South Africa Finally Starts Vaccinating Elderly Despite Severe Vaccine Shortages Health Systems 17/05/2021 • Kerry Cullinan Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) South Africa’s Health Minister Zweli Mkhize announced the official start of the country’s vaccine programme when people over the age of 60 will get vaccinated. CAPE TOWN- South Africa finally started to vaccinate people over the age of 60 on Monday, but it’s roll-out is being severely hampered by a hold-up in the verification of millions of Johnson & Johnson (J&J) vaccines by the US Food and Drug Administration (FDA). Although Monday marks the official start of the country’s vaccination programme, in the preceding weeks it had vaccinated 478,000 of its approximately 1.2 million health workers as part of a programme dubbed the Sisonke “implementation study” to get around the fact that the J&J vaccine was not registered when vaccinations started. Initially, South Africa had planned to use AstraZeneca vaccines it had purchased from the Serum Institute of India but changed its mind and opted to use only the Pfizer and J&J vaccines after the publication of a small study that showed AstraZeneca’s vaccine had markedly lower efficacy in protecting people against mild and moderate infection with the B1.351 variant dominant in the country. “The worst thing would have been to start a vaccination programme with vaccines and then say to the population, ‘we are sorry but the vaccine that you had is not going to protect you because our variant is able to escape that’. So we’re taking that cautious approach and that’s the reason for the pace that we’ve moved at,” Anban Pillay, Deputy Director General of Health, told a meeting of the Government Employees Medical Scheme (GEMS) last week. Only Pfizer Doses Currently Available in South Africa A healthcare worker receives his COVID-19 vaccine jab during the implementation phase of South Africa’s vaccination drive. Currently, the country only has 975,780 of the two-dose Pfizer vaccines for its adult population of 40 million. This phase, consisting first of those over the age of 60 then later essential workers and those working in congregate setting is targeting 16.6 million people. At this stage, though, give the dire shortage, urban health workers and residents of old age homes are likely to be the only ones who will get vaccinated during the first few weeks. Meanwhile, 1.1 million J&J vaccines are sitting inside the country at the warehouse of Aspen Pharmacare, a local pharmaceutical manufacturer which has been contracted to “fill and finish” millions of J&J vaccines globally. In an address on national television on Sunday evening, Health Minister Zweli Mkhize said that he was waiting for the US FDA to release these. The hold on J&J vaccine stems from problems at the Bayview manufacturing plant of Emergent BioSolutions in the US, which was also manufacturing AstraZeneca vaccines. The FDA requested the plant to halt production on 16 April after it identified a number of problems including the cross-contamination of the two vaccines. This has led to the destruction of 15 million vaccine doses. According to an agreement filed three days later, “at the request of the FDA, Emergent agreed not to initiate the manufacturing of any new material at its Bayview facility and to quarantine existing material manufactured at the Bayview facility pending completion of the inspection and remediation of any resulting findings”. Vaccine Nationalism ‘Unravels’ Equitable Access Stavrou Nicolaou, Aspen’s head of Strategic Trade, told the GEMS meeting that the country was hoping for “good news” about the release of the J&J vaccines during the course of the week. “J&J has committed to an initial 1.1 million with another 900,000 doses at the end of this month (May),” said Nicolaou, who also chairs Business for South Africa (B4SA), a huge private sector initiative to assist the public roll-out. The pause on J&J vaccine deliveries means that vaccinations in rural areas will not get off the ground as the Pfizer vaccines need to be stored at temperatures of minus 20C, meaning and only urban areas have such storage facilities. During May, Pfizer is delivering 325,260 doses every week and this will increase to 636,480 in June, while another 1.4m doses are expected from COVAX. “By the end of June, we should have 4.5m Pfizer doses and 2 million J&J,” Mkhize said on Sunday. According to Nicolaou, the country has secured enough vaccines to cover 45 million people by the end of the first quarter of 2022. “This is very complex and, in terms of scale, the largest public initiative that our country has ever embarked on,” said Nicolaou. “We’ve analysed the [vaccine] delivery schedule against the vaccination capacity, understanding that it will be slow initially, and we believe we will be able to start peaking at that 260,000 vaccines a day from July,” he said. However, Nicolaou added that “vaccine nationalism” had “unravelled” concepts such as equal distribution and placed “a particularly sharp focus on building local capacities and local capabilities – basically becoming self-dependent”. In order to get the vaccines, people aged over 60 have been asked to register on an online electronic vaccination data system (EVDS) and wait for an SMS to notify them about when and where they will be vaccinated. But by Sunday night less than a quarter of the 5 million eligible people had registered, and no one had yet been sent SMS notifications of their appointments. The government has since set up a helpline to enable people to register by phone, but Pillay said he envisaged that, as the vaccine supplies picked up, facilities would allow “walk-ins”.“The first few days will start slowly as vaccinators get used to the process. It will take a few days to iron out teething problems,” warned Mkhize. However, the country’s biggest teething problem is a dire shortage of vaccines. Image Credits: GCIS, WHO African Region . Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.