Publication date: Jan 30, 2025

Significant progress has been achieved in the introduction of rotavirus vaccines in the World Health Organization, African Region (WHO/AFR), with only 19% (9/47) of the countries yet to introduce the vaccines. Despite this achievement, a considerable number of eligible children in Africa still lack access to these lifesaving rotavirus vaccines. We performed in-depth data exploration and analysis on the WHO/UNICEF rotavirus vaccine uptake estimates of vaccine coverage to document progress and estimated the number of children missing vaccination through under- or un-vaccination between 2012 and 2023. Thirty-eight countries have introduced the vaccine in the national immunization programs and the vaccine coverage rates have increased from 5% to 61% between 2012 and 2023 in the WHO/AFR, compared to 11% to 55% at the global level. Coverage by sub-regions ranged from 48% in Central African countries to 73% in the Southeast sub-region in 2023. Vaccine coverage has been increasing every year, yet some countries reported a significant drop during the COVID-19 pandemic (2020-2022) compared to the pre-pandemic (2019_or earlier) period. For instance, in Senegal, coverage declined from 94% to 70%; Namibia, 90% to 55%; Republic of Congo, 71% to 23 %; for 2019 and 2022, respectively. Four countries experienced a significant decline between 2021 and 2022. For instance, Botswana (85% to 65%), Kenya (95% to 23%), Zambia (87% to 32%), and Zimbabwe (86% to 55%); but coverage increased in 2023 (post-pandemic) in Kenya (71%), Senegal (83%), and Zambia (40%). The estimates of vaccinated children increased steadily over the years, reaching 23. 5 million in 2023. However, 257. 8 million children missed vaccination between 2012 and 2023, of which 18. 5 million in 2022. Although countries in the WHO/AFR have made significant progress in introducing rotavirus vaccines, reaching every eligible child remains a challenge; and more than half of children are missing the full benefit of protection against rotavirus diarrhoea. There is a need for accelerated actions and concerted efforts to reach missed children and support for the nine remaining countries to introduce the vaccine.

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