South Africa under pressure in race to vaccinate older people

Slow start to rollout blamed for country being unlikely to meet Covid innoculation goals

Elderly residents at the Evanna Tehuis nursing home near Klerksdorp await their turn for the  Pfizer vaccine. Photograph:  Michele Spatari/AFP via Getty Images
Elderly residents at the Evanna Tehuis nursing home near Klerksdorp await their turn for the Pfizer vaccine. Photograph: Michele Spatari/AFP via Getty Images

South Africa has admitted it is unlikely to meet its Covid-19 vaccination targets after a sluggish start to its rollout.

The country is in a race against time to inoculate older people before the southern hemisphere’s winter and an anticipated third wave of the pandemic hit the country in the next few weeks.

President Cyril Ramaphosa’s African National Congress-led government has struggled to roll out an effective vaccination programme due to a range of challenges, including access to supplies.

South Africa has a limited amount of Pfizer vaccines available to it, and there have been delays in getting alternative shots, specifically the Johnson & Johnson vaccine after production was halted at a plant in the US over a contamination issue.

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Roughly 11,000 South Africans received their first shots of the Pfizer vaccine on Monday last, when phase of the country’s rollout was launched. Of the more than 3,000 promised vaccination sites, only 87 were operational that first day.

The number of vaccinated people had jumped to 39,371 by the end of Tuesday, after 13 more vaccination sites were brought online.

Vaccination centres nationwide are expected to increase to 200 by the end of next week and further facilities will be added as the programme speeds up, according to health minister Zwelie Mkhize.

The pace of the vaccination plan’s overall rollout to date has been heavily criticised by some health experts, and South Africa’s main opposition party has called it “slow and shambolic”.

Democratic Alliance leader John Steenhuisen said that no detailed rollout programme had been published ahead of the vaccination programme's phase two.

‘Vulnerable public’

“What little information there is was communicated to the public piecemeal, in a last-minute presentation, as if government suddenly woke up yesterday morning and realised there is a vulnerable public out there anxious to know when they can get vaccinated,” Steenhuisen stated last Sunday.

The government’s aim is to inoculate up to five million elderly people by the end of June, but on Tuesday Mkhize said that the rollout target might not be met.

"Some provinces will meet their targets earlier than others. We are going to work hard to try and meet them," he told reporters in KwaZulu-Natal province during a vaccination site tour.

Responding to his critics, Mkhize said the government was working with the South African Social Security Agency and religious leaders to reach as many elderly people as possible, especially those in rural areas.

Overall health officials want to have vaccinated 16.5 million people in the country of nearly 60 million by late October, and more than 46 million by March next year.

However, if results from phase one of the government’s vaccine programme – which ran from mid-February to May 15th – are anything to go by, health officials may struggle to see their goals realised.

Using a local Johnson & Johnson vaccine trial as the vehicle to inoculate the country’s 1.25 million healthcare workers under phase one, only 479,000 people had received a shot by the time the initiative came to an end.

Sitting in the Covid-19 vaccination queue on May 18th at the Karl Bremer Hospital in Cape Town’s northern suburbs, maternity nurse Thandazile Sombo was one of those who declined to get vaccinated during the trial.

She explained it was the vaccine’s possible adverse side-effects that had made her initially hesitant to get the jab. “I was worried about how sick the vaccine would make me, so I kept putting it off,” she said, before adding, “but a third wave of Covid-19 is expected here soon, so I just decided it [getting vaccinated] is the right thing to do”.

Increase in cases

South Africa has reorded more than 1.6 million cases of coronavirus and in excess of 55,000 deaths. Over the past week all provinces have shown increases in Covid-19 cases. Nearly 600,000 vaccine doses have been administered.

In late April, Veronica Ueckermann a professor at the University of Pretoria's department of internal medicine wrote in the online academic journal, The Conversation, that several factors have contributed to South Africa's slow vaccine rollout to date.

“These include global health inequality, South Africa’s delay in joining the global race for procurement, delays in the rollout plan as well as uncertainty around efficacy and side effects of vaccines that were procured.

However, she maintained the biggest challenge has been access to vaccines. “Like other developing countries, South Africa has really struggled to get doses,” she said.