COVID-19 vaccine roll-out in middle-income countries: Lessons learned from the Jordan experience.

Jordan is an upper-middle income country which was dramatically affected by two waves of COVID-19, the first wave in November 2020 and the second peaking mid-to-late March 2021. The country has developed its first National preparedness and response plan even before the first case of COVID-19 had been reported and has been being updating periodically. Similarly, Jordan has developed an effective plan for COVID-19 vaccine roll-out, thereby starting the registration to vaccination during late 2020. The aim of the vaccination program was changed from vaccinating 20% of the population to vaccinate over 5 million residents, corresponding to over 80% of the total population over the age of 18 years. Securing bilateral agreements and the ability to ensure additional vaccine supplies enabled the country to increase its vaccination target. Similar to equitable COVID-19 response in Jordan, COVID-19 vaccination plan includes all population, including refugees and migrants. 1.1. Strengthening existing immunization program The National Immunization Program (NIP) of Jordan is one of the most effective and successful public health programs which is highly trusted by the public. Country has reported immunization coverage rates over 90% for all vaccines during pre-COVID-19 period. A recent survey conducted by the World Bank reported that a country’s ability to roll out mass adult vaccination programs doesn’t depend on the existence of a well-functioning childhood immunization system [1]. This is evident through the recently established electronic registration, reporting, and monitoring system for COVID-19 vaccination. While childhood immunization is still relying on a paper-based vaccination electronic system, the COVID-19 vaccination data system is built on a solid electronic registration system, with minimal data entry.