Ny3 is critical to the success of the EPI’s national vaccination campaigns and the ambition of Ghana’s government to make the country self-sufficient in vaccine manufacturing.