Morocco achieves the highest COVID-19 vaccine rates in Africa in the first phase: what are reasons for its success?

The coronavirus disease 2019 (COVID-19) pandemic continues to spread and poses serious threats to economic activities and public health around the world. At the start of the pandemic in Morocco, the authorities imposed a total and strict containment during 4 months. When the country recorded its first cases of new variants of coronavirus, the government applied several measures such as extending the national state of emergency and imposition of the national night-time curfew. These measures have been successful in reducing the number of cases. Still, Morocco is the second most affected country by COVID-19 in African continent with 483 410 cases after South Africa.

Since vaccine introduction, each country tries contracting the number of vaccines doses needed. Table 1 presents data for African countries that have started the COVID-19 vaccination as of 28 February 2021. As we can see, the number of countries is low and the gap between Morocco and other countries is large. Morocco has administered 3 597 903 doses (9.75% per 100 population), while rates of vaccination in other countries did not exceed 1%. In 1 month, the vaccination rate in Morocco is slightly higher than that in France (6.97%), Italy (7.12%) and Spain (7.71%) in 2 months of vaccination. In Morocco, vaccination is carried out gradually. Priority is given to persons in the frontline, such as health workers, teachers, security forces, authority agents, elders and people with underlying health conditions. Thereafter, the vaccination will be extended to the general population by age group.

Table 1

COVID-19 vaccine doses administered in African countries as of 28 February 2021

Country	Total administered doses	Administered doses per 100 people
Morocco	3 597 903	9.75
Algeria	75 000	0.17
South Africa	70 725	0.12
Senegal	25 653	0.15
South Africa	70 725	0.12
Egypt	1315	0.0
Zimbabwe	18 843	0.13

This vaccination campaign had clearly been rapid and effective compared to other African countries and neighboring European ones. It is important to identify the factors that contributed to this success. Morocco has suffered economically from the first containment and cannot withstand a second one. For this, the population vaccination became a major priority for the government which provided all financial and logistic resources to achieve this objective. Indeed, Morocco anticipated planning for the implementation of a vaccination strategy such as the signing of agreements for the acquisition of vaccines, the transfer of technology and participation in clinical trials. These agreements were done with several pharmaceutical companies to have the sufficient quantity of vaccine and to reduce the risk of delivery delays. Details of these agreements and negotiations are not publicly disclosed. Until 28 February, Morocco has received 7 500 000 doses, which is significantly higher than those received by other African countries such as South Africa (1 160 000 doses). In addition, the majority of health professionals have been mobilized, and 2880 primary health care institutions, a large number of vaccinations centers and mobile vaccination teams have been designated. Any citizen or resident is automatically assigned to the nearest vaccination center using its digitized identity card number, unlike South Africa where vaccination is carried out in only 18 hospitals and is based on a pre-vaccination registration and appointment system. To facilitate the vaccination operation, a platform has been created to find out vaccination appointments, report an adverse event following vaccination, or download the vaccination certificate. Also, the Moroccan COVID-19 vaccination campaign took advantage of the National Immunization Program already in place. Morocco is thus a pioneer in the field of vaccination and health programs in the western Mediterranean area, achieving vaccination coverage rates of over 90% against several infectious diseases.

The authorities have reassured the vaccine hesitant about the robustness of the country's regulatory process for vaccine approval. In addition, since August the health ministry has also deployed a large communications campaign to provide information, reassure and encourage people to get vaccinated. Moreover, the senior officials of the country were the first to be vaccinated.

Authors’ contribution

The authors contribute equally to this work.

Funding

There is no funding for this submission.

Conflict of interest

The authors have no conflict of interest.