HEALTH Minister Dr Zweli Mkhize, Deputy President David Mabuza and President Cyril Ramaphosa took delivery of the one million AstraZeneca vaccines on Monday. | Elmond Jiyane/GCIS
HEALTH Minister Dr Zweli Mkhize, Deputy President David Mabuza and President Cyril Ramaphosa took delivery of the one million AstraZeneca vaccines on Monday. | Elmond Jiyane/GCIS

Prof Madhi slams SA govt for exporting AstraZeneca vaccine instead of giving it to high-risk individuals

By Sihle Mlambo Time of article published Mar 23, 2021

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Johannesburg: Vaccinologist Professor Shabir Madhi has criticised the South African government for selling AstraZeneca vaccine to other African countries, saying the doses should have been given to people deemed ‘high risk’.

Madhi, who was speaking to Talk Radio 702 on Tuesday, said the more than one million doses, which had been bought from the Serum Institute of India, should have been used even though there was a study which said the vaccine was found to have a low efficacy for individuals with mild symptoms.

The one million AstraZeneca vaccine doses were the first vaccines to touch down in the country in January. They were expected to be rolled out to health workers, but the government announced that it had suspended the roll-out after a study found that the vaccine had a low efficacy against mild symptoms.

The government opted for the Johnson & Johnson vaccine, which it is currently rolling out to health workers under the Sisonke implementation study. It has secured over 43 million vaccine doses, which are expected to arrive in batches throughout the year.

Madhi said the AstraZeneca vaccines should have been rolled out to high-risk individuals as the vaccine would protect them against severe disease, even though a study found it offered minimal protect to mild and moderate Covid-19 cases.

“Unfortunately our vaccination programme has been largely disappointing when it comes to Covid-19. There have been a number of errors made.

“Even right now it does not appear that we have a coherent strategy when it comes to the roll out of Covid-19 vaccines.

“There is a complete form of contradiction in terms of how we are approaching it. As an example, over the weekend it seems we were celebrating the export of the AstraZeneca vaccine to other African countries and saying that we are not going to lose much money. But the reality is that the very same vaccine we are shipping out to other countries is the same vaccine Covax is making available to other African countries,” he said.

Madhi said the country’s focus regarding the Covid-19 battle was about reducing risk to high-risk people with co-morbidities, people over the age of 60 and minimising the number of people who die as a result of complications with the virus.

“Rather than use the vaccine that the World Health Organisation indicates would protect against severe disease, even with the B1513 variant, and instead of making it available to high-risk individuals, we uniquely decided to ship it out of the country,” he said.

Madhi said the focus on vaccinating 40 million people - which would be unlikely as he believed SA did not have a coherent logistical plan - was not the main issue. He said for South Africa, the main priority was to inoculate 17 to 20 million people deemed to be at high risk of severe disease, hospitalisation or death.

““The AstraZeneca will still protect against severe disease, even if it didn’t protect against mild and moderate cases, like the study in South Africa showed.

“Unfortunately the interpretation of the data in South Africa has been completely misguided.

“The AstraZeneca vaccine, for example, should not be rolled out to all health-care workers; it should be rolled out to people that are at high risk of developing severe disease.

“Your average 20 to 30 or 40-year-old health-care worker who will only develop mild symptoms when infected with the virus, those individuals are not going to benefit much from the AstraZeneca vaccine, or any other vaccine,” he said.

Madhi said if the 40 million vaccination target was achieved after a fourth wave, it would be less effective as the natural infection of people by then would have made vaccination a less urgent exercise. He said people should forget about the coronavirus disappearing in our lifetimes.

“What South Africa should be focusing on is rolling out vaccines as quickly as possible to high-risk individuals. What we need to avoid is the type of resurgence that we have experienced which results in large numbers of people ending up in hospital and large numbers of people dying.

“It is not about trying to get rid of the virus; that is not going to happen in our lifetime, let alone during the course of 2021.

“We need to recalibrate our thinking about Covid-19 vaccines and who needs to be targeted. It's too late to start vaccinating people after we go through four waves of the virus, because by then the amount of immunity in the population, just because of natural infection, probably won’t make vaccination that much of an urgent need.

“We need to recalibrate what we are doing and how quickly we can achieve that,” he said.

Madhi said he believed the vaccine roll-out to health workers under an implementation study was going well given that there were limited vaccine doses available, and because of the limited vaccination centres made available for the Sisonke Protocol.

The Health Department’s director-general, Dr Anban Pillay, who spoke earlier this month, said 11.6 million vaccine doses would be rolled out during Phase 2, commencing in May.

He said 2.5 million vaccine doses were reserved for essential workers, 1.1 million for people in congregate settings, five million for people over the age of 60, and eight million for people over 18 with co-morbidities.

During Phase 3, everybody would be free to get vaccinated.

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