In Africa, where pictures of COVID-19 vaccination in high-income countries validate the existence of inequality in global health, there is still a long wait for the vaccines—which though promised, remain largely elusive.Calls for the adoption of equitable access to the vaccines and for countries to jettison vaccine nationalism have been largely ignored. “Vaccine nationalism will prolong the pandemic, not shorten it”, WHO warned. But this did not deter the USA and other countries from pre-ordering hundreds of millions of doses before the vaccines exited clinical trials.Respite, however came for African countries through COVAX, the global initiative to ensure rapid and equitable access to COVID-19 vaccines for all countries, regardless of income level. Through COVAX, Africa is guaranteed vaccines for 20% of its population by the end of 2021, but this is not enough for the continent, which is aiming to vaccinate at least 60% of its population.Although Africa is lagging behind the rest of the world in rolling out COVID-19 vaccines, getting them about a year after WHO approval for emergency use is an unprecedented achievement that shows that the age-long drug lag is reducing, said Jude Nwokike, Vice President of the US Pharmacopeia (Rockville, MD, USA). Nwokike told The Lancet Microbe that while the development and deployment of vaccines usually take years, the speed for COVID-19 has been unprecedented.“Many years ago, it used to take up to 30 years between the development, registration and approval of vaccines in developed countries like the United States and when it gets to developing countries in Africa. But nothing has been as dramatic as the current COVID-19 pandemic”, Nwokike said. While waiting for the doses to become available on the continent, Nwokike urged African countries to commence procedures to facilitate quick regulatory approvals of the vaccines.In addition to the vaccine doses that the continent will be getting through COVAX, Africa on its own has also secured 250 million additional doses from Pfizer, AstraZeneca, and Johnson & Johnson, through the African Vaccine Acquisition Task Team. The African Union Chair, South African President Cyril Ramaphosa, on Jan 13, 2021, disclosed that the continent will receive at least 50 million doses for roll out between April and June.“From the onset of this pandemic, our focus as a continent has been on collaboration and collective effort. We have taken the additional step to independently secure vaccines using our own limited resources as member states”, Ramaphosa said.Several individual African countries are also racing to secure their own doses of the COVID-19 vaccine. Starting with its health workers, Seychelles became the first country in Africa to commence COVID-19 vaccination. The country was able to kickstart the exercise due to a donation of 50 000 doses of China's Sinopharm vaccine from the government of the United Arab Emirates. Seychelles is also expecting 100 000 doses of the Oxford-AstraZeneca vaccine from the government of India by the end of January for its approximately 98 000 residents.Beyond the challenge of accessing vaccines, low immunisation coverage in large African countries such as Nigeria has been a major concern that put in doubt the continent's ability to satisfactorily meet the peculiar burden of rapidly immunising hundreds of millions of people within a short period of time.BCG is one of the popular vaccines in Africa and WHO records indicate a BCG immunisation rate of about 53% in 2018, in Nigeria. Moreover, only 57% of the targeted population have access to 3 doses of the diphtheria-tetanus-pertussis vaccine.“Vaccination and vaccine uptake are low but Nigeria has lots of experience with vaccination campaigns including the one that led to polio eradication in Nigeria. We are better placed now—working with communities and religious leaders”, Dr Jafiya Abubakar, Head of Epidemiology at the Nigeria Center for Disease Control, told The Lancet Microbe.Dr John Nkengasong, Director of the Africa Centers for Disease Control, admitted that achieving successful COVID-19 vaccination would be an unprecedented undertaking in Africa, but it is also a feat that the continent can achieve, considering the urgency demands of the pandemic in the light of its impacts on Africa's economy and other facets of life on the continent.“Speed is of essence. We cannot wait. This is not a polio or measles vaccination. We have to do it quickly. Our economies are down. Our people are dying. Now that African countries can access the vaccines, there is absolutely no reason for accelerated preparations not to occur. It shouldn’t be a complex exercise at all. If you remove the whole thinking of the cold chain, then it becomes a logistic arrangement that is very very within reach of our capabilities as a continent”, Nkengasong told The Lancet Microbe.