In Comoros, containing mpox means vaccinating, tracing – and rebuilding trust
After the country’s first cases of mpox and the launch of a targeted vaccination campaign, health authorities in Comoros are working to prevent the virus from gaining a foothold in the archipelago. On the ground, the response depends not only on vaccines, but also on rapid case detection, contact tracing and the patient work of rebuilding trust with communities.
- 26 June 2026
- 6 min read
- by Natidja Adabi Soilihi
On a May morning at the Ouzioini health district, in the south of Ngazidja, or Grande Comore, a man in his forties is standing by the entrance, waiting. Wearing a red short-sleeved T-shirt, Ali Mouhsine Mchinda keeps an eye out for his turn. He is not among the groups targeted by the campaign, but he runs a shop and restaurant inside the hospital compound.
“They clearly explained to me that this vaccination is intended for carefully selected groups of people. But because I work in this hospital, I feel exposed to the disease. So I want to make sure I don’t bring it home with me – especially as there are young children there,” he says.
Credit: Ali Khaled
In Comoros, an archipelago off the east coast of Africa where only around 10,000 vaccine doses are available, mass vaccination was never on the table. The aim is different: to protect those most exposed, rapidly trace people who have been in contact with confirmed cases, and prevent the virus from finding an opportunity to take hold.
Protecting the front lines
In Ouzioini, health workers and community health workers take turns at the vaccination post. Kalathoumi Abdoulhamid, an experienced vaccinator, administers doses, reassures people and keeps the line moving. “You’ll see, it doesn’t hurt at all,” she tells the 25 people expected that day. Then she lets slip her own anxiety: “Every time an outbreak is reported, I live with the fear of bringing it home.”
For many, getting vaccinated also means being able to keep reaching out to others. Fahamwe Ali Asma, 51, spends her days raising awareness among residents, sometimes visiting up to 30 homes. “Once vaccinated, I will be immunised and, in doing so, I will protect my children and grandchildren,” she says.
In Mitsamihouli, in the north of Grande Comore, around 30 people were vaccinated on Monday, 25 May. Among them was Moussa Athoumani, a ‘peer leader’, who says he was initially hesitant. “At first, I was reluctant, especially at the thought of being near suspected cases and possibly exposing my children. Now, I feel satisfied and relieved,” he says.
In Ouzioini, midwife Allaouia Saïd Hassane also sees vaccination as a matter of setting an example. “Being among the first to receive this vaccine helps set an example when we are raising awareness among the public. And it also means I won’t risk exposing my loved ones,” she explains.
Credit: Ali Khaled
Abidina Assoumani, a community health worker in Mitsamihouli, shares the same conviction: “The fact that I am vaccinated and feel perfectly well will help me explain to others that the vaccine is not there to harm us.”
Tracing contacts, acting fast
When his brother contracted mpox, 17-year-old Djamadar Abdousalam was identified as a contact. The young man from Oichili was referred for vaccination. “I realised I had to do it to protect myself and protect those around me. I encourage all young people who are eligible to do the same quickly,” he says.
Dr Faouzouz Ben Aboubacar, who leads epidemiological surveillance, sums up the logic guiding the teams’ work: “These 10,000 doses will fully protect just over 5,304 people, as the protocol requires two injections. The operation is primarily targeting contacts of confirmed cases, as well as health workers, community workers and response teams responsible for active case-finding.”
In an archipelago where resources are limited, this strategy depends on speed: identifying, following up, persuading and then intervening.
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Reassuring, persuading – and sometimes insisting
In Mbadjini-Ouest, Faouzia Mmadi says the teams often had to go back to basics. “It was complicated to explain things to people who were confusing mpox with simple scabies, and to get them to take the disease seriously enough. We had to show them that with mpox, lesions can also appear in the armpits, and that they are often accompanied by severe headaches,” explains the community worker.
Travelling through 45 villages across the island’s seven districts, Elhadad Mohamed saw another fear return. “It wasn’t necessarily that people denied the disease existed. But they refused to go to Samba hospital, the treatment site, because memories of COVID-19 there are still very vivid. Some families even went as far as hiding their sick relatives,” says the communications officer at the regional health directorate.
Faced with this resistance, health teams had to rely on traditional and political authorities, with prefects and village chiefs stepping in to help persuade the most reluctant. In Ndzuani, where a patient hospitalised at Bambao Mtsanga hospital had fled, law enforcement even had to intervene to maintain isolation and ensure continuity of care.
Vigilance beyond the outbreak
According to the national epidemiological report of 12 May, 41 cases had been confirmed in Grande Comore and one in Anjouan, including 12 imported from Madagascar, out of a total of 149 suspected cases detected since the first case appeared on 23 January 2026. The youngest confirmed case was an eight-month-old infant; the oldest was a 64-year-old man.
Dr Faouzouz Ben Aboubacar is keen to commend the commitment of health professionals and community health workers, who have been involved in case detection and contact tracing as well as patient care, despite the lack of financial incentives.
With 527 people vaccinated, 55% of them frontline workers in Grande Comore, and more than two incubation periods of more than 42 days passing without any new cases being reported, the authorities announced the end of the outbreak on Monday, 8 June.
But in an archipelago connected to Madagascar by sea and air links, the risk of reimportation remains firmly on people’s minds. In Comoros, the mpox response is therefore not just about injecting a vaccine. It depends on the ability of teams to detect cases quickly, follow up contacts and maintain the trust of communities.
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