The government faces the prospect of losing up to R3.9bn in expired Covid-19 vaccines, as demand for the stocks purchased at the height of the coronavirus pandemic failed to materialise.
The looming waste casts the spotlight on the government’s difficulties in sourcing timeous supplies and the challenges it confronted in rolling out a mass vaccination campaign.
Vaccine hoarding by wealthy countries and a series of missteps by the government caused SA’s vaccination programme to be repeatedly delayed, but the department of health eventually secured enough shots for the entire adult population.
Demand was initially brisk, but soon flagged and the department is now grappling with an unexpected surfeit of shots as the number of people seeking vaccination has slowed to a trickle.
As of June 19, only 22.8-million of SA’s population of 60.8-million people has received at least one Covid-19 vaccine, government figures show. At its peak, SA’s vaccination programme reached more than 934,000 people in the week to July 25 2021, but in the week to June 18, barely 13,200 shots were administered.
As a result, the department is holding 7.48-million doses of Pfizer’s Covid-19 vaccine that may go to waste, health minister Joe Phaahla told parliament in a written response to questions by IFP MP Magdalena Hlengwa.
Even if SA’s medicines regulator, the SA Health Products Regulatory Authority (Sahpra), agrees to Pfizer’s request to extend the shelf life of these vaccines by six months, the current vaccination rate will barely make a dent in the government’s stockpile.
The department also purchased large quantities of Johnson & Johnson’s (J&J) Covid-19 shot, and estimates 20.8-million doses worth R2.68bn may go to waste, the minister said. A third of these shots expire by the end of August and the remainder will have all expired by the end of February 2024, according to deputy director-general for National Health Insurance Nicholas Crisp, who also heads the Covid-19 vaccination programme.
“There has been no indication that J&J will apply for any extension of [the] expiry date,” he said.
Wits vaccinologist Shabir Madhi said fewer vaccines would have gone to waste if there had been better planning.
Indictment
“The fact that they haven’t been able to deploy the vaccines, and that they expired and need to get Pfizer to extend the shelf life, is an indictment of the vaccine rollout. We raised concerns right at the start, saying they had aspirational goals without a meaningful strategy,” he said, referring to the scientists who advised the government on its Covid-19 response.
Madhi, who is a member of the World Health Organisation’s Strategic Advisory Group of Experts on Immunization, said there is no longer a strong case for vaccinating children and healthy adults as 95% of the population have already been exposed to SARS-CoV-2, the virus that causes Covid-19. Current WHO advice is to vaccinate only healthy people over the age of 55 to 65, he said.
Provincial health departments were instructed to stop administering Pfizer vaccines after April 30, and to expect an interruption in supply that could extend to July, according to a circular by director-general, Sandile Buthelezi. Pfizer is seeking a six-month extension on the shelf life of these vaccines, he said in the circular.
The lack of Pfizer vaccines means there are no shots available to children from 12 to 17 years old, as it is the sole vaccine authorised by Sahpra for this age group. Children are at relatively low risk of severe illness and death from Covid-19 compared with older adults, and the department of health is not concerned about the lack of vaccines for this group, said Crisp.
“Vaccination of adolescents was not a primary target of the Covid-19 programme,” he said.
Sahpra referred questions on extending the shelf life of Pfizer’s Covid-19 vaccines to the company. Pfizer had not responded by the time of publication.
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