The dire COVID-19 situation in India has agitated South African journalists, parliamentarians and even public health experts as our domestic vaccine roll-out appears to move at a snail’s pace, with unexpected set-backs off-setting modest progress. The Minister of Health and top health officials are calmly assuring us that it is “systems go” for mass rollout to over-60s from 17 May – and, indeed, the closing weeks of May will tell us much about the state of the country’s capacity to deliver on scale.

Vaccine stocks

The release of the first commercial doses of the Johnson & Johnson vaccine, compounded at the Aspen plant in the Eastern Cape, has been delayed. This is due to the US Food and Drug Administration’s decision to undertake an extensive safety assessment of J&J facilities worldwide following an adverse finding during an inspection at a facility in the US. “We are confident that the final outcome will be positive and, provided there are no further disruptions, J&J will be in a position to release stock from the Aspen plant by the middle of May,” Health Minister Zweli Mkhize told Parliament last week.

J&J vaccines for use under the Sisonke research protocol were not affected by this precaution and the programme to immunise South African health workers is proceeding.

In addition, the first 325 000 doses of the Pfizer/BioNTech vaccine arrived in South Africa on Sunday night and will undergo routine quality testing at the national quality control laboratories before being cleared for use. Minister Dr Mkhize said a total of 1.3 million doses were expected by the end of May and 4.5 million by end of June.

Progress to date

Only 318 670 health workers of an estimated 1.25 million have been immunised to date. It is difficult to see how this phase of the vaccination programme will be completed by 16 May. Professor Barry Schoub, who heads the Ministerial Advisory Committee on vaccines, told a recent Daily Maverick webinar that the Sisonke trial had shown “tremendous benefits” with only 20 breakthrough cases of COVID-19 occurring among immunised health workers to date.

By the middle of last week 533 283 individuals over the age of 60 had registered to receive the jab. Since the total eligible population is around five million, there is still a long way to go.

Communication and registration systems are being ramped up. Last weekend the Sunday Times carried an advert inviting expressions of interest for the set-up of a dedicated COVID-19 vaccination call centre, sponsored jointly by the Department of Health and Business Process Enabling South Africa (BPESA), the industry association for call centres). Some public clinics in Johannesburg opened on Saturday specifically to assist over-60s without internet access to register.

Anxiety about third wave

Members of the Parliamentary Portfolio Committee on Health are anxious about the possibility of South Africa experience a third surge akin to that currently engulfing India. Last week Director-General of Health Dr Sandile Buthelezi told them maintaining preventive behaviours, plus a high level of alertness to the possibility of new variants could help contain our third wave at levels similar to the second. An additional consideration, he said, was the waning of immunity conferred on those infected during the first wave.