Vaccinating the globe: Workers on the Covid-19 vaccine production line at the Serum Institute of India in Pune. The factory is making the Oxford-AstraZeneca vaccination. Photo: Dhiraj Singh/Bloomberg/Getty Images
As South Africa deploys heavy security to prevent theft from the precious first batch of 1.5-million Covid-19 vaccine doses intended for vital frontline healthcare workers, it has emerged that the vaccines will not go to “hotspot” facilities first.
Instead, they will be distributed across provinces simultaneously after they land at OR Tambo international airport from India’s Serum Institute in the next few days, with delivery promised by Monday, according to department of health spokesperson Popo Maja.
The security contingent guarding the first vaccine batch’s transport to a secret central depot in the Gauteng area will probably be akin to that afforded a foreign head of state.
Maja said South Africa was drawing heavily on the vaccine-rollout experience of other countries, adding that whenever consignments were transported, and wherever they were stored, security would be top of mind.
“We have to guard against criminality and corruption. We’ve learnt our lessons from the corruption we encountered with the personal protective equipment for healthcare workers. We don’t want a repeat, especially with something as vital as this,” he said.
“Also, we’re prioritising healthcare workers wherever they may be — not by hotspots … [The vaccines] will first go to a central base and, once all the regulatory protocols are completed, to the provinces,” Maja added.
Even with South Africa’s second infection peak slowly waning, both the private and public healthcare sectors remain under enormous pressure, with intensive care units full, wards almost at capacity and healthcare workers fast burning out.
Grilled about the rushed attempt to bolster the country’s historically underfunded and thin adult immunisation network, Maja said President Cyril Ramaphosa and Health Minister Dr Zweli Mkhize had assured that “money should not be a problem”.
“Covid has made us all realise, in public and in private, that we need a health system that tends to the needs of all our people, regardless of their socioeconomic status,” he said.
Covid-19 vaccine researcher and government adviser Professor Shabir Madhi, from the University of the Witwatersrand, said South Africa has among the lowest vaccine coverage rates and is among the top 10 countries with the most under-immunised children globally, performing worse than Uganda and Zimbabwe.
Madhi described Mkhize’s goal of sufficient Covid-19 vaccination to reach herd immunity by the end of the year as “unrealistic, if not impossible”.
Dr Lesley Bamford, who is overseeing the Covid-19 vaccine roll-out, confirmed that the first planning meeting of provincial department heads took place only on 8 January.
The impending vaccine rollout is the largest ever attempted in South Africa, and expert observers are sceptical about whether the country will be ready with Eskom outage back-up plans, proper vaccination training, a strategy to overcome vaccination hesitancy, and the human resources necessary to effect the rollout.
However, Maja said that the Expanded Immunisation Programme would be “doubly expanded now,” and the lessons learned from that programme, plus a partnership with the private sector, would ensure a successful response.
“Our colleagues are working flat out to ensure this happens … We’re putting together online manuals, training, social-mobilisation programmes, reallocating staff, a quality-assurance team — we’re scaling up wherever we can,” he said.
Vaccination would begin with frontline healthcare workers (1.25-million), then move to essential workers (2.5-million), people in congregate settings (1.1-million) and people older than 60 years (5-million), before moving on to larger groups at a lower risk.
Janine Simon-Meyer, a South African organiser for UN children’s agency Unicef, told the health department’s stakeholder cyber briefing last week that there was “a lot of concern and a big gap around understanding what healthcare workers think and feel about the vaccine and the rollout”.
A snap cyber survey has been designed and is available on the Internet of Good Things (Which in many countries, including South Africa, does not incur data charges for visitors).
The survey aims to establish the potential effect of vaccination hesitancy on training, implementation, and vaccine uptake by healthcare workers.
A Human Sciences Research Council survey conducted early this month found that up to 18% of all South Africans would “definitely or probably not take the vaccine” and 15% “didn’t know if they would”.
Simon-Meyer said the intention was to have all vaccinators trained by 3 February and all frontline workers vaccinated by the end of the month. She said the cyber attitudinal survey would provide crucial preliminary behaviour-change data.
Dr Pradaruth Ramlachan, the director of the Newkwa Health and Wellness Centre in Newlands, Durban, last week told a Discovery Health webinar that the 30% positivity rate for Covid-19 tests in South Africa’s second wave was six times higher than the level at which the World Health Organisation determined a red flag warning.
Ramlachan said poor access to hospital beds and a paucity of facilities and equipment were taking healthcare practitioners to their limits, with drug and ventilator shortages forcing them to decide who died and who lived. Added to this was the constant fear of their own infection and death.
This week, the South African Health Products Regulatory Authority also announced the green light for patients to take Ivermectin to treat Covid-19.
The regulators’s chief executive, Dr Boitumelo Semete-Makokotlela, said there was not enough data for the body to give full authorisation of the drug for human use.
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