South Africa may have to take a mix-and-match approach to its vaccinne rollout strategy, with three vaccines currently leading the race, each with its own benefits and drawbacks.
Government would most likely choose one of the AstraZeneca, Johnson & Johnson, or Pfizer/BioNTech jabs for rollout in the country in the second quarter of the year, with each of the three having its own benefits and drawbacks.
While the Pfizer/BioNTech vaccine, with a 95% efficacy is the most effective, it is somewhat unsuitable for a mass inoculation drive locally, due to requiring storage at minus 70 degrees Celsius. This is the vaccine variant currently being rolled out in the United Kingdom.
Despite South Africa’s limited deep refrigeration storage capacity of only two sites, a medical expert on Tuesday said these facilities could be used to vaccinate frontline healthcare workers, if the country could get hold of this vaccine, while waiting for access to other options.
“Although requiring an ultra-low cold temperature refrigeration capacity, the Pfizer vaccine can work, should there be a smart distribution strategy to get health-workers around the country inoculated from the two sites – in just two hours,” said Dr Aslam Dasoo, convenor for the Progressive Health Forum.
“If we get access to the Pfizer vaccine, we should get enough to inoculate the health-worker cohort, who must be vaccinated quickly. We are losing many health-workers through illness, infection, and death at a rapid rate, which has implications for the health system.
“If that collapses, it will be bad for the country. It is important that they get vaccinated as fast as possible, so that they can work without fear – keeping the system stable.”
Experts have found that the AstraZeneca vaccine and Johnson & Johnson, would be most suitable for mass inoculation in South Africa.
Dasoo said: “The candidate that seems to suit our condition in terms of infrastructure, delivery, rollout, efficacy and safety, would be the AstraZeneca vaccine and perhaps the Johnson and Johnson one.
“The AstraZeneca vaccine requires two doses, making it a logistical nightmare. Within 275 days, AstraZeneca requires being doubled, because you need to have two shots of that.
“The one jab Johnson & Johnson vaccine may be okay. AstraZeneca and Johnson & Johnson is your answer for now in reaching many people, while there are many more vaccines coming on line – but not yet registered.”
Professor Glenda Gray of the SA Medical Research Council, said the country required a range of vaccines, with those requiring an ultra-low cold temperature, being used in urban areas and “those requiring less cold storage, delivered in rural areas”.
“You would not use a minus 70 degrees vaccine in an area without a deep refrigeration capacity,” said Gray.
University of Cape Town professor Heather Zar, of the department of paediatrics and child health at the Red Cross Children’s Hospital, said: “The problem with the Pfizer vaccine is the ultra-low cold temperature that is required.
“The two-dose AstraZeneca vaccine is the only approved one and would be suitable for South Africa, especially considering that the trials were done here. We also hear that the Serum Institute of India is producing billions of doses of this vaccine at low cost – so it may be procurable.
“On the Johnson & Johnson vaccine, people are all waiting for the results to be released – hopefully later this month.
“This would be an advantage to South Africa because it is a single dose rather than a two-doses – not requiring a freezer.
“With some countries having gone for more than one vaccine, it may not be a matter of one size fits all.
“If our priority is to safely vaccinate our healthcare workers through this second-wave pandemic, the AstraZeneca vaccine is probably the best option.
“But if we could get the Pfizer vaccine, why not, for healthcare workers?
“We need a less rigid approach to this.”
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