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This paper summarises trends in SARS-CoV-2 infections among CA, compare COVID-19 vaccination patterns in Africa to more developed parts of the world, and discuss some of the benefits, challenges and unknowns associated with vaccinating CA for COVID-19. In light of situational realties related to COVID-19 vaccine availability and the current progress that the African continent has made towards vaccinating the adult population against COVID-19, we conclude by offering recommendations for a vaccination roll-out strategy in Africa.

Findings:

• African countries need to free up capacity to prioritise COVID-19 vaccines for children and adolescents (CA) by accelerating vaccinations in the adult population through early 2022.

• Countries throughout Africa should consider offering COVID-19 vaccines to CA who are at increased risk of severe illness from the disease, with subsequent roll-out efforts focusing initially on older and school-going CA.

• Effective collaboration between global partners (eg, humanitarian agencies, high-income countries) and African countries is needed to ensure equitable access to COVID-19 vaccines and assist with improving vaccination roll-out infrastructure for the administration of COVID-19 vaccines in Africa.

• More data are required to develop a better understanding of the safe and effective use of COVID-19 vaccines in children younger than 12 years of age, particularly among those who are living with chronic and life-threatening medical conditions that are particularly prevalent in Africa.