Challenges Facing COVID-19 Vaccines Cold Chain Systems in Low-income Countries and Their Effects on COVID-19 Vaccine Inequity in Africa and Globally

Abstract

Realizing that the COVID-19 pandemic is a tremendous public health burden due to dramatically increased morbidity and mortality rates, countries undertook measures to limit the transmission of the virus. Eventually, experts and scientists met the urgency of this matter with unprecedented extensive efforts to develop safe and effective vaccines for COVID-19. Unfortunately, the COVID-19 vaccines were developed quickly, and little attention was drawn to their deployment. Therefore, it is justified to expect supply chain challenges in low-income countries, especially those related to the vaccination cold chain. This literature review dissertation aims to explore the challenges facing the COVID-19 vaccines’ cold chain systems in low-income countries and discuss what impacts these challenges have on vaccine inequity in the African region and on larger global efforts to end the pandemic. The methodology of this dissertation is a literature review that employs a qualitative research approach to address the research questions. It is conducted by referring to the six-phase framework for doing a thematic analysis by Braun and Clarke. All publication types were retrieved electronically by searching relevant databases. A total of 14 papers were included in this review. Thematic analysis resulted in four themes, including the challenges facing cold chain systems in low-income countries which are: inadequate cold chain establishment, special vaccine requirements, lack of human resources, and poor infrastructures. Findings show that low-income countries struggle to provide and maintain cold chain systems for COVID-19 vaccines, leading to difficulty deploying them where they are needed, which confirms the contribution of the COVID-19 vaccines cold chain systems’ deficiencies in low-income countries to vaccine inequity in Africa and globally. These consequences and delays in COVID-19 vaccines’ deployment cause vaccine inequity in low-income countries, further exacerbating the pandemic’s dire global effects and challenging global health’s progress towards achieving global health equity.