Queue jumping favours the rich in SA’s slow vaccine rollout

Poor and uninsured South Africans are being sidelined in favour of the privileged few who can jump the queue in the Covid-19 vaccine roll-out, says a researcher.

The South African Federation of Trade Unions (Saftu) has accused the government of misrepresenting the pace of the vaccine rollout, saying the health department was bungling its own plan because of incompetence. The federation says claims that 1.3 million people have been vaccinated appear to be a vast overestimation.

The system is rigged

Professor Kate Alexander, a University of Johannesburg sociologist conducting research into the vaccine rollout, says the government appears to have inadvertently rigged the rollout plan against those who live in poor areas, those who are uninsured and those who don’t have the technology required to be registered.

Now it appears walk-ins are an emerging area of the process where the privileged are favoured thanks to the government’s guidelines for this scenario.

Also Read: SA more than three times slower than Zimbabwe with its vaccine rollout

According to a June 4 2021 circular from the Department of Health, director-general Dr Sandile Buthelezi said although walk-ins are allowed, private sites are warned that the department would not pay for uninsured walk-ins. These individuals are to be referred to public sites.

Insured individuals are, however, allowed to get a free vaccine at government vaccination sites. Alexander says this is yet another way the poor are being slighted in the Covid-19 pandemic response.

According to the circular:

• All individuals with scheduled appointments must be given priority over unscheduled “walk-ins”.
• Site managers must ensure they have sufficient stock to vaccinate those scheduled for vaccination at their site before they open for walk-ins.
• If a walk-in is not yet registered on the Electronic Vaccination Data System (EVDS), they will need to be registered on the EVDS at the site before they can be vaccinated.
• Public sector sites may accept walk-ins over 60 at their own discretion – subject to the above conditions. Private sector sites conditionally may accept insured walk-ins over 60 at their own discretion.
• The only exception to the rule on uninsured walk-ins at private sites are people over the age of 80, which is not expected to exceed 5% of the private sector site’s vaccine allocation.

There is also institutional discrimination, Alexander argues.

“If people are insured, that is, covered by medical aid, they can get a walk-in vaccination at a private or public site, but if they are not insured they can only go to a public site. Because some provinces are encouraging walk-ins and because there is a shortage of public sites in particular, this difference is significant.”

Discrimination works in other ways too. The EVDS only uses English, many poorer people do not have a smart phone and some even lack a simple mobile phone, while many complain about inadequate information.

Also Read: Russia wanted to donate 15m vaccines to SA, worth R2bn, but we said ‘no thanks’ – report

Next phase of rollout could possibly only start in August

Of the around 3.2 million people registered on the EVDS system, 1.1 million have reportedly been vaccinated against Covid-19 at a rate of 350,000 a week. The government has promised to double this pace, which would bring it to around 700,000 vaccinations a week.

Alexander estimates it could take three weeks to clear the queue at the promised pace. Even with this wishful thinking, the government could only begin vaccinating those under 60 in August, she concludes.

South Africa’s 450,000 teachers are expected to be vaccinated by the end of June, with Johnson & Johnson doses expected to expire on 28 June.

By this time it would probably be time for those who have had their first Pfizer jab to get their second dosesat the end of  July.

“You’re not going to have dealt with everybody over 60 by the end of July. We are only going to get to the people under the age of 60 with exceptions such as teachers in August at the earliest,” Alexander said

Saftu secretary-general Zwelinzima Vavi says the roll-out is already far from where it should be. This has been exacerbated by the halting of Johnson & Johnson vaccine distribution two weeks ago due to the contamination of a plant in Baltimore.

The matter is being investigated by the US Food and Drug Administration (FDA). The debacle led to the halting of 500,000 doses of the same vaccine produced in South Africa, thus making the Pfizer vaccine the only available drug for inoculation.

“Because Pfizer requires two doses to constitute a complete vaccination, the 900,000 vaccinations administered through Pfizer are incomplete. This means we are dismally lagging behind where we should be,” says Vavi.