Challenges and enablers to establishing COVID-19 vaccine effectiveness studies in the World Health Organization Africa region: A mixed-methods evaluation of the African region monitoring vaccine effectiveness (AFRO-MoVE) network.

Background: The African Region Monitoring Vaccine Effectiveness network (AFRO-MoVE) was established by the World Health Organization Regional Office for Africa in March 2021 to support implementation of COVID-19 vaccine effectiveness studies in the region.

Objectives: Primary goals of the evaluation were to assess how AFRO-MoVE addressed its objectives supporting regional vaccine effectiveness (VE) studies, to describe challenges and opportunities, and make recommendations to strengthen future efforts related to regional VE research.

Methods: From September 2023 through June 2024, a mixed-methods approach was employed to synthesize information from: (1) documentation provided by AFRO-MoVE; (2) a standardized study review tool; (3) an electronic stakeholder survey; and (4) a series of key informant interviews. Data were collected and exported via REDCap and summarized using Microsoft Excel. Thematic analysis was used to analyse the qualitative data. Perceived challenges were summarized together with perceived support by the network in addressing each challenge.

Results: AFRO-MoVE provided support to ten VE studies, including support for protocol development, study implementation, data management, and analysis, while also facilitating knowledge exchange and experience sharing among study implementers. While respondents reported strengthened capacity for VE studies at the national and regional levels in these areas, enrollment of SARS-CoV-2 positive cases was challenging, due to a decline in reported cases in network countries in mid-2022, when many studies were launched. These challenges contributed to a lack of published VE estimates from network study sites in time to inform vaccine policy.

Conclusion: AFRO-MoVE technical assistance and financial support was viewed positively by network members and contributed to increased capacity for conducting VE studies in the region. Publication of study results would further bolster the impact of the network. These finding underscore opportunities to enhance capacity for rapid VE generation and support preparedness for future pandemics.