To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (AH1N1 pdm09) to resource-constrained countries with otherwise very little access to the A(H1N1)pdm09 vaccine, the World Health Organization (WHO) coordinated distribution of donated vaccine to selected countries worldwide, including those in Africa. From February through November 2010, 32.2 million doses were delivered to 34 countries in Africa. Of the 19.2 million doses delivered to countries that reported their vaccination activities to WHO, 12.2 million doses (64%) were administered. Population coverage in these countries varied from 0.4% to 11%, with a median coverage of 4%. All countries targeted pregnant women (median proportion of all vaccine doses administered mpv, 21% range, 4%–72%) and healthcare workers (mpv, 9% range, 1%–73%). Fourteen of 19 countries targeted persons with chronic conditions (mpv, 26% range, 5%–66%) and 10 of 19 countries vaccinated children (mpv, 54% range, 17%–75%). Most vaccine was distributed after peak A(H1N1)pdm09 transmission in the region. The frequency and severity of adverse events were consistent with those recorded after other inactivated influenza vaccines. Pandemic preparedness plans will need to include strategies to ensure more-rapid procedures to identify vaccine supplies and distribute and import vaccines to countries that may bear the brunt of a future pandemic.