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PROGRAM CASE STUDY
Open Access

Accelerating COVID-19 Vaccination Among People Living With HIV and Health Care Workers in Tanzania: A Case Study

Mohamed F. Jalloh, Florian Tinuga, Mohamed Dahoma, Anath Rwebembera, Ntuli A. Kapologwe, Daniel Magesa, Kokuhabwa Mukurasi, Oscar Ernest Rwabiyago, Jaiving Kazitanga, Angela Miller, David Sando, Haruka Maruyama, Redempta Mbatia, Florence Temu, Eva Matiko, Kokuhumbya Kazaura, Prosper Njau, Jennifer Imaa, Tara Pinto, Sophia A. Nur, Nicolas Schaad, Augustine Malero, Damian Damian, Jonathan Grund, George S. Mgomella, Alison Johnson, Gbolahan Cole, Eunice Mmari, Wangeci Gatei and Mahesh Swaminathan
Global Health: Science and Practice June 2024, 12(3):e2300281; https://doi.org/10.9745/GHSP-D-23-00281
Mohamed F. Jalloh
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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  • For correspondence: yum8@cdc.gov
Florian Tinuga
bImmunization and Vaccine Development, Tanzania Ministry of Health, Dar es Salaam, Tanzania.
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Mohamed Dahoma
cZanzibar Integrated HIV, Hepatitis, TB and Leprosy Program, Zanzibar, Tanzania.
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Anath Rwebembera
dNational AIDS Control Programme, Tanzania Ministry of Health, Dodoma, Tanzania.
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Ntuli A. Kapologwe
ePresident’s Office - Regional Administration and Local Government, Dodoma, Tanzania.
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Daniel Magesa
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Kokuhabwa Mukurasi
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Oscar Ernest Rwabiyago
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Jaiving Kazitanga
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Angela Miller
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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David Sando
fManagement and Development for Health, Dar es Salaam, Tanzania.
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Haruka Maruyama
gTanzania Country Office, ICAP at Columbia University, Dar es Salaam, Tanzania.
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Redempta Mbatia
hTanzania Health Promotion Support, Dar es Salaam, Tanzania.
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Florence Temu
iTanzania Country Office, Amref Health Africa, Dar es Salaam, Tanzania.
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Eva Matiko
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Kokuhumbya Kazaura
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Prosper Njau
dNational AIDS Control Programme, Tanzania Ministry of Health, Dodoma, Tanzania.
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Jennifer Imaa
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Tara Pinto
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Sophia A. Nur
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Nicolas Schaad
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Augustine Malero
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Damian Damian
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Jonathan Grund
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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George S. Mgomella
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Alison Johnson
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Gbolahan Cole
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Eunice Mmari
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Wangeci Gatei
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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Mahesh Swaminathan
aTanzania Country Office, U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania.
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    FIGURE

    Trends in Percentage of PLHIV and HCWs Fully Vaccinated Against COVID-19 in Monitored Health Facilities, Mainland Tanzania and Zanzibar, October 2021–September 2022

    Abbreviations: HCW, health care worker; PLHIV, people living with HIV.

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    TABLE.

    Successes, Emerging Improvements, and Lessons Learned From Thematic Groups at the Stakeholder Workshop on COVID-19 Vaccination Intensification and Scale-up

    Thematic areaSuccessesChallengesLessons Learned
    Collaboration and coordination
    • Joint strategy and plan for COVID-19 vaccination uptake activities

    • Formation of National Vaccine Pillar with diverse stakeholders

    • Collaborative planning on developing microplans and implementation

    • Political and government leadership commitment at regional level

    • Timely availability and disbursement of funding

    • Unifying approaches took time

    • Delay of microplan implementation at lower levels

    • Use bottom-up approaches to reduce time

    • Enhance demand forecasting tools to improve reporting and communication across national and regional levels

    Capacity-building
    • Continuous awareness and education promotion to combat vaccine misconceptions

    • Incentives to reach vaccination targets

    • Used community health care workers to bridge gap to communities

    • Inadequate information on disease epidemiology, treatment, and vaccines

    • Lack of Internet connection at facilities to access and enter data systems

    • Create sustainable capacity building plans at regional and national levels

    • Advocate vaccination to influential local and national leaders, religious leaders, and important members of society

    Data management
    • Standardized data collection tools through registers and weekly reports

    • Systematic collection of COVID-19 data from vaccination points to the national level through an online system

