Status of COVID-19 Vaccine Rollout in Somalia

As of 16 June 2021, more than 160,759 (54%) people was inoculated with COVID-
19 vaccine, while 137,157 (45.7%) individuals received their first dose. Banaadir region which was allocated the highest vaccine doses (85,000 doses) administered only a quarter of the planned vaccinations while Somaliland which was given the second largest share (65,000 doses) successfully administered 87.8% of the vaccines received. Table 1 below summarizes COVID-19 vaccination by States in Somalia.
The uptake of the second dose has been very slow as only 23,602 (17%) people have so far received their second dose. Puntland performed remarkably well in the second dose COVID-19 vaccination administering 12,611 (83%) individuals for second dose.

Source: WHO/Federal MoH. AZ – AsteraZenaca, SN – Sinopharm

The KI interviews indicated that confidence barriers which relate to concerns about the safety and effectiveness of Oxford/AstraZeneca could be one of the main factors for the low uptake of COVID-19 vaccine in Somalia. The arrival of COVID-19 vaccine coincided with the reports of rare cases of blood clotting in people who received Oxford/AstraZeneca vaccine and the subsequent suspension and limitation of its use in certain age groups in a number of European countries in March 2021. The low COVID-19 vaccine uptake seen in April and May 2021 was attributed to specific concerns about the permissibility of the vaccination during fasting religious observance in Ramadan.
The slow pace of the vaccination programme in most of the Federal Member States and Banaadir region is in contrast with Somaliland where the relatively good uptake of COVID-19 vaccine was ascribed to better community mobilization, awareness and outreach services.
Regarding the priority groups, front line workers represented the highest vaccinated (44%) individuals followed by elderly population (34%) and healthcare workers (22%). See table 2.

Table 2: COVID-19 vaccine uptake priority groups (up to June 16,2021)

Banadir 24,278 6,243 (26%) 10,085 (42%) 7,950 (33%)

Jubaland 7,486 1,447 (19%) 4,163 (56%) 1,876 (25%)

Hirshabele 11,278 3,275 (29%) 6,803 (60%) 1,200 (11%)

Somaliland 57,090 12,695 (22%) 2,0621 (35%) 23,774(42%)

Source: WHO/FMoH, data represented only first dose.

Figure 1 Vaccinated people by Occupation. Source: Federal MoH / WHO Somalia (Does not include data from Somaliland)

The official COVID-19 data summary revealed significant disparity in vaccine access in Somalia. Significant majority of the vaccinated people were male (69.1%) from urban settlements (92.5%), see figure 2. The data indicated that the majority of the four of the target priority groups (teachers, police, municipal officers and point entry staff) are men, which might explain the high number of vaccinated men compared to women but the data analysis also suggests that the limited social mobility of women, unequal access to information, low health literacy among women, and the perception of the risk of contracting COVID-19 infection, among other social and cultural factors, contribute to this gender disparity of COVID-19 vaccine uptake in Somalia. See figure 1.

Figure 2: Vaccinated people by settlements. Source: Federal MoH / WHO Somalia (Does not include data from Somaliland)

There is also a significant inequality in access to vaccines across different settings and settlements in the vaccinated population. People living in nomadic settlements and IDP camps and refugees were the least vaccinated people (0.6%), (0.7%) and (0.1%)

respectively, see figure 2. The distribution of vaccine supplies to fixed health centers in and around major towns and the lack of mobile and outreach vaccination teams are the main reason given for this low vaccine coverage of rural areas and IDP camps.