A Retrospective Analysis of the COVID-19 Vaccine Express Strategy in Malawi: An Effort to Reach the Un-Reach

Background: Malawi is a low-income country where the COVID-19 vaccine was introduced on 11 March 2021 as one of the preventive measures to control the COVID-19 pandemic. However, more than 400,000 vaccine doses were at risk of expiry due to low uptake. The key reasons for poor uptake of vaccines were hard-to-reach areas, misinformation, fear of side effects, and vaccine hesitancy. Hence, a project, "Covid-19 Vaccination Express," was implemented to increase the uptake consume all the vaccines before their expiry.Materials and Methods: We conducted a retrospective analysis to compare the daily vaccine administration rate in the COVID-19 vaccine express and routine vaccination program. The routine Covid vaccination program data was collected from March 2021 to October 2021. The data regarding the vaccine express program was collected from 5 November 2021 to 31 December 2021. Data was collected regarding (1) the total number and type of vaccine doses administered and (2) Demographic details like age, gender, occupation, presence of comorbidities, the first dose, or the second dose of the people who received a vaccine.Results: From March-December 2021, a total of 2,063,542 COVID-19 vaccine doses were administered, out of which 1,341,320 doses were administered at a daily utilization rate of 5,588 doses as a part of a routine vaccination program, and 722,222 doses were administered at a daily utilization rate of 12,037 doses as a part of "Covid-19 Vaccination Express" program.Comparing the mean daily doses (Astra Zeneca, AZ doses 1 & 2) administered in the Covid-19 vaccination express program and the routine Covid-19 vaccination program showed that the mean daily doses of AZ vaccine administered were significantly higher in the vaccine express program (p<0.05).Conclusion: "Covid Vaccination Express" successfully increased the uptake of the Covid-19 vaccine by making the vaccines available, accessible and acceptable to the general public.Funding: None to declare. Declaration of Interest: The authors declare that there is no competing interest. Ethical Approval: An approval from the National Health Sciences Research Committee was taken toconduct this study.