Establishing the African region monitoring vaccine effectiveness (AFRO-MoVE) network for respiratory pathogens

Population-level vaccination with newly developed vaccines to respond to the COVID-19 pandemic created a need to monitor vaccine effectiveness (VE) in the context of emerging SARS-CoV-2 variants and changing epidemiology. WHO and partners launched the African Region Monitoring Vaccine Effectiveness (AFRO-MoVE) Network in March 2021 to assess the performance of COVID-19 vaccines in real-world conditions in Africa. The Network aimed to facilitate and support comparable COVID-19 vaccine effectiveness studies in the African region, to provide a platform of scientific expertise and infrastructure, encourage the use of robust similar study designs to enable pooling to produce regional VE estimates and to build a sustainable network of hospitals, institutions, and experts to evaluate vaccines against pandemic and endemic respiratory pathogens. In the two years since its inception, the network has coordinated VE studies in the region and provided technical guidance and generic protocols employing robust methodologies. It brought together over 200 experts, representing 22 African countries and 55 organisations, and strengthened capacities by hosting ten webinars and six technical workshops. Of the 55 partners organisations, 25 based in 13 countries collaborated on implementing VE studies in the region. AFRO-MoVE supported study implementation in two phases, first targeting COVID-19 vaccination priority groups, then the general population. The network provides technical and financial support to nine studies, including three cohort studies in health workers and adults with comorbidities, and six test-negative design studies evaluating VE against symptomatic and severe disease. A data platform was established for pooled regional estimates. The AFRO-MoVE Network can form a sustainable platform to provide data for evidence informed decisions and timely VE monitoring for existing and new vaccines against respiratory pathogens and other diseases in the African region. Further development and consolidation of the network's activities can enable rapid response to future epidemics and pandemics.