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SA’s vaccine roll-out explained: who will receive it and can you refuse it?

Picture: Pexels

Picture: Pexels

Published Jan 4, 2021


The focus of the Covid-19 pandemic has now shifted to governments around the world securing vaccine deals and how quickly they will be able to distribute them among their populations.

Within the first half of 2021 the Department of Health aims to have secured enough vaccines to distribute to over two-thirds of the South African population.

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Health Minister Zweli Mkhize revealed the country’s three phased Covid-19 vaccine rollout strategy on Sunday during a public online briefing.

Here’s what you need to know about vaccines in South Africa:

Who is first in line for the vaccine and when will it be available?

The Health Department aims to vaccinate around 40 million people by the end of the year. The vaccine rollout strategy will see three phases where healthcare workers will receive the jab first, followed by essential workers, the elderly and those with comorbidities.

“We have been advised that we should expect the vaccines in the second quarter of 2021. We have been in constant contact with Covax who have advised us that they are working very hard to bring the batches releases forward to quarter one,” said the department in an official document.

The three phased rollout which is likely to start in April will prioritise the most vulnerable groups in the South African population.

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Phase 1: Around 1.2 million front line healthcare workers.

Phase 2:

  • 2.5 million essential workers.
  • 1.1 million persons in congregate settings.
  • 5 million persons older than 60 years.
  • 9 million persons older than 18 years with co-morbidities.

Phase 3: Around 22.5 million other persons older than 18 years.

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Elsewhere, over 4.2 million Americans have already received their first shot of the Moderna and Pfizer/BioNTech vaccines, according to the Centers for Disease Control and Prevention.

Who are the vaccine suppliers?

The Department of Health and the Ministerial Advisory Committee have been in discussions with five potential vaccine suppliers, including: Pfizer, AstraZeneca, Johnson and Johnson, Moderna, and Cipla.

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South Africa is part of the Covax vaccine programme, the global initiative aimed at working with vaccine manufacturers to provide countries worldwide with equitable access to safe and effective vaccines.

Covax has focused on vaccines that can be stored at usual cold storage facilities.

How effective are the Covid-19 vaccines? Do they work?

Vaccines work by teaching the immune system to recognize and mount a defence against a virus. Mkhize said the aim of vaccination is to prevent ongoing transmission and to achieve herd immunity.

According to the Health Department, the Pfizer/BioNTech vaccine has shown to be 95% effective in protection against the virus. The biggest challenge with this vaccine option is that it needs to be stored at -70°C. South Africa only has a limited amount of commercial ultra low cold chain storage.

The AstraZeneca/University of Oxford Vaccine offers 70% protection against Covid-19. This vaccine is likely to be widely used around the world as it can be stored at 2-8°C, which is around fridge temperature and easier to store.

Can South Africans refuse a vaccine?

Vaccination is not compulsory in the country and people are entitled to refuse the jab according to the Health Department’s spokesperson, Popo Maja.

“What needs to be communicated clearly is that the vaccination is important for any health system. It prevents outbreaks of diseases that could be catastrophic to societies,” he said to IOL.

Conspiracy theories about the Covid-19 vaccine have been running rife from the time the vaccine was developed. Claims have circulated worldwide among anti-vaxxer groups which include theories that the vaccine will alter a person’s DNA and that microchips will be implanted after a person receives the jab.

Maja says only vaccines that have been licensed or authorised for use by the South African Health Products Regulatory Authority (SAHPRA) will be used.

“We will need to ensure citizens are informed clearly about the safety and all the safety monitoring that is in place for vaccines right from the trials through to the licensing and monitoring even after that,” he continued.

How much will it cost to vaccinate the targeted 67% of the population?

It would cost South Africa over R10 billion, to vaccinate the targeted 67% of the population to achieve herd immunity, said Wits University vaccinologist, Professor Shabir Madhi during an ENCA interview.

AstraZeneca and Johnson & Johnson vaccines are the more practical options for South Africa, he says, as they are more affordable.

Moderna and Pfizer were never going to be an option for South Africa, says Madhi. Moderna is a US funded vaccine; its vaccine is currently being distributed in Canada and the US.

The AstraZeneca vaccine is priced at no more than $3 (R43,69) a dose. The vaccine is designed for two injections four weeks apart.

Unlike some of the other vaccines, which require two doses a few weeks apart, the Johnson & Johnson vaccine may only require one dose at about $10 (R145,54).

How does the vaccine work?

The AstraZeneca vaccine is made up of another virus (of the adenovirus family) that has been modified to contain the gene for making the SARS-CoV-2 spike protein.

The adenovirus itself cannot reproduce and does not cause disease. Once it has been given, the vaccine delivers the SARS-CoV-2 gene into cells in the body. The cells will use the gene to produce the spike protein. The person’s immune system will treat this spike protein as foreign and produce natural defences − antibodies and T cells − against this protein.

If, later on, the vaccinated person comes into contact with SARS-CoV-2, the immune system will recognise the virus and be prepared to attack it: antibodies and T cells can work together to kill the virus, prevent its entry into the body’s cells and destroy infected cells, thus helping to protect against Covid-19.

The Johnson & Johnson vaccine uses the modified version of the virus to carry a gene from the coronavirus into the human cells. It then produces coronavirus proteins in the cells – but not the virus itself. This should help prime your immune system to attack the coronavirus when it enters your body.

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