Government doesn’t really have a vaccine roll-out plan

South Africa’s readiness to rollout vaccines to the general public has been called into question as it appears even though it is currently in its first phase earmarked for healthcare workers, government is essentially still overseeing trial-phase roll-outs of the AstraZeneca and Johnson and Johnson vaccine.

To Professor Alex van den Heever, head of the Wits School of Governance, these were some of the many signals that South Africa was nowhere near having a concrete roll-out plan for the general public. Delays caused by supposed uncertainty on how the South African mutation of Covid-19 may be affected by different vaccines have only served as veil for government’s lack of preparedness despite South Africa approaching a year under lock down.

ALSO READ: Vaccine roll-out raised real world questions

Last week, President Cyril Ramaphosa and his deputy David Mabuza publicly received doses of the J&J vaccine despite the vaccines only being approved for trial purposes and earmarked for healthcare workers only.

The South African Health Products Regulatory Authority (Sahprah) later issued a clarification on this saying it had approved the protocol amendment of the J&J implementation study targeted at Health Care Workers (HCW) to include the two statesmen. Whilst they are not classified as healthcare workers, Sahprah CEO Dr Boitumelo Semete-Makokotlela said this initiative would assist greatly in encouraging vaccine uptake and reduce vaccine hesitancy.

Taking the vaccine was quick, easy and not so painful. I urge all our healthcare workers to register to receive their vaccinations as they are our first line of defence against the coronavirus pandemic. #WeChooseVacciNation #VaccineforSouthAfrica ???????? pic.twitter.com/11tyl1f9Xs

— Cyril Ramaphosa ???????? #StaySafe (@CyrilRamaphosa) February 17, 2021

The roll-out of the Astra-Zeneca vaccine was temporarily paused and down-graded to a tightly controlled trial roll-out after it turned out the vaccine was notably less effective in preventing severe Covid-19 disease among those infected with the 501Y.V2 virus strain which was currently dominant in the second wave of infections in South Africa.

ALSO READ: WHO defends SA over halt of AstraZeneca vaccine roll-out

Constant delays meant to buy time

At the same time, the Democratic Alliance decried having had to approach the courts before the government finally made public its roll-out plan and strategy following months of campaigning for more transparency, a call joined by unions and civil society organisations.

“The long delay and the bungles so far, especially as far as the Astra Zeneca vaccine from India is concerned (which will expire before the second dose can be administered) is indicative of the extent to which oversight is necessary to hold this government accountable. The same applies to the release of the vaccine strategy and roll-out plan,” said DA leader John Steenhuisen. Tomorrow the National Assembly is expected to debate COVID-19 vaccination plan for South Africa.

That the roll-out of the J&J vaccine began within 24 hours of its arrival also brought into question why the AstraZeneca vaccine was supposedly going to take two weeks before reaching its intended recipients.

“Note the time difference between when the plane arrived with the J&J vaccines and the first dose being administered. It was within 24 hours. Yet when theAstraZeneca vaccine arrived they said they were taking it to Bloemfontein for testing for 14 days to do quality checks. What was that? That was because they had no roll-out plan. It was just a delay tactic,” said Van den Heever.

“One can’t say that this is the formal roll-out because it can’t be. It is a very restricted roll-out until the Sahprah approval occurs for Johnson & Johnson, so it’s really only approved by Sahprah at this stage for trial purposes. I assume that will happen quite soon, then the general roll-out can begin.”

Since the roll-out is in a trial phase, the vaccination sites are limited, he pointed out, causing a bottleneck in some places as both private and public healthcare workers scramble to get the jab.

Healthcare workers are two sites in Gauteng had to go home without getting their shots on Sunday, due to chaos in the delivering of the vaccines.

A screenshot of the message delivered to some hopeful healthcare practitioners, who could not get vaccinated on Sunday, due to logistical issues at the rollout sites.

Healthcare workers from several government hospitals are also apparently clueless about how to go about getting vaccinated.

According to complaints from some, they have had no indication from the department of health on how to get jabbed, while some claim to have been rejected as not being valid candidates. A doctor at one hospital on Gauteng’s West Rand said she had received a message rejecting her as a candidate for the vaccine, despite her working in the emergency department of one of the biggest hospitals in Johannesburg.

She questioned whether the department was capable of managing a proper vaccine rollout, saying her hospital’s Covid-19 committee has not received any updates on how their staff should register or sign up for the vaccines.

How do the available vaccines  fair against the South African Covid-19 strain 501.Y

Two vaccines developed in China, one from pharmaceutical company Sinopharm and another government funded vaccine called NovaVax were found to have a weaker effect on the South African variant of Covid-19.

According to the research paper on the two vaccines, twelve serum samples each taken from recipients of two vaccines developed by a subsidiary of China National Pharmaceutical Group (Sinopharm) and a unit of Chongqing Zhifei Biological Products retained neutralising activity against the South African variant. But according to the paper,  which had yet to be peer-reviewed the samples’ activity against the variant was weaker than against the original virus and the South African variant.

Weeks before a Wits university trial on the AstraZeneca came out with similar results showing a weakened efficacy against the South African variant, although it was over 80% efficient for preventing severe Covid-19 disease of the original strain of the virus.

Van den Heever shares the opinion of some critics who have brought to question the efficacy of the vaccines coming out of China and Russia, citing a heightened risk that government interference into scientific research on those vaccines may compromise their reliability.

“Some of the vaccines that are available such as the Sputnik V and the Novavax and Sinopharm in China is kind of because they are being pushed  by those countries and there is no test data to show that they would be efficatious in the South African context,” he said.

“So there is an issue there about the independence of the data that has come out although there have been studies that have come out about the Sputnik V vaccine in  The Lancet.” The study, which was sponsored entirely by Russian government entities  showed 91·6% efficacy against COVID-19 and was well tolerated in a large cohort.

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