'We need all hands on deck for vaccinations' - experts

More pharmacists should be trained to administer Covid-19 vaccines and volunteers should be brought on board to help with administrative tasks when mass vaccinations begin in May, experts say.

Dr Velisha Perumal-Pillay of the University of KwaZulu-Natal told the Sunday Times this week that the pool of vaccinators consists mainly of doctors and nurses who could be "diverted to immunisation services" and away from other aspects of health care.

Writing in the South African Journal of Science, she pointed out the large pool the vaccine rollout could tap into.

"According to 2020 statistics of the South African Pharmacy Council, there are 17,842 registered pharmacists (including interns and community service pharmacists) and 3,481 community pharmacies, 306 institutional private and 613 institutional public pharmacies that can contribute to this workforce."

Perumal-Pillay told the Sunday Times that "pharmacists have knowledge of vaccines and immunisation from their primary degree" and this could be augmented with training on "competency in immunisation and injection technique".

With a population of more than 59-million, she said, "South Africa will need a suitably sized workforce to meet the demand of the Covid-19 vaccine rollout".

Only a small portion of pharmacists had undergone postgraduate training, but no provision is explicitly made "for pharmacists to practise as vaccinators in the country, although it is not prohibited if adequate training is provided".

Vaccines are "predominantly administered by a nurse at the pharmacy". But in countries such as the US, UK and Australia, pharmacists have been providing vaccination services for years.

"South Africa is lagging behind in advocating for, and establishing, all pharmacists as vaccinators in the health-care system," said Perumal-Pillay.

Ross Hofmeyr, associate professor of anaesthesia and perioperative medicine at Groote Schuur Hospital in Cape Town, said many senior specialists were involved in giving the Covid-19 J&J shots at the hospital.

"All departments were asked to volunteer people to undergo training and give vaccinations, and so many of the senior specialists were involved," said Hofmeyr.

"I'll happily give shots if it helps keep numbers down and lets us get back to other catch-up work. There is a huge backlog of surgical work building [up]."

According to Professor Linda-Gail Bekker, co-lead investigator on the Sisonke trial, "volunteers would be a great addition. There is much admin to be done, including marshalling and other such functions. In America and other parts of the world, they've made great use of volunteers."

She said involving more volunteers in the rollout would also "build a sense of citizenship" and this would be "very good for vaccine messaging and getting people engaged in the process".

Earlier in the pandemic, the Community Action Network, which saw well-heeled communities preparing food for those worse off, had generated an "extraordinary response" and the same could unfold with vaccinations, said Bekker.

"Maybe volunteers could be incentivised by helping out in exchange for a vaccine."

The department of health did not answer questions posed by the Sunday Times, but according to Discovery CEO Dr Ryan Noach: "The national department of health is currently finalising eligibility criteria for vaccinators. Our understanding is that this list will include a range of health-care workers with various skills and qualifications. Other countries have adopted wide-ranging criteria for vaccinators.

"Many countries are using trained community volunteers with clinical oversight from nurses and doctors."

Professor Glenda Gray, co-principal investigator of the Sisonke implementation study, said volunteers could contribute by "beefing up" the administration and logistics. "We will need all hands on deck."