A health expert has warned that without rapid vaccination to achieve population immunity, a third wave is definitely on the cards.
“Without rapid vaccination of at least two thirds of the population, we are not going to get to population immunity in the country, and without that, we will see another wave,” says Prof Marc Mendelson, head of the University of Cape Town’s (UCT) division of infectious diseases and HIV medicine at Groote Schuur hospital.
In president Cyril Ramaphosa’s address to the nation on Monday 11 January, he stated that while the actual level needed for population immunity, also referred to as herd immunity, is not known, scientists estimate that South Africa will likely reach herd immunity once around 67% of the population are immune.
“This amounts to around 40 million people in SA,” Ramaphosa said.
Prof Gregory Hussey of the Vaccines for Africa Initiative at the Institute of Infectious Diseases and Molecular Medicine, UCT, explains herd immunity refers to the population that must be vaccinated to prevent transmission.
“To vaccinate the 40 million people, we require 80 million doses as each person must receive two doses,” Hussey adds.
He further explains that even people who have tested positive for Covid-19 before will still need to be vaccinated.
“There is no guarantee that you will be protected from Covid-19 in the future if you have the disease now. There will be some protection but this is not 100% guaranteed, especially in the light of the emergence of new mutant viruses,” says Hussey.
The national minister of health, Dr Zweli Mkhize, has indicated that the first of 1.5 million vaccines, supplied by the Serum Institute of India, will arrive in the country by the end of the month, with more arriving by the end of February.
On Wednesday 13 January, premier Alan Winde said the Western Cape had already started the work to put the correct systems in place to manage the roll-out of this massive vaccination operation.
According to Winde, the provincial government’s vaccine strategy involves three phases:
- Healthcare workers: There are approximately 100 000 healthcare workers in the public and private sector. This number also includes community healthcare workers, care workers and health science students.
- Essential workers, as well as those in congregate settings (such as care homes), those over 60 years old, and those over 18 with co-morbidities.
- General population. This will include anyone over 18.
“The vaccine has not been tested for safety in pregnant women and in children and will not be administered to these groups,” he said.
According to Winde they have devised a process which will be followed for the rollout of the vaccines, in all three phases.
“Firstly, facilities offering vaccination, as well as those individuals doing the vaccinating will be pre-registered and accredited,” he said.
The next step will be the creation of a vaccination register which will be similar to a voters role and list those who require the vaccination.
“In this regard, we have started consultations with the Electoral Commission of South Africa (IEC) to share information about the systems they use.”
Winde explained that those on the register would receive an appointment time and date, where they sign a consent form, receive their first dose, and an appointment date for their second dose. They would also be issued with proof of vaccination.
On the appropriate date, the person would receive their second dose.
“We will also be putting in place data systems to track the progress of the rollout and vaccine coverage at an individual and community level.
“The national Department of Health has proposed a computer application system for this process, however, should there be any delays with this system, the Western Cape government will have its own system and mitigating processes in place to avoid any delays,” Winde said.
The support of the public and private sectors as well as civil society will be vital in the successful roll out of the strategy, Winde said.
In a statement issued by UCT’s faculty of health sciences, the Dean, Associate Prof Lionel Green-Thompson, also emphasised that the rollout needs to be accompanied by a process which deals with the challenges of vaccine hesitancy, misinformation and disinformation which “threaten to undermine vaccine uptake and coverage”.
And in this regard it seems that the government will have its work cut out for them. An Ipsos survey of more than 18 000 adults from 15 countries conducted in partnership with the World Economic Forum last year found that general opposition to vaccines among those who won’t get one is highest in South Africa (21%) and India (19%). One of the questions posed in the survey were: “From the time a vaccine is available, when would you become vaccinated?” Of the South Africans surveyed, 21% said immediately after available, 42% said within three months, and 62% said within a year.
Concerns about side effects and concerns that vaccines are moving through clinical trials too fast were each cited by one-third of those who said they would not get a vaccine when it is available, the survey stated.
Herd immunity may be difficult to reach as Hussey says vaccination is not compulsory.
“People have the constitutional right to refuse. Our job is to convince people that they should have the vaccine,” he concludes.