Liberia received an initial 123,000 COVID-19 vaccine doses through COVAX in early March, with an expiration date of July 10 — creating a race against the clock to administer the vaccines before they expired.
The Liberia Ministry of Health teamed up with partners like Last Mile Health to administer the vaccines across 14 counties, focusing on rural and remote communities. Together, we were able to provide the first COVID-19 vaccine dose to more than 86,000 people, including 12,000 community and frontline health workers.
Last Mile Health has been a key partner to the Ministry of Health on the country’s COVID-19 response, and when the Ministry of Health asked us to help vaccinate community and frontline health workers living in rural and remote communities, we quickly mobilized a campaign that prioritized getting vaccines from tarmacs into arms. We started by vaccinating the majority of community and frontline health workers, as well as some health facility staff, in Grand Bassa, Grand Gedeh, and Rivercess counties, where we directly manage the National Community Health Assistant Program. Due to the success of this initial campaign, the Ministry of Health asked us to travel to 11 other counties to roll-out the vaccine to all community and frontline health workers employed in the national program.
Nowai Gray, Last Mile Health’s Senior Technical Coordinator of Digital Education, was one of the leaders of this campaign who traveled from Monrovia to 14 counties to administer vaccinations. She said the most rewarding part of the work was hearing from the community health workers themselves, “they felt respected, they felt important, they felt like they were not being left out.”
The vaccination campaign has demonstrated that community and frontline health workers are powerful allies in the fight against vaccine hesitancy. Focus groups we conducted in one remote county in Liberia suggested that, while misinformation about the vaccine was prominent in some communities, counselling from community and frontline health workers and encouragement from vaccinated individuals could effectively dispel myths and increase vaccine uptake.
- “What encouraged me to take the vaccine was when I was counselled by the vaccinator. I was talking with him and I decided it would be a good idea to take the vaccine to prevent myself just in case of the COVID-19.” – Male, partially vaccinated community member
- “I had concerns about fever and side effects from the vaccine… After all the counselling, it made me brave enough to take the vaccine.”- Female, partially vaccinated community member
- “I was influenced to take the vaccine by the information that came out of the health worker because they were the first one to take it”– Male, partially vaccinated community member
In addition, community health workers, supervisors, and health facility staff indicated that their main motivation to get vaccinated was to lead by example in their communities and promote the vaccine to their neighbors and patients.
One frontline health worker said, “If we health workers are not taking the vaccine then we should not be expecting the community to take the vaccine. That’s why I decided to take the leap, so I can show people the vaccine is safe because I took it. Even my family and friends, I was able to counsel them to take it.”
While these results are only a snapshot of what is required for effective vaccine delivery nationally, they underscore the importance of investing in those closest to the community.
At the end of June, the Last Mile Health team supported the Ministry of Health to administer the second dose of the vaccine to the majority of community and frontline health workers, and a number of health facility and county health team staff, in the three counties where we directly manage the national program. This has resulted in 833 community and frontline health workers fully vaccinated against COVID-19 in Grand Bassa, Grand Gedeh, and Rivercess counties. Currently Liberia has no COVID-19 vaccine doses in the country, which means additional outreach efforts are on pause.
In the meantime, Last Mile Health, in partnership with the Ministry of Health, will continue to equip community health workers with the tools to educate their neighbors and encourage vaccine uptake, including vaccine reminder cards that state why the vaccine is important, the type of protection it will provide, and what to expect after you have been vaccinated. As Nowai says, “Community health workers will be the champions to inform community members, saying that the vaccine is safe and using the vaccine card as a tool to address any myths and hesitancy.”
Though this is an encouraging milestone, less than 2% of the Liberian population has been vaccinated against COVID-19, which reminds us all of the long road ahead to achieving vaccine equity. As many countries in Africa experience a third wave of COVID-19 cases, it will be essential to leverage community health systems to deliver and administer additional doses of the vaccine.