Plan Nacional para la Introducción de la Vacuna Contra la COVID-19 en la República de Guinea Ecuatorial

Objectives

The National Plan for the Introduction of the COVID-19 Vaccine in Equatorial Guinea forms part of the national COVID-19 response and is aligned with the National Health Development Plan 2021–2025. Its overarching mission is to reduce COVID-19 morbidity and mortality while preserving essential health services and strengthening national readiness to introduce vaccines safely, equitably and effectively.[1][2][3]

• Vaccinate at least 70% of the population, estimated at 840,000 people, through three stages that prioritise vulnerable groups, while aiming to reduce the daily positivity rate from 3% to below 0.5%.[2]
• Target an initial 20% of adults aged over 18 years, estimated at 112,153 people, beginning with health workers, security and law-enforcement personnel, people at high risk of severe disease or death, and people with comorbidities or poor health.[1][4]
• Prioritise vaccination under constrained supply through successive coverage scenarios of 10%, 20%, 30% or 50% of the population; the staged framework identifies high-risk health workers first, people with comorbidities or poor health next, and people over 65 years subsequently.[5][6]
• Apply equality and equity principles by quantifying, geolocating and fairly vaccinating women and men within each priority group, using locally collected epidemiological evidence and World Health Organization guidance.[7][1]
• Consider pregnant women, breastfeeding women and children in later-stage vaccination when sufficient evidence indicates that benefits outweigh risks for these populations.[7]
• Secure adequate vaccine supply, strengthen procurement and logistics, maintain the cold chain, build workforce capacity, monitor adverse events following immunisation, and implement nationwide communication, awareness and social-mobilisation activities.[2]
• Strengthen community confidence, acceptance and demand for vaccination through early engagement and communication that is accessible, ethically delivered and responsive to local languages and contexts.[8][9]

Implementation

Implementation is designed around the COVID-19 Vaccine Introduction Readiness Assessment Tool pillars: planning and coordination; resources and financing; regulation; prioritisation and surveillance; service delivery; training and supervision; cold chain and logistics; safety surveillance; demand generation and communication; and monitoring and evaluation. Delivery is decentralised to regional and district levels under national and regional supervision, with strategies adapted to vaccine characteristics, local geography and target-population needs.[8][10][11]

• Coordinate introduction through a national coordinating committee responsible for planning, implementation and follow-up, alongside the Interagency Coordination Committee, the National Political Committee chaired by the Vice-President, the National Technical Committee chaired by the Minister of Health and Social Welfare, and a proposed multidisciplinary national expert group.[12][4]
• Apply accelerated emergency regulatory procedures, complete authorisation and import documentation, and ensure compliance with national and subregional regulatory arrangements.[4][12]
• Seek vaccine access through the COVAX initiative and bilateral discussions while retaining flexibility to use affordable, reliable and safe alternatives.[8]
• Deliver vaccination through fixed sites for people living within 5 km of facilities, outreach services for populations 5 to 15 km away, and mobile services for more remote, riverine or geographically difficult areas.[7]
• Use 67 health structures potentially capable of immunisation delivery, including 58 operational fixed vaccination posts with cold-chain capacity at 2°C to 8°C, while addressing gaps in personal protective equipment, handwashing facilities, electricity reliability and cold-chain equipment.[7][11][13]
• Conduct a two-dose mass campaign in two seven-day phases separated by three weeks, supported by district or health-area microplans, fixed and outreach sites, and delivery strategies selected according to logistical and geographical constraints.[4]
• Train national trainers first and cascade training through national, regional, provincial and field levels; provide vaccinators, registrars, supervisors, mobilisers, community leaders and adverse-event monitoring personnel with role-appropriate preparation.[6]
• Strengthen supervision before, during and after introduction, addressing identified weaknesses in district-level logistics, immunisation training and supervision planning.[11][4]
• Manage centrally ordered vaccines through storage hubs in Malabo and Bata, monthly distribution to vaccination posts, mapped storage and transport points, cold-chain inventories, adapted distribution frequencies and strengthened logistics teams.[13][6]
• Establish a national adverse-events-following-immunisation surveillance committee or team to develop reporting procedures, coordinate surveillance, review safety data, promote infection prevention and control, and strengthen pharmacovigilance.[14][9]
• Implement a communication and demand-anticipation plan involving media, scientific experts, health workers, community actors and authorities, with trained community relays and designated focal points.[2][9]
• Monitor supplies, cold-chain performance, quantitative and qualitative coverage, implementation milestones and adverse events through the existing health information system, with daily, weekly and monthly site reporting.[9][15]
• Conduct final campaign evaluation through a multidisciplinary team of independent national and international experts.[15]
• Mobilise domestic and international technical, material and financial support; the plan identifies vaccine acquisition and operational delivery as requiring substantial resources.[12]

