Vaccine introductions in the WHO African Region, 2023-26: a country-level ecological analysis by Gavi eligibility and conflict-affected status

The study analyzed vaccine introductions in 47 countries in the WHO African region from January 2023 to June 2026. A total of 72 vaccine-related events were recorded in 38 countries, including 48 new-antigen introductions, 20 dose or schedule expansions, and 4 combination vaccines. Gavi-eligible countries affected by conflict recorded an average of 2.50 events per country compared to 1.27 in other groups. The study found that conflict-affected status in Gavi-eligible countries was associated with a higher number of vaccine introductions. Malaria vaccines accounted for 21 of the total introductions. Surveys of immunization program managers revealed constraints in prioritization, financing, and preparation for 2026. The results indicate that recent vaccine-introduction activity concentrated in countries with a combination of Gavi eligibility, conflict-affected status, and weaker health system performance.