Health dept to release final list of Covid-19 vaccination sites by Sunday

SA's Covid-19 official vaccination roll-out will finally get under way tomorrow, amid concerns of chaos, a looming third wave and a glaring lack of information from the government.

By yesterday, the health department had not yet released a final list of vaccination sites, saying it was due to be published today.

It also said vaccine availability may slow down the rollout, which will target the about 700,000 health workers not already vaccinated in the Sisonke trial, as well as SA's estimated 5.5-million people over 60.

The Sisonke implementation study was a programme to give 500,000 healthcare workers early access to Covid vaccines since February. It finished yesterday amid claims of queue-jumping and extended queues.

The government's goal is to vaccinate 120,000 people a day in phase 2 of the rollout, but health deputy director-general Anban Pillay said this was a fluid target and would depend on vaccine availability and other issues.

"As of yesterday [Friday], South Africa had 650,000 Pfizer doses, with a further shipment of 325,000 doses due to arrive tomorrow [today]. A shipment of 1.1-million J&J doses due to arrive at the end of last month has been delayed," he said.

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The distribution of J&J vaccines is on hold globally pending an assessment of the US plant following contamination.

The surge in demand for vaccines over the past week suggests the national rollout will be under strain initially, said professor Glenda Gray, co-principal investigator of the Sisonke implementation trial.

"In the first week you can expect chaos and inefficiencies but if the teams are dedicated and enthused, they will rapidly find ways to work more efficiently and at scale," she said.

Sibongiseni Dhlomo, National Assembly chair of the committee on health, urged the health department to speed up.

"In the next 24 hours, the department should, and must, release [the venues of] those [vaccination] sites," he said.

Vaccinations will be free. Medical schemes are expected to support the programme and ease pressure on vaccination sites.

The biggest scheme, Discovery Health, estimated that its vaccination sites could deliver up to 25,000 vaccinations a day.

Discovery Health chief commercial officer Dr Ron Whelan said this number would depend on "supply of vaccine and demand for vaccination, and collaboration with various provider partners including pharmacies, GPs, hospitals".

Its Sandton headquarters, for instance, will have 30 fulltime vaccinators, capable of giving about 2,000 vaccinations a day.

"Discovery will have access to over 500 vaccinators across sites to ensure the rollout is as fast and efficient as possible," Whelan said. A list of national rollout sites was being finalised by the health department, he said.

Registration will be the same for state and medical aid patients. Once registered, citizens will get a unique code with a location, date and time slot, to take to the site with a valid ID and medical aid card, if applicable.

The department's Pillay told the Sunday Times yesterday that the public and private sector had identified sites. "Some will come online at a later date. The total number is quite dynamic as sites keep coming online and there are outreach sites through mobiles, etcetera. My colleagues are planning to publish a list of sites but bear in mind that this would change over time.

"There will be temporary sites, especially the outreach sites to old-age homes, hostels, or workplaces. Once everyone in the site is vaccinated, the team will move to another."

He said DSV Healthcare and Biovac had been contracted to secure and store and deliver vaccines.

"We plan to publish a dashboard that reports on vaccination progress," said Pillay. "Our main objective is to vaccinate as many people in the shortest period. The rate-limiting step is the quantity of vaccines available.

"Phase 2 is intended to vaccinate the high-risk groups, estimated to be about 16-million people, over a six-month period. This averages out at about 120,000 vaccinations per day. This target will not be constant as we will receive more doses from July. The pace is linked to vaccine delivery. Also, if uptake is lower due to hesitancy or other factors, then clearly output will be lower.

"At this stage the Pfizer vaccines are available for distribution. We have received two deliveries thus far, totalling 650,000 doses. Another shipment of 325,000 doses is due tomorrow [today], so by Monday [tomorrow] we should have about a million doses. The shipment of 1.1-million Johnson & Johnson doses has been delayed but should hopefully become available in the next week. So next week we will distribute the Pfizer vaccines as these are available."

The Pfizer vaccine requires two doses.

Sisonke vaccination sites were this week overwhelmed. Gray said: "We expanded the definition to include all health workers, including NGOs and undertakers. The queues have been overwhelming. Our teams have been pushed to the edge. We had to close the gates and turn people away."

The scientists have reserved early access "research doses" for pregnant and breastfeeding health workers who were excluded by the April pause in the study. A sub-study of 1,000 people will follow.

Gray said there was capacity at the 95 vaccination sites countrywide and people had been trained what to do. By Friday, the Sisonke teams had not been told if the rollout intended to use these sites.

Gray said that training and logistics were critical to maintaining quality and avoiding bottlenecks.

Business 4 SA's Stavros Nicolai said SA was at a crucial juncture.

"We all need to acknowledge the enormity of the task. The number of vaccines that need to be administered daily to achieve herd immunity is daunting. B4SA continues to work with the government and related stakeholders to ensure our energies are focused on getting phase 2 successfully out of the starting blocks. There will be hiccups. There will be frustrations. But this is an enormous challenge that we must tackle collectively and directly."

Health minister Zweli Mkhize said: "We do accept that this vaccination has not moved at the extent we wanted it to ... we had challenges that are out of our hands.

"We expect that our [J&J] doses, which are manufactured in Gqeberha [Port Elizabeth, at Aspen Pharmacare] are ready and we have been assured that they are free of any challenges or contaminations.

"We expect them to be released as soon as the FDA [the US Food & Drug Administration] has concluded its [assessment]."

Life Healthcare Group spokesperson Tanya Lowth said: "The list of private facilities is still under discussion with the government. The number of staff needed will depend on when, where and how the electronic vaccination data system allocates the public to vaccination sites."

The health department said that although increased infections were "worrying", the country was not yet in a third wave.

"Free State, Gauteng, Northern Cape and North West are of particular concern, but every province, with the notable exception of Eastern Cape, has at least one district of concern," the department said.

- Additional reporting by Matthew Savides, Paul Ash and Amanda Khoza