Monitoring & Evaluation

The plan establishes monitoring and evaluation as a core vaccine-introduction function, combining preparedness tracking, epidemiological and vaccine-safety surveillance, supportive supervision, routine reporting and a final independent campaign evaluation.[8][9][15]

• Monitor vaccine-introduction preparedness continuously against key milestones through a situational analysis aligned with the COVID-19 Vaccine Introduction Readiness Assessment Tool (VIRAT).[8]
• Use locally collected national surveillance data to assess vaccination benefits and risks, identify and geolocate priority groups, and adapt prioritisation to the epidemiological situation.[5][1]
• Track COVID-19 transmission through testing, confirmed cases, positivity and geographic spread, and publish the national situation periodically through the Ministry of Health website.[10][3]
• Monitor and manage adverse events following immunisation, defined as medical events after vaccination regardless of whether they are causally related to the vaccine, through systematic and standardised collection of critical information.[14][2]
• Establish a national adverse-event surveillance committee or team to coordinate surveillance, develop reporting procedures, review vaccine-safety data, promote infection prevention and control, and strengthen pharmacovigilance at all levels.[14][9]
• Use a monitoring and evaluation plan to define data-collection and transmission procedures, assign responsibilities across health-system levels, and build on the existing health information system.[9]
• Collect and report information on vaccine supplies, cold-chain performance, and quantitative and qualitative vaccination coverage, using vaccination-site data for daily, weekly and monthly reports.[15]
• Measure performance through indicators covering the supply chain, vaccination coverage, quality, vaccination processes and implementation of roadmap activities.[2][15]
• Conduct supportive supervision before, during and after introduction, using training and supervision plans and improved monitoring tools; address identified limitations in provincial and district logistics, supervision capacity and planning.[11][4]
• Analyse shortcomings and bottlenecks systematically during supervision, reporting and documentation of adverse events following immunisation.[15]
• Conduct a final campaign evaluation through a multidisciplinary team of independent national and international experts.[15]

Accountability and coordination are principally assigned to the Interagency Coordination Committee and proposed national coordinating structures, which support follow-up, monitoring and partner coordination.[8][12][4]The available material does not set out a complete reporting calendar, detailed evaluation methodology, formal public accountability framework, or comprehensive indicator definitions beyond the stated reporting frequencies and performance areas.[12][4][15]

Costing & Financing

Financing is recognised as a vaccine-readiness pillar, and the plan calls for mobilisation of human, material and financial resources from government and domestic and international partners.[3][8][12]The only quantified operational estimate provided is for the first phase covering 20% of the population, excluding vaccines and supplies.[15]

• Record government funding of five billion Central African CFA francs made available at the beginning of the pandemic.[12]
• Estimate priority interventions for the first vaccine-introduction phase at approximately 367,270,603 Central African CFA francs, equivalent to 567,826 US dollars, excluding vaccine and supply costs.[15]
• Cover electricity and water costs at all levels through public funds.[14]
• Seek technical and financial contributions from partners, including exceptional support despite the country not receiving Gavi financing, and pursue vaccine access through COVAX, bilateral discussions and other affordable, reliable and safe options.[8][12]
• Recognise operational resource needs for trained personnel, supervision, monitoring tools, regulatory authorisation, importation, fixed and outreach delivery, cold-chain infrastructure and logistics.[13][4]

No total vaccine-introduction budget, detailed activity allocation, confirmed financing plan, funding-gap estimate, affordability assessment or economic assumptions are specified in the supplied material.[12][1][15]