During his eighth and last State of the Nation address on 30 November 2021, Uhuru Kenyatta reminded the nation of his pledge to have at least 10 million Kenyans vaccinated by Christmas. With just 25 days to go, the president urged Kenyans to get vaccinated to meet and surpass that target.
On the day of the president’s address, just 7,175,590 doses of the 13,909,670 received in the country had been administered.
The pressure to vaccinate Kenyans has been increasing. Data shared by the Ministry of Health in late November indicated that less than 10 per cent of the targeted population was fully vaccinated and about 15 per cent had received at least one of the COVID-19 vaccine doses.
Just nine days before the president encouraged Kenyans to get their COVID jabs, Cabinet Secretary for Health, Mutahi Kagwe announced some tough measures. He said that Kenyans will be required to show proof of vaccination when boarding domestic flights, trains and buses, and while travelling from one region to another.
“Everybody seeking in-person government services should be fully vaccinated and proof of vaccination availed by December 21st 2021,” he said. “Such service will include but not limited to KRA services, education, immigration services, hospital and prison visitation, NTSA and Port services among others.”
The announcement sparked much debate among the public. Human rights defenders argued that the measures violated freedom of choice and threatened to deny basic services to citizens. Some taxpayers even joked about not paying their taxes since if they were unvaccinated, they would not be receiving government services.
Business owners, especially in the tourism sector, criticised the potential negative impact of these pronouncements on their businesses which experience a boom during the Christmas holidays.
But in the week following this announcement, the number of doses administered daily increased to over 100,000, except on the Saturday and Sunday. This is a significant rise. If we take data beginning on 28 September 2021, when MOH began to consistently upload the status reports, the average number of vaccines administered on a daily basis since that date was 52,796.
Vaccine roll out
The vaccination process has been highly dependent on the availability of vaccines, with more than half being donations from higher-income countries like the US, UK, Denmark, Poland, France, etc.
Where the dates have been disclosed, the duration to expiry of the donated batches was between 25 and 136 days. While the Johnson & Johnson batch that the government of Kenya had received on 3 September 2021, just before it last reported the expiry date of various vaccine batches, had 635 days to expiry.
It is not reported whether there were any vaccines that were discarded because they had expired.
Kenya had received 13,909,670 vaccines by 30 November 2021. The challenge is to match uptake with the now increased availability of vaccines. More than half of these vaccines are yet to be administered.
So, how likely is it that the government will have every adult Kenyan vaccinated by 21 December 2021 to avoid the consequences announced by CS Kagwe? Or is President Kenyatta’s Christmas pledge more realistic?
Based on the MOH daily cumulative number of vaccines administered, Kenya is on course to have 10 million vaccines administered by Christmas, based on the predictive AutoRegressive Integrated Moving Average (ARIMA) model.
But this forecast will become reality if more Kenyans are persuaded to take the time to visit their nearest medical facility which according to the President is now stocked with the vaccine doses.
More realistically, about 9 million doses could be administered by Christmas if all factors remain constant.
The cumulative number of vaccines administered is non-stationary, meaning that it has a time-dependent structure and does not have constant variance over time. This can be attributed to pattern changes based on the availability of COVID-19 vaccine doses in the country and also due to various efforts undertaken by the ministry at different times.
It is clear, however, that the uptake of the doses has now become steady. But the uptake is not increasing at the same rate as the vaccines are becoming available. This could be because of ineffective communication to the public. Also, there may be vaccination apathy following the long waits for sufficient vaccines, the long queues once they become available and visits to medical facilities only to find no vaccine. I made one such visit which was disappointing.
Worthy of note is that in August the government issued its first vaccine mandate to all public servants who were compelled to get COVID jabs or face disciplinary action.
Now, over 95 per cent of health workers and teachers are fully vaccinated. The new mandate widened the scope to the general population, including millions of jobless Kenyans, and seems to be bearing fruit already.
Data management challenges
The prediction above is based on the kind of data the ministry of health has released. The MOH Twitter page and website have been the main avenues through which vaccination progress has been communicated.
Looking at the vaccination data, one gets a sense of how the data aspect of this pandemic has been a case of “building a plane while you fly it”. This can be seen in the way data is released for public use.
Data is first shared in the form of images on twitter and PDF documents are then uploaded on the MOH website.
Let us drill down to illustrate some problems by focusing on 14 July 2021.
- The vaccines that had been administered on this day were 1,565,344.
- The same status report indicates that 31 first dose and 1034 second dose were administered on that same day.
- Total vaccinations on 15 July 2021 were 1,590,765. It is not clear why the difference between the two days is 25,421, since the doses reported to have been administered on the 15th are 263 for the first dose and 6730 for the second dose.
- The discrepancy is not comprehensible and it is the case for many other days until much later, in November, when the numbers start to add up.
Additionally, the number of total daily vaccinations in the status reports uploaded on the MOH website differs with what is in the Humanitarian Data Exchange (HDX), HUMDATA, an open platform for sharing data across organisations which relies on figures that are verifiable based on official public sources including Our World in Data (OWID) who in turn extract data from the updates from the MOH twitter timeline as well as on the website.
Another major issue for anyone seeking to explore Kenya’s vaccination data is missing data.
Dataset such as HUMDATA and OWID had data scraped from the MOH twitter updates initially. We had to combine data from the HUMDATA dataset and MOH status reports together to reduce the amount of missing data. However some figures recorded by Humdata were a day ahead compared to the figures in the available status reports presented on the MOH website.
The level of readiness in terms of how to capture and manage the data is questionable. The status reports shared had not captured or anticipated the assortment and diversity of the vaccines Kenya would receive over time. Several elements (variables) are introduced at different times. This makes any automated technique of extracting the data extremely difficult and time-consuming. For example, up until 1 July, the reports had “Cumulative persons vaccinated to date”. But this was changed to “Total vaccinations” to cater for those who were receiving their second doses of the AstraZeneca vaccination which began on 28 May 2021. Later it emerged that just a single dose of Johnson & Johnson would amount to full vaccination status so official data was changed from Dose 1 and Dose 2 to partially and fully vaccinated persons.
Gender was another variable that evolved with time. Initially genders were badged male, female and “other”. This was later changed to “intersex”, and “transgender” was subsequently added.
These discrepancies, in addition to the data provided in PDF forms, make it extremely difficult and time consuming for experts to explore the data and for the public to monitor the accountability and transparency of the vaccine uptake.
This OUTBREAK story was supported by Code for Africa’s WanaData program as part of the Data4COVID19 Africa Challenge hosted by l’Agence française de développement (AFD), Expertise France, and The GovLab