Last-mile delivery increasing vaccine uptake in Sierra Leone

In partnership with the Ministry of Health, Concern Sierra Leone has been supporting outreach and mobile teams to increase access to life saving vaccinations including COVID-19, HPV (Human Papillomavirus) vaccines and routine childhood immunisations.  

Between 2021 and July 2022 teams administered 841,309 COVID-19 vaccines, achieving a 96% national coverage, making it one of the highest in Africa. To reach this figure, vaccine uptake in remote rural communities was targeted. This included the establishment of temporary vaccination clinics where communities did not have an existing health clinic, providing an opportunity for communities to ask questions receive appropriate and accurate information about the COVID-19 vaccine, as well as the provision of alternative forms of transport such as motorbikes and boats for accessibility purposes. 

Since 2022, Concern has been involved in exciting research partnerships with Yale University, Wageningen University and the International Growth Centre (IGC), changing the global conversation surrounding vaccine access and programme design. As a result, our sustainable outreach vaccination model is being proven to be inclusive, cost effective and replicable.  

In 2024, research conducted by the IGC was published in Nature (the leading international weekly journal of science), showing that by improving access, the number of people receiving the COVID-19 vaccine in 100 rural villages of the study, increased by 400%.  

The team conducted a randomised controlled trial involving almost 30,000 Sierra Leoneans aged over 12, living in rural towns and villages outside Sierra Leone’s national clinic network. The research addressed why, one year into its COVID-19 vaccine roll-out, only 14% of the population – two thirds of whom live in rural areas, were immunised, and how to increase this number. By December 2022, that percentage had increased to 70%, reaching the WHO's global target. By July 2023, over 9.1 million doses of the COVID-19 vaccine had been administered in Sierra Leone.  

Following this publication, we are embarking on further research to positively impact global knowledge and practice on vaccine access.