Vaccine hesitancy, inequality hinder SA’s vaccine roll-out

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There are enough Covid-19 vaccines in the country, but the roll-out programme has lost momentum, with a marked dip over the past fortnight, the department of health said on Tuesday.

During a briefing to the national council of provinces, Deputy Health Minister Sibongiseni Dhlomo cited vaccine hesitancy and inequality among the main reasons for the drop in the number of vaccines administered daily.

“The president called for 300 000 vaccinations per day. On 21 July, around 275 000 were vaccinated, but recently we are down to about 175 000 [vaccinations] per day. That is a red light,” Dhlomo said.

“The uptake has been good with people aged 60 and above, but we want to accelerate it to 70% of that population. The group 50 and above has not been good and neither has the 35 and above group.”

Dr Nicholas Crisp, who is helping the department with its roll-out strategy, said social norms and other societal issues were also discouraging some people from taking the vaccine.

“People often share stories, which becomes like a game we played when we were young called broken telephone, and in this the message changes,” Crisp said.

“It is very difficult within this social environment to counteract what is the truth and what is not the truth. However, once people are motivated to take the vaccine, the responsibility then shifts to the health sector.”

Crisp said the health department needed to improve the user experience around vaccines, from registration until the time an individual got jabbed, which would then churn out positive stories in communities and push demand higher.

Inequality has also been a key factor, with a small part of the population with access to medical schemes benefitting ahead of those who cannot afford medical aid.

When assessing South Africa’s provinces in the 60+ age group, Limpopo fared best with 66% of that cohort being vaccinated, but only 64% of people without health insurance were vaccinated versus 98% of those with health insurance getting the jab.

In Gauteng, 63% of people with health insurance were vaccinated, compared with only 38% of those without.

“Most of the provinces paint this picture. Only the Free State, North West and Eastern Cape show a more equal distribution of vaccines, but they are a concern for a different reason as they are not vaccinating as many people as they should,” Crisp said.

Crisp emphasised that the main purpose of the vaccine was to ensure that fewer lives were threatened by the virus, and for the population to eventually to reach herd immunity. He admitted, however, that with the complex and evolving mutation of the virus into different variants, it was difficult to predict when South Africa would reach herd immunity.

“We don’t actually know how many people we need to vaccinate to get herd immunity. Twelve percent of the population has been vaccinated and it will be easy to get to 45%, but it will be very difficult to get past that,” he added.

Dhlomo was optimistic, however, that once people decided to take the vaccine, the country would have enough resources. He said thousands of sites were open and millions of doses were available.

About 1.5-million Johnson & Johnson vaccines were received in the last week of July, with a further 619 450 received in the second week of August. Some 2 898 300 doses are expected on 23 August and 1 512 000 on 30 August, meaning South Africa would have received around 6.5-million Johnson & Johnson vaccines in August.

The country is now also receiving about 1 556 100 doses of Pfizer vaccines weekly. Coupled with the Pfizer vaccines acquired through the Covax facility, South Africa is expected to have received a total of 23 111 520 vaccines for the month of August. 

As of the 14th of this month, 9 373 343 vaccines had been administered, with 2 081 229 people receiving the Johnson & Johnson vaccine while 7 292 114 got the Pfizer drug. However, just 4-million people have been fully vaccinated.