Bringing COVID-19 Vaccines to Hard-to-Reach Areas

Rural outreach visits proved to be a successful approach for COVID-19 vaccine distribution across Lake Chilwa in the Zomba region of Malawi. Over one week in January 2022, by going door to door, visiting bars and cafes, and traveling across the lake to where people work, 180 people received Johnson & Johnson’s (J&J) Janssen vaccination and two children received the Pfizer vaccination. To boost COVID-19 vaccination numbers in Malawi, ONSE, the Ministry of Health, and other partners embarked on a campaign to deliver vaccinations to people where they live and work. The campaign, called “Finish a Vial,” was effective in delivering vaccinations in rural and hard-to-reach areas. 

The campaign focused on delivering the J&J Janssen vaccine because it can be stored using conventional vaccine storage conditions, which allows for easy distribution in rural and hard-to-reach areas, and it requires only one dose to be effective. Lake Chilwa’s population of 11,973 is spread across many islands, but only Chisi Island has a clinic and a nurse. This deprives much of the population of critical essential health care services. Many residents in this area either fish for a living or work in the fishing industry and cannot visit a health clinic because of the demands of their work. Also, a lack of reliable transportation, a low literacy rate, and vaccine resistance contributed to low vaccination rates (20%) in the Lake Chilwa area. 

ONSE worked with Health Surveillance Assistants (HSAs) to bring COVID-19 information and vaccine services closer to the people living and working in and around Lake Chilwa. The HSAs visited homes, places of work, social gathering places, and even boats in the middle of the lake.  

Wiskesi Moyenda Chisale, who fishes at Thongwe, received his J&J Janssen shot on the lake as he was working. “I am very happy getting vaccinated today. I will not have the hassle of looking for a vaccine again.” 

“I am very happy getting vaccinated today. I will not have the hassle of looking for a vaccine again.”

Wiskesi Moyenda Chisale