Covid-19 vaccine rollout: 200,000-a-day jabs plan unveiled

Mkhize outlines how Covid-19 vaccine rollout will be intensified

28 March 2021 - 00:05
By Zimasa Matiwane
The phase one rollout will pick up where the trial ends, alongside phase two, which includes people over 60, those with comorbidities and essential workers.
Image: Sasirin Pamai/123rf.com The phase one rollout will pick up where the trial ends, alongside phase two, which includes people over 60, those with comorbidities and essential workers.

The government has finally unveiled details of its vaccine rollout plan, which sets an ambitious target of inoculating up to 200,000 people a day.

More than 2,000 vaccination sites - including stadiums, shopping centres, churches and hospitals - have been identified. The rollout is due to kick off in mid-May, following the expected arrival of the first batch of 2.8-million Johnson & Johnson vaccine doses at the end of April.

Registration for phase two of the rollout is due to start next month.

Health minister Zweli Mkhize yesterday briefed top ANC members on the plan at the party's national executive committee meeting. Shortly before this, he told the Sunday Times that both phase one and phase two would get under way simultaneously.

Phase one involves finalising the vaccination of SA's 1.5-million health-care workers. By the end of next week, 250,000 health-care workers are expected to have been vaccinated under the Sisonke programme, part of an ongoing J&J trial that is due to finish at the end of April.

The phase one rollout will pick up where the trial ends, alongside phase two, which includes people over 60, those with comorbidities and essential workers.

Mkhize said the order of the priority groups for phase two has been submitted to him for consideration.

"Older people are at highest risk of death and severe disease, and have the highest incidence of comorbidities. This would also be in line with international best practice and we would like to start with older people and move down as quickly as possible," he said.

Phase three - all other adults not falling into the phase one and two categories - is set to begin in mid-November, unless vaccines arrive sooner.

This means that herd immunity - which the government hopes to achieve by inoculating 67% of the adult population - may only be achieved in early 2022, as opposed to the end of this year as initially planned.

"During the mass vaccination phases we will need to be targeting about 200,000 [people] per day nationally, with variations across provinces because of the differing concentrations of populations. We will be grouping and defining vaccination sites as small, medium and large," said Mkhize.

He announced earlier this week that between April and June, 7-million doses of the Pfizer vaccine would have been delivered, as well as 2.8-million from Johnson & Johnson.

The Sunday Times has established that the first batch of J&J's 2.8-million doses will land before the end of April.

Highly placed sources in the health department also revealed that 4.1-million doses are due in the third quarter, with a further 4.1-million scheduled to arrive in the fourth quarter.

"The Johnson & Johnson vaccine will be prioritised for delivery to sites in more rural areas as it is possible to store these vaccines at 2°C-8°C for three months," Mkhize said.

"Additionally, the Pfizer vaccine can be stored at -20°C for 14 days, plus at 2°C-8°C for five days. Because we expect to use vials as we receive them, we will be focusing on mechanisms for short-term delivery and storage."

Mkhize said infrastructure was already in place to ensure the process runs smoothly.

"We already provide 15-million doses of vaccines to children across the country through our network of primary health-care facilities, so infrastructure and distribution networks are already in place. Reaching people in remote rural areas will be a challenge, so communication and demand creation will be critical components of the rollout."

The government has been criticised for its lack of detail about the rollout plan, as well as its slow progress. But Mkhize is adamant the inoculation plan is possible.

He said the plan was to have about 1,200 small sites doing about 100 vaccinations a day, which equates to about 120,000 inoculations a day. These will include community pharmacies, primary health-care facilities and general practitioners.

Medium sites are expected to each do about 300 vaccinations a day. They may be fixed, temporary or mobile sites, and could include hospitals, medical centres and retail locations.

"Our expectation is that 500 such sites would provide 150,000 inoculations a day. We should point out that a number of the facilities under Sisonke are already able to achieve or exceed the target of 300-500 vaccinations per day," said Mkhize.

The department aims to do 1,000-2,000 vaccinations a day at large and very large sites. Fifty sites will be able to achieve about 50,000-100,000 jabs. These include venues such as stadiums and conference centres.

"The plan is in advanced stages and, once registered, citizens will receive instructions for appointments. Registration is scheduled to start in April. People will be able to register online, but those without access will also be able to register in person," Mkhize said.

He added that each vaccinator was expected to do about six vaccinations an hour and work an eight-hour day, equating to about 48 vaccines per vaccinator a day.

He said that the government needs 6,250 vaccinators a day, and manpower will be sourced from existing staff, although additional staff will also need to be recruited in some areas.

He said bidders have been invited to submit their proposals for storage and distribution on an open-tender basis, but that no tenders have been awarded yet.

Meanwhile, negotiations with vaccine manufacturers Moderna, Sputnik, Sino-pharm and Sinovac are ongoing, Mkhize said.

"We also continue to engage all the other candidates who are in various stages of research and development."

Mkhize said the health department's national team is responsible for supporting provinces and districts to implement the vaccine rollout, and provinces will then be responsible for implementing the operations for inoculations.

Responding to a report on News24 this week that the delivery of J&J vaccines could be delayed due to a failure by the government to set up a key no-fault compensation mechanism to cover damages claims arising from unlikely but potential adverse side-effects from the jab, Mkhize said the issue was being addressed.