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The reasons South Africa’s Covid-19 vaccine programme looks bleak

The economic cost of the pandemic is evident on the streets and healthcare facilities have been under considerable strain during the waves of the pandemic.
Image: Deaan Vivier/Beeld/Gallo Images via Getty Images

South Africa has the highest number of Covid-19 cases on the African continent. It has more than 50 000 reported deaths. This may be an underestimate, looking at excess death statistics. The economic cost of the pandemic is evident on the streets and healthcare facilities have been under considerable strain during the waves of the pandemic.

It was with much relief, elation and a renewed sense of hope that many healthcare workers enrolled in the Johnson and Johnson vaccination trial mid-February and received their much-anticipated vaccination.

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But the relief and elation has given way to frustration and disillusionment. The country’s rollout is proceeding at a pace much slower than expected.

To date just over 293 000 South Africans have had received their jab, which represents only a fraction of the 1.25 million healthcare workers who are first in line. This adds up to about 0.5% of the general population. The initial target of having 67% of the country’s citizens vaccinated by the end of 2021 is now unlikely to be achieved.

The new rollout plan promises to vaccinate 1.5 million by the end of May 2021. Phase 2 is set to happen between May and October 2021 with the aim of an additional 13 million vaccinated in that time frame.

Several factors have contributed to South Africa’s halting start. 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.

At the current vaccination pace it will take over a decade for South Africa to reach herd immunity, with many lives lost along the way.

Vaccine hiccups

The biggest challenge has been access. Like other developing countries, South Africa has really struggled to get doses.

The WHO director, Tedros Adhanom Ghebreyesus, put it succinctly when he said:

Even as they speak the language of equitable access, some countries and companies continue to prioritise bilateral deals, … driving up prices and attempting to jump to the front of the queue. This is wrong.

Ghebreyesus was referring to the fact that developing country governments have procured and hoarded vaccines for their own populations. Even before many of the Covid-19 vaccines had received final approval, some countries had procured several million doses of those that held promise.

An additional factor was South Africa’s slow start. The government has been criticised for not actively engaging in vaccine procurement through other avenues at an earlier stage. By mid-January 2021 the country’s participation in the COVAX vaccine scheme only secured enough doses for around 10% of the population.

On top of this, there has been a series of problems with vaccines South Africa managed to secure. And the evolution of new variants and uncertainties around the efficacy of vaccines to emerging variants has slowed the country’s efforts to overcome this pandemic through prevention.

For example, the planned rollout of the Oxford University-AstraZeneca vaccine from the Serum Institute of India was abruptly halted when locally generated data showed decreased efficacy against the B.1.351 variant first identified in the country.

Then the Johnson and Johnson hit a roadblock. The rollout was recently halted following the FDA-mandated suspension of its use in the US. This has posed another challenge to vaccination efforts. The halt spoke to safety concerns and allowed the South African Health Products Regulatory Authority to evaluate the scientific evidence and establish appropriate risk to benefit ratios. Last week, it was announced that the Johnson and Johnson rollout would be allowed to resume.

Another big issue that is likely to slow down the momentum of the country’s vaccination programme is vaccine mistrust. In a survey done by the University of Johannesburg, up to a third of South Africans said that they would refuse a Covid-19 vaccine if it was offered to them.

This could be echoing a deterioration in trust in the handling of the pandemic as a whole.

Misinformation, exaggeration and de-contextualisation of facts on various social media platforms have led to a large degree of vaccine mistrust among people. Aside from conspiracy theories and grossly inaccurate misrepresentations of facts, there is an increasing mistrust in science, pharmaceutical companies and authorities.

The road ahead

Balancing efficacy, safety, storage requirements and sustainability when it comes to vaccine selection is no easy task. But some countries have managed it better than others.

South Africa is one of the countries that is lagging far behind.

The human and economic cost of passively allowing the pandemic to run its course in an era where vaccines are available is unacceptable. In addition, the emergence of variants is a compelling reason to step up vaccination efforts. Suboptimal levels of immunity will mean more people get ill and die. It will also increase the likelihood new variants emerging.

The South African government needs to shift gear on a number of fronts.

It needs to make vaccine procurement a budget priority and procure more vaccines.

Secondly, it needs to clarify urgently what the requirements are for the involvement of private medical providers in the vaccine rollout. It also needs to expand the number of platforms (such as local clinics, GP practices, pharmacies, and private and state facilities) on which the vaccines are rolled out. If ever there was a need for public-private collaboration it is now – both in terms of funding vaccines and in providing platforms. This would enable large-scale vaccination to occur at the pace needed to turn the tide against Covid-19 in South Africa.

The government also needs to do more to raise public awareness and dispel myths at community level.

Clearly this will have to be a collaborative effort between all stakeholders – from international efforts for equity, to engagement by the pharmaceutical industry, procurement by government, the involvement of private sector players and widespread information and education of the general public.The Conversation

Veronica Ueckermann, Adjunct Professor: Department Internal Medicine, University of Pretoria

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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The real reason why the vaccine program situation is that dire in SA is due to the ANC and its corrupt Command Council.

