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      COVID-19 vaccines for children and adolescents in Africa: aligning our priorities to situational realities

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          Abstract

          The evolving COVID-19 pandemic is an unprecedented global public health crisis that continues to have a major impact on the African continent. Most countries within Africa are facing significant challenges vaccinating their populations for COVID-19. Inadequate COVID-19 vaccine supply, weaknesses in health system infrastructure, COVID-19 misinformation and disinformation, and ineffective health risk communication are contributing to low adult vaccination rates on the continent. Without sufficient COVID-19 vaccine coverage on the African continent, the prolonged social, economic and health impacts of this public health crisis are likely to exacerbate pre-existing social-structural issues in this part of the world. In this paper, we highlight trends in SARS-CoV-2 infections among children and adolescents (CA), compare COVID-19 vaccination patterns in Africa to those in high-income countries, and discuss some of the benefits, challenges and unknowns associated with vaccinating CA for COVID-19. In light of ongoing COVID-19 vaccine supply challenges and the slow progress that the African continent is making towards vaccinating the adult population, we suggest that the immediate priority for Africa is to accelerate COVID-19 vaccinations among adults (particularly high-risk populations) and vulnerable CA (ie, those who are immunocompromised and/or living with certain medical conditions). Accelerating the roll-out of COVID-19 vaccines and rapidly achieving high levels of vaccination coverage in the adult population will free up capacity to vaccinate CA sooner rather than later. While we hope that COVID-19 vaccines will soon become available to CA throughout Africa, countries must continue to prioritise non-pharmaceutical interventions.

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          Most cited references32

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          Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis

          Highlights • COVID -19 cases are now confirmed in multiple countries. • Assessed the prevalence of comorbidities in infected patients. • Comorbidities are risk factors for severe compared with non-severe patients. • Help the health sector guide vulnerable populations and assess the risk of deterioration.
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            A global database of COVID-19 vaccinations

            An effective rollout of vaccinations against COVID-19 offers the most promising prospect of bringing the pandemic to an end. We present the Our World in Data COVID-19 vaccination dataset, a global public dataset that tracks the scale and rate of the vaccine rollout across the world. This dataset is updated regularly and includes data on the total number of vaccinations administered, first and second doses administered, daily vaccination rates and population-adjusted coverage for all countries for which data are available (169 countries as of 7 April 2021). It will be maintained as the global vaccination campaign continues to progress. This resource aids policymakers and researchers in understanding the rate of current and potential vaccine rollout; the interactions with non-vaccination policy responses; the potential impact of vaccinations on pandemic outcomes such as transmission, morbidity and mortality; and global inequalities in vaccine access.
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              The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries

              The ongoing COVID-19 pandemic poses a severe threat to public health worldwide. We combine data on demography, contact patterns, disease severity, and health care capacity and quality to understand its impact and inform strategies for its control. Younger populations in lower income countries may reduce overall risk but limited health system capacity coupled with closer inter-generational contact largely negates this benefit. Mitigation strategies that slow but do not interrupt transmission will still lead to COVID-19 epidemics rapidly overwhelming health systems, with substantial excess deaths in lower income countries due to the poorer health care available. Of countries that have undertaken suppression to date, lower income countries have acted earlier. However, this will need to be maintained or triggered more frequently in these settings to keep below available health capacity, with associated detrimental consequences for the wider health, well-being and economies of these countries.
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                Author and article information

                Journal
                BMJ Glob Health
                BMJ Glob Health
                bmjgh
                bmjgh
                BMJ Global Health
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2059-7908
                2022
                12 February 2022
                12 February 2022
                : 7
                : 2
                : e007839
                Affiliations
                [1 ] University of Kwazulu-Natal College of Law and Management Studies , Durban, South Africa
                [2 ] departmentPsychology , University of KwaZulu-Natal College of Humanities , Durban, KwaZulu-Natal, South Africa
                [3 ] departmentMaternal, Child and Women’s Health Dept , KwaZulu-Natal Department of Health , Pietermaritzburg, KwaZulu-Natal, South Africa
                [4 ] departmentPsychology , University of KwaZulu-Natal , Durban, KwaZulu-Natal, South Africa
                [5 ] departmentHuman Flourishing Program , Harvard University , Cambridge, Massachusetts, USA
                Author notes
                [Correspondence to ] Professor Kaymarlin Govender; govenderk2@ 123456ukzn.ac.za
                Author information
                http://orcid.org/0000-0002-9586-1510
                http://orcid.org/0000-0003-2390-5307
                http://orcid.org/0000-0001-8891-6176
                http://orcid.org/0000-0002-1874-0803
                http://orcid.org/0000-0002-9027-4253
                Article
                bmjgh-2021-007839
                10.1136/bmjgh-2021-007839
                8844950
                35153193
                e168bb2d-bd4a-4452-9305-24ce1f181503
                © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 27 October 2021
                : 04 January 2022
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                covid-19,child health,health policy,paediatrics,public health

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