As of April 11, 2021, Somalia has recorded 12,406 confirmed COVID-19 cases, including 618 deaths, since March 2020. People aged 60 years and older account for more than 80 per cent of the total deaths. 300,000 doses of COVID-19 vaccines arrived in Somalia in March 2021; 195,000 doses were delivered to Mogadishu, 40,000 to Garowe and 65,000 to Hargeisa according to UNICEF. Additionally, UAE delivered 10,000 doses to Puntland in March 2021 and also China brought around 200,000 doses of their vaccine in Mogadishu waiting for redistribution.

The COVID-19 vaccines arrived in a critical time as Somalia is now experiencing a new wave of the epidemic, ten times deadlier than the first wave in 2020.  This is the largest increase in a month since May-June of 2020 when the epidemic peaked at between 500-600 cases a week in Mogadishu, and even now expanded to Galkacyo, Hargeisa, Burco, Bosaso and Erigavo, cities with sizeable population. In addition to this, there is a critical shortage of medical oxygens in main hospitals throughout the country, catching the attention of public with continued condemnation against the health authorities for their poor handling and carelessness.

As per the announcements made by the national health authorities, this first consignment of vaccines will be used to vaccinate an estimated 300,000 frontline workers, elderly and people with chronic health conditions and also Police and Custodial Corps who are working for community on daily basis. These special priorities have been taken  to ensure health and other essential services continue to function and deaths among people at risk, especially the elderly, reduced. The question is how far the vaccination goes on? What is the level of uptake?

Concern over uneven distribution

The 300,000 doses delivered in Somalia in March 16, 2021 were distributed to 6 members states and Mogadishu; 100 to Mogadishu, 65,000 to Somaliland, 40,000 to Puntland, 30,000 to Galmudug,  30,000 to Jubaland,  20,000 to South West and 15,000 to Hirshabelle. This allocation raised concerns over uneven distribution of vaccines at national level in the first days and even continued within local levels. For instance in Puntland, people voiced their concern over uneven distribution of vaccines within Puntland; fo example Bosaso received more allocation than combination of Sanaag and Sool regions.

Uptake of COVID-19 vaccines slowed by misinformation

 As COVID-19 has spread across Somalia, so has misinformation marring uptake of the vaccination. The first shipment, Oxford/AstraZeneca arrived in a time of some countries temporarily suspended use of this vaccine after a small number of recipients developed blood clots. This has been the biggest factor that fuelled the misinformation and myths against the vaccination, thus contributing to slow intake of the vaccines in particular the elderly who are among the first target groups, planned to receive vaccination in the first round.

Furthermore, there are other negative speculations saying that vaccines contain the live virus that causes COVID-19, which means that COVID-19 vaccine can make the recipient sick with COVID-19. These are propped up by death of several persons who have died after taking the vaccine, although some of them have already had the virus.

People are less equipped with the tools necessary to identify and prevent the spread of misinformation and fake news. The public awareness rising, sharing clear content and fact-based advice with the public, to fight circulating conspiracies and misinformation is inadequate, thus leaving all these negative rumours to flourish and making acceptance of the vaccine difficult.

Poor follow up and monitoring of side effects

The COVID-19 vaccines have been developed with unprecedented speed, because of the pandemic and the need to get these vaccines out quickly to save lives, and emergency use authorisations have been given to these vaccines, which means that they are still under observation. There are still systems in place in countries that are following up people that are recording and reporting any serious adverse events or other events. There have been several persons died after taking the vaccine and some who got severe complications, and all these are happening while the national health authorities in Somalia are taking limited monitoring for any unexpected side effects following COVID-19 vaccine use.

Uncertainty of second dose

Most of the vaccines that are being developed need at least two doses, and two different types of COVID-19 vaccines; Oxford/AstraZeneca and Sinovac, are delivered in Somalia. The interval between the doses depends on which vaccine and the health authorities were required to inform public about when the second dose is due, whether two doses from two different manufacturers can be taken and assurance of availability of such vaccines. Although WHO recommended second dose to be taken with the same vaccine, people uncertain whether the current two types of COVID-19 vaccines will be available when the second dose is due.

Inadequate prevention measures

With the increasing caseload of COVID-19, little prevention measures were taken due to fear of that implementation would be less effect; a scenario learned from lockdowns in 2020. There have been measures limited to closure of schools implemented in Mogadishu and Somaliland, while all other life routines are going normal; coffee bars and restaurants are full of people and social gatherings are unchanged without observing any social distancing or wearing protective materials.