The Struggle to Vaccinate: Unveiling the Reality of the first year of Covid-19 Vaccination in the Democratic Republic of Congo

Introduction The emergence of COVID-19 as a global pandemic has affected countries worldwide, including the Democratic Republic of Congo (DRC). The DRC has experienced four waves of COVID-19, each associated with a new variant of the virus. To control the spread of the virus, the government of the DRC implemented various measures, including vaccination. The country developed a COVID-19 vaccine deployment plan, targeting high-risk groups, and launched a vaccination campaign in April 2021. This study aims to comprehensively assess the COVID-19 vaccination program in the DRC during its first year of implementation, including progress, coverage, types of vaccines administered, and a comparison with other neighboring countries. Methods This study was an analysis of the COVID-19 vaccination data during its first year of implementation in DRC. Data were collected from multiple sources, including the Ministry of Health and the WHO, and analyzed using descriptive statistics. The study received clearance and used de-identified and aggregated data. Results Out of the 26 provinces in the country, only 15 began immunization activities with varying levels of coverage, ranging from 0.02% to 6.91%. The number of functional vaccination sites remained patchy across the country. By March 2022, 5.7% of the population had received at least one vaccine dose, with 1.03% fully vaccinated. In most provinces, men were more compliant with vaccination than women. More than half of the vaccinated individuals preferred the Janssen vaccine. Compared to neighboring countries, the DRC has lagged behind in its vaccination efforts, having administered only 1.1 million of doses received (8%) and has vaccinated only 2% of its population with at least one dose, the lowest among the countries analyzed. Conclusion Despite the challenges faced in the first year of the COVID-19 vaccination, DRC has made significant progress in vaccinating its population. The slow progress highlights the need for continued investment in health systems. These insights can inform future Covid-19 vaccination campaigns in DRC and other low-income countries. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee of The Democratic Republic of Congo Ministry of Health gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript