Maputo – “I came to take the COVID-19 booster dose and brought my baby for (childhood routine) immunization,” says Cacilda Manjate, a young mother waiting in the consultation room in Matola II clinic just outside Mozambique’s capital Maputo. “For me taking the vaccine is important because I have a relative who died of COVID-19. I don’t want to lose anyone else in the family.”

The devastation during the first wave of the COVID-19 pandemic still looms large in the memory of many Mozambicans. According to Dr Benigna Maia, Deputy National Director of Public Health at the Ministry of Health, the pandemic’s impact has played a big role in motivating thousands of people to complete their primary series of COVID-19 vaccination and now come forward for a booster dose.

High-level political commitment from the presidency has also been pivotal in expanding the country’s vaccination coverage, as well as social unity by the population, notes Dr Maia. “The COVID-19 vaccination campaign has been a success in the country because Mozambicans embrace vaccination campaigns. They are aware of health-related issues.”

The government ratcheted up COVID-19 vaccination rollout in the first half of this year. Thanks to several mass vaccination campaigns, by May 2022, the vaccination coverage among the total population currently stands at 46% and 93% among adults over 18 years. Doses administered during the fourth phase of the mass vaccination campaign in March spiked by a whopping 341% compared with February.

Additionally, thanks to the support from World Health Organization (WHO) and partner organizations, including Gavi, the Vaccine Alliance, UNICEF, the United States Agency for International Development, World Bank and the European Commission’s Directorate-General for European Civil Protection and Humanitarian Aid Operations (ECHO), Mozambique is now among the 10 African countries that have vaccinated 40% or more of their population.

Part of the success also stems from health worker training. A total of 165 data managers, immunization officers and district physicians in four provinces have been trained through an ECHO-funded initiative that started in May 2022. The funding is part of the European Union’s initiative for COVID-19 vaccination in Africa, which aims to ensure increased access, including for the most vulnerable and people living in hard-to-reach, remote and conflict-affected areas.

“Apart from addressing the issues related to the COVID-19 immunization registry, WHO, funded by ECHO, is providing support that ensures training on data quality, vaccine availability, vaccine demand creation to increase people’s willingness to get vaccinated; and continues to play a big role on the fight against this pandemic,” says Dr Dionizio Machava head of the Expanded Programme on Immunization in Maputo Province.

Despite rising vaccination coverage, the latest review of the COVID-19 vaccination response shows a growing necessity for intensive supervision and monitoring of the vaccine service delivery process, says Dr Carlos Funzamo, WHO technical lead officer on the ECHO project in Mozambique, stressing the need for a “robust systems for monitoring and addressing adverse events following immunization and monitoring the response to infodemics.”