The whole of the ANC should be prosecuted in the Hague by the ICC for crimes against humanity for the theft of the PPE monies as the TERS monies, let alone the theft of the non Covid-19 related monies.

People realize Covid is a “seasonal flu” and not one vaccine is approved and if it is not for the politicians/media propaganda and marketing of Covid, the public would not even worry about it. Politicians and various health officials got paid to create the “plandemic”. Hopefully these bad guys will face military courts one day and hopefully it will be the end of this plandemic.

The best jab(“vaccine”) out there is the Sputnik(as this is based on practical approach for similar viruses, but Bill Gates /Fauci/Schuab and others behind this, don’t have shares in Pfizer/Moderna

Agree. Those that have injections for this (more severe than average) seasonal flu are basically unwitting volunteers and do so at their own risk. The public are being used for the stage 3 of the testing protocol that is legislated. The related law has been suspended by emergency declaration. The same reduction of symptoms efficacy is available over the pharmacists counter from a variety of prophylactics with no risk. I surmise that this choice is evidently far less profitable and has fewer intermediaries seeking profit. Those that are vulnerable to severe effects are from the same groups as usual. The average age of death by Covid in England and Wales has been determined from official data by the ukcolumn group to be the same as the average age of death from all causes. Such analysis of official data is clearly seen as not being propaganda narrative friendly and the truth is avoided by the fear mongering system as if it is a threat to human existence.

The sole reason is that we have an inept government.

Israel is not a “rich” country hoarding vaccines.

They merely planned ahead and have vaccinated at least 55% of their total population.

Because of an inept government??????????????????????????

Israel’s success with the vaccination rollout is due to the fact that smart people can do smart things. The local disaster is due to the fact that it is impossible for stupid fools to do smart things. Money and “health inequality” are not the issue, human material and the inequality in mental capacity are the roots of the problem.

The vaccine process in South Africa is a political one, and our leading politicians have proven their mental capacity as it reflects in the disastrous Debt/GDP, unemployment, SOE and municipal bankruptcies, and social unrest.

We need to privatize the vaccination process to circumvent the sub-standard intellects in Luthuli House. Let Shoprite, Clicks, the mining companies, and farmers take control of the vaccination process and we will beat Israel.

100% combination of stupidity and just don’t give a dam. Oh, and the ANC must have total control to maximise looting, etc

It is fascinating to see south africa fail dismally, the moment it is required to engage in competition from an equal footing. The mere idea of competing from an equal base has been removed by BEE and AA, rationalized by “previous disadvantage”, with the ANC insisting on special treatment because, well, “it must be fair because we say so”. But the rest of humanity could not care less about your feelings, when securing their own survival and prosperity. This entire failure truly exposes the local inadequacy, and global hypocrisy, on such a grand scale.

The reason South Africa’s Covid-19 vaccine programme looks bleak: ANC.

My guess is the vaccine will be used as an October electioneering tool, a promise to voters that the ANC will at least pretend to keep.

Everything our beloved government touches or plans fails. They can’t even get a box of chocolate in a chocolate factory. They are pathetic.

I was a jackaroo in Western Australia, where I did my “apprenticeship” under a sheepdog called Bernie. The two of us had to fetch flocks of sheep, between 500 to 800 strong, over a distance of 15 km sometimes, and drive them to the yard where I, with the help of the dog, “needled” (inoculated) and “drenched”(anti-parasitic oral dose) them. Then we had to take the mob of sheep all the way back again. Over the span of 5 days we “vaccinated” 8000 sheep for pulpy kidney and tetanus and drenched them for tapeworm and wireworm.

The point is this – a group of 700 local farmers will be able to vaccinate the entire South African population in 1 month, with or without the help of a sheepdog.

Allow me to correct the first paragraph (*) for the discerning reader:

“South Africa has the highest number of Covid-19 cases on the African continent. It has more than 50 000 reported deaths. This may be an underestimate, looking at excess death statistics. *It may also be that the effects of the shutdown caused excess deaths that have been falsely attributed to the virus*. The economic cost of the pandemic (*not due to the pandemic, due to the draconian lockdowns*) is evident on the streets and healthcare facilities have been under considerable strain during the waves of the pandemic (*public healthcare facilities are always under strain due to mismanagement of funds – don’t blame a virus for that*).”

This whole overreaction has caused so much misery. We made it through the second wave (thankfully) and are now back to normal. People are going about their lives and the virus is not spreading. There may be a seasonal 3rd wave in June/July, but there’s no point destroying the economy now while we wait. When it arrives we can adapt again, as humans have always done. People will weigh their own risks – we all know the dangers now. Let people make their own choices if earning an income is more important to them and their families than avoiding a virus that most of the population would barely notice catching. People at risk can take additional voluntary precautions, as always.

Incidental that deaths and cases peaked when the WHO advised to down-cycle the PCR tests, and incidentally at the same time vaccines became available.

End of comments.

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