UCT ‘jab grab’ claim mars Covid-19 vaccine rollout
Scramble for vaccine by privileged ‘a sign of coming inequity’
Four out of five people in poorer or more remote areas will not receive a Covid-19 vaccination this year, according to global predictions.
In SA, health-system inequities and the urban-rural divide will haunt the rollout, say experts — and an access row at the University of Cape Town is seen as an indication of things to come.
University of Fort Hare acting health dean professor Leon van Niekerk said an approach where vaccinators “go to the people, rather than the people coming to the vaccinators” could be necessary in some areas.
He said “the first challenge relates to accessibility” and in provinces such as the Eastern Cape, where the population is “geographically dispersed and beleaguered by intergenerational poverty”, access to online connectivity and smartphones for registering is one of many problems.
Lack of commuter services would “constrain travel to vaccine centres”, he said.
On the flipside, well-to-do staff and students at UCT were said to have gained immediate access to the jab when eligibility criteria were changed at the tail end of the Sisonke trial, which had been intended to vaccinate health-care workers.
This did not sit well with some at the university, who said it reflected a lack of integrity on the part of “queue-jumpers”.
After the trial was paused and then restarted, eligibility was broadened and as a result, according to sources, equity fell away as definitions became blurred and people took advantage of or even cheated the system.
A senior UCT staffer who did not want to be named said they had refused on ethical grounds to get the jab as they strongly believe in “fairness and equity”. But those who declined “were then pressurised and stigmatised”. They said students were “encouraged by the health faculty to say they were health-care workers to get a voucher”.
The staffer said: “These are young healthy people who are unlikely to die if they get the virus without being vaccinated … I have been offered it several times but only because of privilege, not my need.
“Meetings were held to convince administrative staff to get it,” said the staffer, and several postgraduate students, “who are not in a clinical setting and who work alone in offices and have no comorbidities”, got the shot.
The faculty of health sciences sent out correspondence saying: “We would like to encourage all members of our faculty and broader community to get vaccinated as soon as the opportunity arises.”
Professor Glenda Gray, co-principal lead investigator on the trial, said if people who fell outside the criteria got vaccinated, “this was done without approval” and “if people lied on their forms” and evidence of this came to the fore, it would need to be followed up with ethics committees and “even the police” if fraud was committed.
She said those registering had to get a letter from their employer, but that these could have been “concocted” to meet the criteria. “This was definitely not a widespread practice or accepted,” she said.
This stood in contrast to the “heartbreaking scenes” at Chris Hani Baragwanath Hospital in Soweto, where an 80-year-old woman and many other elderly people were in tears at being turned away when the team insisted on following protocol.
Gray said: “If protocol was not followed at the sites, I wish those giving vaccinations would rather have targeted the elderly or people with cancer, as that is government protocol.”
According to co-principal investigator professor Linda-Gail Bekker, as the trial attracted fewer patient-facing workers, “the definition of a health-care worker was extended to the definition used by the World Health Organisation”.
This took the scope beyond those on the frontline, but according to the UCT source it was abused by people who do not fall within the broader definition and who have “no contact with people in the clinical setting”.
Correspondence from leaders in the health faculty encouraging students to say they were health workers also predated the expanded definition introduced by Sisonke.
This culminated in what head of health of the Western Cape Dr Keith Cloete described as “worrying and unfortunate incidents” as the system had run on good faith but some had abused that.
UCT denied that "its staff members were engaged in the activity" and that it had "reiterated that the invitation to register for vaccination" was "only open to all health workers and health personnel".
It said this was "as per the criteria determined by national and provincial authorities" and referred only to "people working directly in patient-facing situations and in capacities supporting patient-facing personnel".
Tian Johnson, head of the advocacy group African Alliance, said it was important that vaccines were not perceived as “luxury items” and that existing inequities in health and socioeconomic systems would probably have a bearing on the rollout.
“It is up to the government, not communities, to ensure that everyone gets access,” he said. “We must call this what it is before we start blaming communities for fighting over vaccines: it is a very delayed rollout that should have started months ago.”
— Additional reporting by Claire Keeton
Would you like to comment on this article or view other readers' comments? Register (it’s quick and free) or sign in now.
Please read our Comment Policy before commenting.