SA should soon have a firm date for the start of Covid-19 vaccine deliveries as it continues to assess a range of options, including those developed in China and India and which are being trialed in the country.
Speaking during a panel discussion on SABC’s Morning Live, Dr Anban Pillay, the deputy director-general in the department of health, said the Covax scheme, which is run under the auspices of the World Health Organisation (WHO), will provide a firm date in January as to when the first shipments of vaccine are expected to arrive — after March.
The problem for Covax is that there are about 198 countries involved in the scheme and they were all pushing hard for deliveries as soon as possible to curb the spread of the pandemic that flared up early in 2020, he said.
Many countries, including SA, are experiencing a resurgence of the coronavirus. SA, like others, has re-introduced tougher restrictions on social gatherings, stricter curfews and the compulsory wearing of masks. SA hit a record number of infections this week, with close to 18,000 cases reported in a 24-hour period, while nearly 500 people died from the disease in the same period.
Covax is in talks with pharmaceutical companies and will try to get vaccines shipped to those who have paid into the scheme, Pillay said. AstraZeneca and Johnson & Johnson, among others, are expected to file registration applications in SA during the next three to four weeks, he said.
“Even if a vaccine arrived in SA today, we’d probably still have a third and a fourth wave of infections because of the time it takes to get a vaccine programme to two-thirds of your population to get herd immunity,” Pillay said.
Vaccine trials in SA
A number of pharmaceutical companies are testing vaccines in SA and the government is in talks with them to secure efficacious, proven, clinically trialed products outside the Covax programme, which has received a R283m deposit from the state and privately funded Solidarity Fund.
The introduction of a vaccine will not end the pandemic, Prof Barry Schoub, the chair of SA’s ministerial advisory committee on vaccines, said during the Morning Live discussion.
“Once the vaccines arrive at our doorstep that’s not the end of the epidemic — it does not simply switch it off. Those first vaccines will go to protecting healthcare workers, and will have no effect on the broader population,” he said.
The first tier of vaccination will be medical staff in hospitals, elderly people, key personnel, and those in institutions such as prisons, he said, adding it would take many months before the vaccine was fully rolled out in SA, and that the virus would forever be a factor, requiring ongoing immunisation programmes.
It is too early to tell how long vaccines remain effective barriers to the virus and what any type of immunisation programme will be needed in future, he said.
While there might have been complaints that SA was moving too slowly in securing vaccines, the delay had its own benefits, Schoub said, pointing out a growing number of pharmaceutical companies developing registered vaccines that are suitable for developing countries such as SA.
SA needs a vaccine that is safe, efficacious and can be stored at reasonable temperatures, making it easier to store and transport than those needing -70ºC storage and double-doses to work most effectively. SA has only two facilities that can store medicines at that temperature, meaning it will be unsuitable for a mass immunisation programme to use a vaccine such as that developed by Pfizer-BioNTech.
Russian and Chinese vaccines
SA is a member of the Brics group of countries that includes Brazil, Russia, India and China. Russia and China have developed vaccines and have made representations to the local department of health, said Pillay.
However, these vaccines have not gone through clinical trials to ensure they are safe and efficacious, and both are undergoing trials in SA which are yet to be finalised, he said.
Some countries have deployed vaccines that have not gone through clinical trials or been fully proven as safe and effective to tackle the pandemic, but SA is taking a more considered approach in wanting the best, safest and most suitable vaccine, Pillay said.
“It’s no good injecting people then finding, hell no, this vaccine doesn’t work,” he said, adding that government spending rules meant the department has to purchase proven vaccines rather than taking a chance on these untested products.
Governments that funded vaccine trials in co-operative agreements with pharmaceutical companies were the first to receive the medication, he said. SA is one of the countries in which these trials are underway but the agreements are with academic institutions rather than the state, meaning SA has no preferential access to proven vaccines.
“The reason SA is not able to access a vaccine the way the US and UK can is because we are not a wealthy country,” said Safura Abdool Karim, a public-health lawyer.
“Poorer countries are always left behind when it comes to new health interventions,” she said. “It’s not a result of our government not wanting a vaccine, it’s a result of a system that prioritises profits over people’s lives.”
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