Cape Town - South Africa could have Covid-19 vaccines available within the first three months of next year, and the first people to receive it will likely be health-care workers at high risk for acquiring and transmitting the virus.
In addition, the government legally could compel people to take the vaccine against their personal choice - but this is unlikely to happen.
The Human Sciences Research Council hosted a dialogue on Friday to discuss the plan for rolling out a Covid-19 vaccine, including the progress so far and the challenges that lie ahead, as well as whether the vaccine should be compulsory when it’s available.
Dr Rajesh Narwal, health systems advisor for the World Health Organization (WHO) Africa, said that the urgency for a vaccine isn’t waning.
“The pandemic is just getting worse. Globally, there are close to 600 000 new cases a day per day, and close to 10 000 deaths happening every day. The curve is just going up.”
Two pharmaceutical companies have reported excellent results in vaccine trials so far, and it’s highly likely that a vaccine will be approved for emergency use next month.
“The first use vaccine could be by December in the high-income countries, but for the low- and middle-income countries, it’s pretty realistic to see the vaccine becoming available for the first quarter of 2021, and definitely by the second quarter of 2021,” Narwal said.
Wealthier countries have already pre-procured large orders of the vaccines that will be available, so the WHO has championed a programme called COVAX which will govern how the vaccine is distributed to countries to ensure equitable access.
Narwal said the first stage of vaccine roll-out would aim to immunise 10% of the population in each country.
“Front-line workers who are the highest risk should be the first to receive the vaccine, because we want to maintain most critical essential health services. Once we’ve got them covered, the other high-risk groups are the elderly populations with comorbidities,” he said.
In stage 2, groups to receive the vaccine include older adults, people with severe comorbidities, those in socio-demographic groups that put them at higher risk, healthcare workers who give immunisations, and high-priority teachers and school staff.
Narwal said the vaccine would likely be a two-dose combination, which makes it double the cost. It may also require extreme cold chain storage at -70 degrees celsius.
“The pace at which countries receive the vaccine will largely be guided by how ready are the countries to roll it out safely, timeously and effectively,” Narwal said. “If it becomes available in Q1 2021, are we ready? Or will we miss the train because we are not ready?”
He pointed out that even if the wealthier nations in Europe and America have better access to the vaccine, their safety still depends on poorer countries getting it too.
“Unless the whole world including poorer countries gets the vaccine, the whole world remains vulnerable to resurgences.”
Public health lawyer and researcher at the SA Medical Research Council Safura Abdool Karim, said people being forced to receive the vaccine, despite personal preservations, was legally possible but extremely unlikely.
“Can South Africa’s government compel vaccination? Yes. The Notifiable Conditions and Diseases Act has a mechanism whereby government can compel certain individuals who don’t want to take a treatment or a prophylactic intervention to receive that intervention, even if it infringes on their right to dignity or bodily integrity,” Karim said.
“But the reality is that first we’re going to vaccinate people who actually want to be vaccinated. The people who are going to be dealt with under this regime are the last people we want to tackle. We’ve got a lot of steps to get there, and this is really the last issue when it comes to a Covid-19 vaccine.”
Director of affordable medicines in the National Department of Health, Khadija Jamaloodien, said the department is working towards equitable access to the vaccine for South Africa as well as across Africa - but it will come at a serious cost.
“60% is touted to be the magic number to arrest further transmission and death from Covid-19. Africa will need around 12 billion US dollars and 750 million doses of effective vaccine to immunise 60% of Africa’s population.”
For Dr Boitumelo Semete, chief executive of the SA Health Products Regulatory Authority, the unprecedented speed of developing this new vaccine presents a huge challenge to get the vaccine through the necessary regulatory procedures to make sure it’s safe, as fast as possible.
“We never thought we would see a vaccine being developed in such a short period of time,” Semete said. “Even with the Covid vaccine, we will not compromise on safety, efficacy and quality.”