Staff are working about the clock to improve the appointment system for Covid-19 vaccinations to avoid a repeat of the chaotic scenes at Steve Biko Academic Hospital this weekend as doctors queued for hours to get jabs, according to a senior figure involved in the rollout.
The health department began dispensing Johnson & Johnson’s Covid-19 vaccine to health-care workers last Wednesday under the banner of the Sisonke implementation study. By Sunday evening, 18 sites had been accredited, and more than 15,380 health-care workers vaccinated. But the rollout has been irregular, with some sites proceeding smoothly while others hit snags triggered by unexpectedly large numbers of health-care workers queuing for the shot.
The government is under immense pressure to streamline the appointment system, as this will be vital for the expansion of its Covid-19 vaccine rollout. The first phase of its immunisation drive targets SA’s 1.25-million health-care workers, but it will then need to rapidly broaden out to reach 40-million adults.
The selection of recipients is currently being managed at facility level by public hospitals that have been designated as vaccination sites. Once an individual has registered on the health department’s electronic vaccine data system (EVDS) and enrolled for the Sisonke study, eligible health-care workers receive a voucher: public sector employees are instructed to contact a specific vaccination site to make an appointment, while private sector employees are told that their turn on the vaccination roster will be managed by their professional associations. But it is not clear how individual sites are prioritising vaccine recipients among staff, and the system is being “gamed” in some areas by private sector employees who register their place of work as public sector vaccination sites to try to jump the queue.
Right to Care founder Ian Sanne, who is involved in implementing the Sisonke study, said work was under way to devise an appointment system that would be managed on the EVDS, with eligible health-care workers receiving their voucher and appointment details in a single step. “We are working on a establishing a scheduling system where people will get a vaccination site, a date and a time slot divided up in quarters of the day,” he said.
The EVDS currently asks health-care workers to provide their ID number and professional registration number, but there are no checks built into the system to verify their place of work, he said. “We do consider it a bad reflection on health-care workers and their ethics, because they are basically queue jumping,” he said.
Sanne said the number of vaccination sites is expected to almost double next week, with the addition of up to 16 more facilities. SA has so far received 80,000 doses of J&J's single-shot vaccine, and anticipates another shipment of the same size at the weekend, he said.
Business for South Africa (B4SA) chair Martin Kingston said the problems that manifest in the first few days of the vaccine rollout needed to be fixed as quickly as possible to maintain public trust.
“There are bound to be teething problems. We need to resolve those very quickly, because once we get into phase 2, we will have large sections of the population who will want to be vaccinated,” he said.
Kingston said SA was unlikely to reach the daily vaccination numbers achieved in the UK — which in early February stood at a seven day moving average of about 440,000 doses per day — but would need to reach a level of between 200,000 and 300,000 per day to reach 40-million adults.
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