The negative impacts of COVID-19 are well known, but one positive outcome is stronger national immunization systems in many places. All activities done during the last two years to strengthen national vaccination systems added value to the current routine immunization systems. 

“I think we’ll see the impact of routine immunization systems improvements in the next five years,” said Dr. Ihab Basha, Eastern Mediterranean and North Africa regional epidemiologist for The Task Force’s COVID-19 Vaccine Implementation Program (COVIP), which is helping 35+ low- and middle-income countries establish such systems. 

The need to quickly and safely provide COVID-19 vaccines to all people forced countries to invest in their immunization systems. In the last year, COVIP has supported low- and middle-income countries by providing technical and financial support, including the National immunization Technical Advisory Group and national immunization policy creation; vaccine safety and tracking adverse events following immunization surveillance capacity; building vaccine demand and community engagement; data management and information systems; workforce development; and national immunization program monitoring and evaluation, as well as providing additional support as requested by individual countries.   

As a CoVIP regional epidemiologist, Basha supports nine countries in the Eastern Mediterranean and North Africa region. He said the countries are making great progress on their COVID-19 vaccination coverage, which he attributes to the hard work done by ministries of health and immunization programs to build on existing routine immunization systems to roll out vaccines to their citizens. It  also reflects the work of many partners, including  shipments of vaccines from the COVAX facility and the COVID-19 Vaccines Global Access partnership. 

“COVID-19 has helped countries improve many elements of their existing routine immunization systems,” said Basha, who foresees long-lasting benefits in the years to come.

While instances of new cases are declining in the region, Basha warns that demand typically wanes at this point in an immunization campaign.

Drawing upon his experience from other outbreak response efforts and routine immunization campaigns, Basha noted that the “first 40-50% of the population is easier to vaccinate,” but as the threat of infection declines, the remaining unvaccinated population loses the sense of urgency and desire for the protection against the virus.

Keeping up citizens’ demand for vaccination until these countries reach the World Health Organization’s goal of 70% vaccination coverage by mid-2022 is the greatest challenge Basha sees now. Many countries are falling well short of that goal, particularly the world’s poorest countries. 

Communication plays a key role in keeping citizens invested in ending the pandemic.Many of the countries with whom Basha works started national immunization days throughout the year, conducting outreach to unvaccinated people and sponsoring health education activities. However, there is still lots of misinformation about the COVID-19 vaccine that prevents people from getting their shots. That’s why countries must be both proactive and reactive, said Basha. 

 “You always need social listening because a lot of the rumors start on social media,” said Basha. When misinformation is identified, countries then “implement their risk communications plan to dispel the rumor and provide the facts.”

These activities are all building blocks that can keep high national vaccination coverage against vaccine-preventable diseases and prevent millions of deaths.