Jabs for over-50s top priority as SA braces for Omicron wave of Covid infections

Experts speak out amid early signs of a fourth wave likely being fuelled by the new variant

28 November 2021 - 00:00
It is critical to increase vaccinations after the detection of the Omicron variant, experts say.
It is critical to increase vaccinations after the detection of the Omicron variant, experts say.
Image: Alaister Russell/The Sunday Times

SA's vaccine stockpile of nearly 20m doses should be used to give booster jabs to high-risk groups, and at least 85% of those aged over 50 need to be vaccinated without delay.

This is according to experts who spoke out this week amid early signs of a fourth wave of Covid-19 likely being fuelled by the new variant, Omicron.

Wits University dean of health and professor of vaccinology Shabir Madhi said “the main thing that’s going to determine how well the country manages a fourth wave is the percentage of people above the age of 50 who have been vaccinated”. 

He said SA needs to get 85% to 90% of this age group vaccinated, and 80% of those with underlying medical conditions.

By Thursday, according to the department of health, 58% of those in their 50s are vaccinated, with 53% fully vaccinated.

Among over-60s, 64% are vaccinated and 57% fully vaccinated.

Madhi said it would also be “more efficient to use vaccines to provide booster doses to high-risk groups already vaccinated” than for low-risk  groups seeking their first shots.

The current regimen — one dose of the Johnson & Johnson vaccine or two Pfizer jabs — still “reduce the risk of severe disease” in vulnerable groups, he said. But without the additional protection offered by a booster shot, SA would experience “avoidable breakthrough cases of severe Covid and death”.


6,000+: Active cases in Gauteng

25.2m: Vaccine doses administered in SA

Professor Tulio de Oliveira, who announced the discovery of the Omicron variant at a briefing on Thursday, said “vaccinating remains a critical tool” in the fight against Covid regardless of the new variant.

Madhi said that even if Omicron reduces the efficacy of vaccines in lowering the spread of the disease, he remains optimistic that vaccines will still “maintain protection against severe Covid due to Omicron”.

He said breakthrough infections will continue to happen as with other variants, but that vaccines are primarily about preventing severe disease and should be used for that purpose.

Dr Samukeliso Dube, general manager at health-care group AfroCentric, said: “Some agencies are approving booster doses for those who may be immunocompromised. That’s because the chance of getting symptomatic infection after contracting the virus from an unvaccinated person is increased for those who are immunocompromised and those who are older.

“This is because one may already have a weakened immune system and may not build the same level of immunity from the vaccine.”

Dube said she hoped the vaccines would be a “game-changer” in subsequent waves of Covid-19, and if the current resurgence turns into a fourth wave “it is reassuring that the older cohort has been more receptive to vaccination, and we are hoping that this would avert higher rates of hospitalisation and mortality”.

An oversupply of vaccine doses means that boosters for the vulnerable would be viable.

Health department acting director-general Dr Nicholas Crisp said: “We have way more capacity to vaccinate people than we have people coming for vaccination at the moment.

“For some time now we have been deferring our deliveries so we don't stockpile vaccines that become difficult for us to manage, and there are other countries in Africa that need deliveries as well.”

For Wits University professor of history Hlonipha Mokoena, a bigger sociopolitical context is overriding many individuals’ sense of seeking protection through vaccines and other measures.

She told the Sunday Times: “Our minds are failing to comprehend the enormity of the crisis that we are facing. This pandemic has stopped being a virological issue and is now rapidly becoming a psychological, sociological, political and cultural battle.”


A study published in the British Medical Journal this week said protection after a second dose of the Pfizer vaccine can wane, warranting a third (booster) dose. The researchers said  "protection seemed to decrease over time, and the risk of breakthrough infection increased progressively compared with the protection provided during the initial 90 days".


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