Half of the adults living in SA have yet to get a coronavirus vaccine. Despite incentives, lotteries and high-profile weekend campaigns, the demand for shots has plummeted. Last week barely 44,000 jabs were administered, a fraction of the 1-million peak recorded in the last week of August 2021.
The case for getting inoculated has never been clearer, with a growing body of evidence demonstrating vaccines provide significant protection against severe disease, hospitalisation and death.
Health and life insurer Discovery released compelling real-world data earlier this week showing the Pfizer-BioNTech shot held firm during SA’s unofficial fifth wave of infections, allaying fears that the latest Omicron sub-lineages to emerge in SA, BA.4 and BA.5, might pierce the shield of vaccines. It adds further weight to a SA study published in the New England Journal of Medicine in May showing both the Pfizer and Johnson & Johnson jabs did an excellent job of reducing the risk of hospitalisation for severe Covid-19 during the fourth wave, driven by Omicron sub-lineages BA.1 and BA.2.
We have known since early on in the pandemic that age is the single biggest risk factor for hospitalisation or death from Covid-19, yet millions of SA’s most vulnerable people remain unvaccinated. About one-third of people aged between 50 and 59 have not had a single shot, nor have 30% of those aged 60 and above. So what is to be done?
The government has squandered any opportunity for introducing vaccine mandates for its 1.3-million employees, a move that would have signalled its confidence in the national inoculation drive. The time for that was a year ago, when public servants were seeing friends, family and colleagues felled by successive waves of infection, and powerful public sector unions were clamouring for their members to be prioritised.
Teacher unions made sure educators were next in line after healthcare workers and were vaccinated ahead of many older people. Yet fearful of invoking union ire, the government balked at requiring public servants to get inoculated and left it to the private sector to forge a path.
A variety of companies across the economic spectrum now have policies in place requiring employees to provide proof of vaccination or get regular testing at their own expense, as do numerous higher education institutions. But not a single national, provincial or local government department has gone down this road.
It is now virtually impossible to do so. There is such tension over the wage bill that the government has no political capital to spare, and the fear factor has all but disappeared.
SA’s latest two waves of infection have seen such a pronounced decoupling of cases and hospitalisation that an exhausted society has decided the pandemic is largely over. The latest resurgence in cases lasted barely eight weeks and was the shortest and least severe wave to date. Patients continue to be admitted to hospital with severe Covid-19, the disease still kills people, but it now has less impact on the health system than trauma.
But that doesn’t mean the government should wash its hands of the matter and leave citizens to take responsibility for themselves. There are several things it can still do. It should restrict access to public places such as cinemas, restaurants and gyms to people who can show vaccination certificates or proof of a negative test result. There is clear evidence from countries such as France and Canada that such measures lift vaccination rates. And while SA may not get as big a benefit as wealthier countries, even a modest uptick will make a difference.
Most important, it needs to make it easier to get a shot. That means ensuring there are places where workers can get vaccinated outside office hours, figuring out what incentives will work for the most vulnerable in society, taking vaccines to communities that are not in easy striking distance of a clinic, and offering jabs as part of routine health services. Just as pregnant women are now routinely offered an HIV test, so too every patient in a diabetes or hypertension clinic should be offered a Covid-19 shot.
If it doesn’t up its game by the time the next wave strikes or a new and more virulent variant emerges, it will be too late.
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