The impact of COVID-19 on Malawi’s routine immunisation programmes

The pandemic is having an adverse effect on Malawi’s continued drive to provide all children with routine vaccines.

  • 18 May 2021
  • 2 min read
  • by Morton Manjaa
Gavi/Malawi/Karel Prinsloo
Gavi/Malawi/Karel Prinsloo


Routine immunisation has been practiced in Malawi since the arrival of missionaries and colonial administrators. Before 1973, smallpox vaccinations were administered in large numbers. Following that antigens like DTP3 were administered at health facilities countrywide.

While there are ‘mission’ and private health facilities that are major players in the administration of routine vaccines, the Ministry of Health is the largest provider of vaccination services nationwide through its hospitals, health centres and outreach clinics.

The main purpose of outreach clinics is to take the vaccines to the people, eliminating accessibility and availability issues in the process. With this dual-approach and support from donors and the civil society, Malawi has made notable strides in ensuring that the majority of children under five are vaccinated.

It is against this background that, as of 2019, the Malawi Expanded Programme on Immunisation reported that 75% of children aged 12 to 23 months had received all eight basic vaccinations.

However, the COVID-19 pandemic, which has affected all facets of life, threatens to undo this progress. There have been difficulties administering first vaccines, let alone follow-up vaccinations in the basic immunisation schedule. Elliness Ngwira is a first-time mother who sought a first vaccine for her newborn baby: "I was told that the hospital had no vaccines for babies and was referred to a private facility. It has been hard accessing vaccines for my child during the pandemic."

Misinformation and misconceptions around COVID-19 is also hurting routine immunisation. George Mgemezulu, a clinician at Mzimba Hospital in the centre of the country, says:

Credit: Morton Manjawira
George Mgemezulu, a clinician at Mzimba Hospital, Malawi.
Credit: Morton Manjawira

"Initially, there was fear of visiting government facilities due to their track record of overcrowding. Outreach clinics also experienced difficulties in administering routine vaccines because of the hostility towards medical personnel caused by the lack of understanding and awareness around COVID-19. With COVID-19 vaccines, the fear was that government facilities would administer the vaccine to children as a routine vaccine without consent from their guardians."

Quizzed on what was being done to rectify the situation. Mgemezulu says that awareness campaigns on COVID-19 and the vaccine are being conducted.

"Mobile vans have been sent to rural areas to spread the correct messages. It’s not looking like an easy task; trust has been lost in government facilities, but so far so good."