    • Periodic data reporting, verification, and feedback mechanism to lower levels

    • Delays in data entry led to backlogs

    • Lack of human resources to complete data entry

    • Build human capacity for data entry at vaccination points

    • Integrate data collection systems to national online systems

    Demand creation
    • Engaged and sensitized key stakeholders across village, ward, district, regional, and national levels

    • Used peers and call back strategies to sensitize PLHIVs

    • Aired local and national media coverage of vaccination uptake and dialogues

    • One-on-one demand creation strategy effective at addressing myths

    • Types of vaccines affected acceptance rate

    • Variance of COVID-19 vaccination acceptance among rural versus urban communities

    • Competing family and community values

    • Maximize weekends to ensure no drop in vaccination progress

    • Engage government-specific HIV organizations and religious leaders to reach PLHIV network

    • Incorporate relevant media and press for widespread appeal and education

    Supply chain
    • Single-dose vaccines accelerated vaccination coverage

    • Weekly monitoring of vaccine inventory

    • Stakeholders filled gap in transportation of vaccination distribution

    • Unable to meet demand for single dose vaccines

    • Lack of daily vaccination monitoring at facility levels

    • Vaccine wastage due to short half life

    • Consider client vaccination preference when forecasting demand

    • Increase capacity for cold chain vaccination storage

    Service delivery
    • Integrated COVID-19 vaccination activities at HIV clinics and community ART outreach services

    • Merged vaccination activities with mass gatherings such as political events, religious gatherings, markets, sport outings, and sociocultural events

    • Employed vaccine champions for hard-to-reach populations

    • Political will and support from leaders at national and subnational levels

    • Lack of knowledge, misconceptions, and stigma around COVID-19

    • Logistic shortages including intermittent supply of vaccines, limited trained staff, lack of transport, small number of vaccination certificates

    • Low commitment and buy-in among health care providers

    • Multifaceted approach of door-to-door, temporary fixed points, integration with other services, and community gatherings

    • Improve logistic vaccination shortages to ensure consistent availability of supply

    • Involve stakeholders at all levels to increase political will and vaccination support

    • Abbreviation: PLHIV, people living with HIV.

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Global Health: Science and Practice: 12 (3)
Global Health: Science and Practice
Vol. 12, No. 3
June 27, 2024
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Accelerating COVID-19 Vaccination Among People Living With HIV and Health Care Workers in Tanzania: A Case Study
Mohamed F. Jalloh, Florian Tinuga, Mohamed Dahoma, Anath Rwebembera, Ntuli A. Kapologwe, Daniel Magesa, Kokuhabwa Mukurasi, Oscar Ernest Rwabiyago, Jaiving Kazitanga, Angela Miller, David Sando, Haruka Maruyama, Redempta Mbatia, Florence Temu, Eva Matiko, Kokuhumbya Kazaura, Prosper Njau, Jennifer Imaa, Tara Pinto, Sophia A. Nur, Nicolas Schaad, Augustine Malero, Damian Damian, Jonathan Grund, George S. Mgomella, Alison Johnson, Gbolahan Cole, Eunice Mmari, Wangeci Gatei, Mahesh Swaminathan
Global Health: Science and Practice Jun 2024, 12 (3) e2300281; DOI: 10.9745/GHSP-D-23-00281

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Accelerating COVID-19 Vaccination Among People Living With HIV and Health Care Workers in Tanzania: A Case Study
Mohamed F. Jalloh, Florian Tinuga, Mohamed Dahoma, Anath Rwebembera, Ntuli A. Kapologwe, Daniel Magesa, Kokuhabwa Mukurasi, Oscar Ernest Rwabiyago, Jaiving Kazitanga, Angela Miller, David Sando, Haruka Maruyama, Redempta Mbatia, Florence Temu, Eva Matiko, Kokuhumbya Kazaura, Prosper Njau, Jennifer Imaa, Tara Pinto, Sophia A. Nur, Nicolas Schaad, Augustine Malero, Damian Damian, Jonathan Grund, George S. Mgomella, Alison Johnson, Gbolahan Cole, Eunice Mmari, Wangeci Gatei, Mahesh Swaminathan
Global Health: Science and Practice Jun 2024, 12 (3) e2300281; DOI: 10.9745/GHSP-D-23-00281
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  • Article
    • ABSTRACT
    • BACKGROUND
    • STRATEGIES TO SCALE UP COVID-19 VACCINATION AMONG PEOPLE LIVING WITH HIV AND HEALTH CARE WORKERS
    • INSIGHTS FROM INTRA-ACTION REVIEW
    • EXPANDING INTO THE COMMUNITY
    • COMPARATIVE PROGRESS AND CONSIDERATIONS
    • CONCLUSION
    • Acknowledgments
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