Gaps in vaccine clinical trials in Africa: A mixed scoping review and bibliometric analysis before, during, and post- COVID-19 pandemic.

Africa's participation in vaccine trials has historically been limited, but the COVID-19 pandemic highlighted the need for greater involvement. This study explores vaccine clinical development in Africa, emphasizing its importance for global health security. Using a scoping review and bibliometric analysis, we examined 662 vaccine trials conducted before, during, and after the pandemic. The analysis revealed a significant increase in vaccine trials after 2018 and particularly following the end of the COVID-19 pandemic in May 2023. Most trials focused on viral infections and were single-country studies. Pharmaceutical company sponsors funded most of the earlier trials, with increased government and academic involvement post-2020. Despite progress, challenges remain in the geographic distribution of trials, the number of government-supported studies, and the diversity of conditions studied. Addressing these gaps is crucial to bolstering Africa's role in global vaccine development.