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Zimbabwe's Minister of Defence Oppah Muchinguri Kashiri receives her first first dose of the Sinovac COVID-19 vaccine on March 24, 2021 in Victoria Falls, Zimbabwe.Tafadzwa Ufumeli/Getty Images

Melisa Hungoidza keeps changing her mind about the Chinese vaccine.

Three times she has visited the COVID-19 vaccination centre at Wilkins Hospital in Zimbabwe’s capital, Harare. Three times she has decided to walk away without a jab.

“I told myself I’d have to wait to see if other health workers join the vaccination, but I saw nobody,” the 34-year-old nurse’s aide said. “I’m afraid, because nothing much was said to us as health workers about the side effects of the Sinopharm vaccine.”

Canada vaccine tracker: How many COVID-19 doses have been administered so far?

Tracking Canada’s COVID-19 vaccine rollout plans: A continuing guide

Moderna, Pfizer, AstraZeneca or Johnson & Johnson: Which COVID-19 vaccine will I get in Canada?

Canada pre-purchased millions of doses of seven different vaccine types, and Health Canada has approved four so far for the various provincial and territorial rollouts. All the drugs are fully effective in preventing serious illness and death, though some may do more than others to stop any symptomatic illness at all (which is where the efficacy rates cited below come in).

PFIZER-BIONTECH

  • Also known as: Comirnaty
  • Approved on: Dec. 9, 2020
  • Efficacy rate: 95 per cent with both doses in patients 16 and older, and 100 per cent in 12- to 15-year-olds
  • Traits: Must be stored at -70 C, requiring specialized ultracold freezers. It is a new type of mRNA-based vaccine that gives the body a sample of the virus’s DNA to teach immune systems how to fight it. Health Canada has authorized it for use in people as young as 12.

MODERNA

  • Also known as: SpikeVax
  • Approved on: Dec. 23, 2020
  • Efficacy rate: 94 per cent with both doses in patients 18 and older, and 100 per cent in 12- to 17-year-olds
  • Traits: Like Pfizer’s vaccine, this one is mRNA-based, but it can be stored at -20 C. It’s approved for use in Canada for ages 12 and up.

OXFORD-ASTRAZENECA

  • Also known as: Vaxzevria
  • Approved on: Feb. 26, 2021
  • Efficacy rate: 62 per cent two weeks after the second dose
  • Traits: This comes in two versions approved for Canadian use, the kind made in Europe and the same drug made by a different process in India (where it is called Covishield). The National Advisory Committee on Immunization’s latest guidance is that its okay for people 30 and older to get it if they can’t or don’t want to wait for an mRNA vaccine, but to guard against the risk of a rare blood-clotting disorder, all provinces have stopped giving first doses of AstraZeneca.

JOHNSON & JOHNSON

  • Also known as: Janssen
  • Approved on: March 5, 2021
  • Efficacy rate: 66 per cent two weeks after the single dose
  • Traits: Unlike the other vaccines, this one comes in a single injection. NACI says it should be offered to Canadians 30 and older, but Health Canada paused distribution of the drug for now as it investigates inspection concerns at a Maryland facility where the active ingredient was made.

How many vaccine doses do I get?

All vaccines except Johnson & Johnson’s require two doses, though even for double-dose drugs, research suggests the first shots may give fairly strong protection. This has led health agencies to focus on getting first shots to as many people as possible, then delaying boosters by up to four months. To see how many doses your province or territory has administered so far, check our vaccine tracker for the latest numbers.

New study casts doubt on time between COVID-19 vaccine doses

Zimbabwe was one of the first African countries to receive vaccines for the virus, thanks to a donation from China five weeks ago. Today it has received 600,000 doses of two Chinese vaccines, Sinopharm and Sinovac. Yet it has managed to administer fewer than 59,000 of those doses so far, largely because of a lack of enthusiasm from the Zimbabwean people.

The vaccines are free, there are usually no age or occupation restrictions and the queues are often relatively short. It took only 15 minutes for people to be vaccinated at Wilkins Hospital on Friday. Yet people are still reluctant to take the jab.

Analysts say the slow acceptance of the Chinese vaccines in Zimbabwe is largely owing to a mistrust of the country’s authoritarian government, a lack of a concerted campaign to educate people about the benefits of vaccination and a widespread suspicion of corruption in China’s deals with the Zimbabwean government.

“It shows that millions of people here have no trust in the Chinese vaccine,” said Claris Madhuku, an activist who heads the Platform for Youth Development, a Zimbabwean civil society organization.

“People question China’s sincerity in donating the doses to Zimbabwe,” he told The Globe and Mail. “They don’t trust the deals between China and Zimbabwe at the government level because they associate it with lots of corruption.”

Some people even believe that Chinese companies have bribed the Zimbabwean government to accept the vaccines for their own financial interests, he said.

The suspicions about the Chinese vaccines have added yet another complication to the vaccination challenges in Africa. The continent, with a population of about 1.3 billion people, has administered only about 7.7 million vaccine doses so far – the lowest number per capita of any region in the world.

The biggest obstacle is simply a lack of supply. “Africa urgently needs more COVID-19 vaccine supplies as deliveries begin to slow down and initial batches are nearly exhausted in some countries,” the Africa branch of the World Health Organization said in a statement on Thursday.

“A critical proportion of the population targeted in the initial phase of the vaccination campaign may remain unvaccinated for months to come, due to global supply constraints,” it said.

Matshidiso Moeti, the WHO regional director for Africa, noted that some wealthy countries are already beginning to vaccinate young and healthy people, while many African countries are still struggling to cover their high-risk groups, including front-line health workers.

“A slowdown in vaccine supply could prolong the painful journey to end this pandemic for millions of people in Africa,” she said.

But supply is not the only problem. Another issue is the reluctance of some African governments to accept the vaccine developed by AstraZeneca.

Cameroon and the Democratic Republic of the Congo both announced temporary suspensions of their use of AstraZeneca this month after a number of European governments questioned a possible link between the vaccine and rare blood clots.

South Africa, meanwhile, purchased 1.5 million doses of AstraZeneca – but then refused to use it after a study found it ineffective in preventing mild and moderate illness from the new variant detected in South Africa. The government eventually sold the vaccines to other African countries, and it is now seeking to renegotiate its agreement with the COVAX supply program to get another vaccine instead of the AstraZeneca doses that it was due to receive.

The concerns about AstraZeneca are crucial because it is the main option provided by COVAX, the non-profit program that has become the major source of supply for most of the world’s poorest countries.

Aside from AstraZeneca and an extremely limited number of Pfizer doses, the only other vaccines available to most African countries are from Russia and China.

So far, 19 African countries have received deliveries of the two main Chinese vaccines. But as the Zimbabwe example illustrates, the Chinese vaccines might not solve the supply problems.

An online survey of the general public by Zimbabwe’s College of Public Health Physicians found that nearly half of respondents would refuse to take any COVID-19 vaccine or were uncertain about whether to take it.

The hesitancy was shown on March 18, when Zimbabwean Vice-President and Health Minister Constantino Chiwenga arrived at Wilkins Hospital to get his second dose of the Chinese Sinopharm vaccine. Journalists took photos of him and dutifully stood in line for their own vaccines. But when the powerful politician left the scene, many journalists and other people quietly slipped away from the queue.

Charity Mushonga, a 27-year-old fruit and vegetable seller, was one of the few who remained. “I am just giving it a try,” she said.

“I realized that few people were willing to be vaccinated, and I said to myself, ‘Let me take the chance.’ ”

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