Last-mile delivery increases vaccine uptake in Sierra Leone

Niccolò F. Meriggi*, Maarten Voors, Madison Levine, Vasudha Ramakrishna, Desmond Maada Kangbai, Michael Rozelle, Ella Tyler, Sellu Kallon, Junisa Nabieu, Sarah Cundy, Ahmed Mushfiq Mobarak*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)


Less than 30% of people in Africa received a dose of the COVID-19 vaccine even 18 months after vaccine development1. Here, motivated by the observation that residents of remote, rural areas of Sierra Leone faced severe access difficulties2, we conducted an intervention with last-mile delivery of doses and health professionals to the most inaccessible areas, along with community mobilization. A cluster randomized controlled trial in 150 communities showed that this intervention with mobile vaccination teams increased the immunization rate by about 26 percentage points within 48–72 h. Moreover, auxiliary populations visited our community vaccination points, which more than doubled the number of inoculations administered. The additional people vaccinated per intervention site translated to an implementation cost of US $33 per person vaccinated. Transportation to reach remote villages accounted for a large share of total intervention costs. Therefore, bundling multiple maternal and child health interventions in the same visit would further reduce costs per person treated. Current research on vaccine delivery maintains a large focus on individual behavioural issues such as hesitancy. Our study demonstrates that prioritizing mobile services to overcome access difficulties faced by remote populations in developing countries can generate increased returns in terms of uptake of health services3.

Original languageEnglish
Pages (from-to)612-619
Number of pages8
Issue number8004
Publication statusPublished - 21 Mar 2024


Dive into the research topics of 'Last-mile delivery increases vaccine uptake in Sierra Leone'. Together they form a unique fingerprint.

Cite this