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‘First in, first vaccinated’: Why you should register for your Covid-19 jab ASAP

  • More than 7 000 healthcare workers, about 4 000 people of 60 and older received SMSes for vaccination appointments by 23:00 on Sunday –  by 08:30 on Monday, seven had been vaccinated.
  • People with comorbidities are no longer being prioritised for vaccination – rather, the health department is going by age.
  • Provincial health departments are prioritising public healthcare workers for vaccination, after which workers at private healthcare institutions will be targeted by their employers and then those working from home.

The national health department has confirmed that 7 707 health workers and 4 288 people of 60 years and older had received SMS messages by 23:00 on Sunday for Covid-19 vaccination appointments on Monday.

According to Nicholas Crisp, who is helping to manage the rollout of Phase 1B for health workers, seven people who had received such messages had been vaccinated by 08:30 on Monday.

Crisp said the people who received messages had been selected on the basis of who registered first on the government’s electronic vaccination data system (EVDS).

“First in, first vaccinated,” was the general rule, Crisp said.

Crisp continued: 

If you registered early, we will select you first, but, of course, within the context of making the selection geographically representative.

More SMS messages were expected to go out on Monday and each day of the week for vaccination appointments, although people residing in old age homes would be prioritised in most provinces (people in homes won’t receive SMS messages for appointments, as teams would visit the institutions and register and vaccinate residents on-site).

We answer four questions that people in South Africa raised on social media on Monday.

Will all healthcare workers be vaccinated this week?

On Sunday night, Health Minister Zweli Mkhize said the remaining 700 000 healthcare workers in the country – so those who were not one of the 478 733 health workers covered by South Africa’s implementation study, the Sisonke trial – would get jabs this week.

Pfizer, however, required two jabs, generally three weeks apart, so all health workers who get vaccinated this week would have to return for their second shot. Mkhize said South Africa was still deciding on how long after a first Pfizer jab the second shot would be given.

Crisp said there would be local challenges at different sites with all healthcare workers getting their first shot this week.

“Some will be stuck in theatre, some will miss their appointments or be on night duty, and some will be on maternity leave. So, it’s possible that all workers won’t get vaccinated this week. But the reality is, if a healthcare worker doesn’t get vaccinated this week, they’ll get vaccinated next week,” said Crisp.

Crisp said public healthcare workers were being prioritised by provincial health departments, after which workers at private healthcare facilities would be targeted by their employers and those in private practices, such as doctors and psychologists working from home, would be managed through a separate appointment system.

“We will announce the arrangements soon.”

Crisp said South Africa had enough vaccinations to cover all healthcare workers within the next two weeks. According to Mkhize, the country received 975 780 Pfizer doses and another batch of 325 260 doses would arrive next Sunday.

Are comorbidities in or out as a prioritisation category?

Crisp confirmed that comorbidities were no longer used as a category to prioritise vaccinations. Rather, age is.

Why?

Research had shown that age is the strongest predictor of how likely someone is to end up in hospital or die of Covid-19. According to the US government’s Centres for Disease Control (CDC) more than 80% of Covid-19 deaths occur in people over the age of 65, and over 95% in people older than 45.

Because many Covid-19-related comorbidities such as diabetes were more likely to affect middle-aged and older people, a sizeable proportion of comorbidities would be covered if older people were vaccinated first.

In South Africa, people older than 40 make up the bulk of people living with comorbidities (such as high-blood pressure or diabetes), according to a South African Medical Research Council policy brief.

Also, if the government prioritised people with underlying conditions such as high blood pressure or diabetes, people who are unaware that they had comorbidities wouldn’t be included, explained Lesley Bamford during an April presentation to union leaders. Bamford is the co-chair of the national vaccine coordinating committee.

Crisp said comorbidities were also complex to verify on the EVDS system and age was therefore a considerably more reliable indicator to use for prioritisation.

But Crisp said, although the EVDS generally prioritised people on the basis of age, age within a cohort, for instance, age within the category of people of 60 and older, didn’t play a role.

Crisp says: 

Those in a certain category, for instance, healthcare workers of people of 60 and older, who registered first, will get SMS messages for appointments first, not those who are the oldest.

What will happen to the unused doses of the Sisonke trial?

The Sisonke trial, which ended on Saturday, received 500 000 Johnson & Johnson doses – of those doses, 21 267 were not used. The jabs would now be used for research by the South African Medical Research Council. For what? To test vaccines on specific groups of people, such as people with HIV, pregnant and lactating women, as well as people with comorbidities.

Why can’t we use the leftover Sisonke doses for Phase 1B (healthcare workers not covered by Sisonke) and Phase 2 (starting off with people 60 and older)? Because the Sisonke doses were donated by Johnson & Johnson for research purposes, and they were registered in South Africa for use in a research setting. They can therefore not be used outside of a study environment.

How do people who don’t have internet access register?

On Sunday night, provincial health representatives announced that teams were being sent to villages, churches, shopping malls and South African Social Security Agency (Sassa) payout points to help people to register. Provincial health departments were also working with traditional healers to get people registered.

In addition to this, the government launched a USSD service that could be used with an analog phone and didn’t require phone or data credit to use: Dial *134*832* and your ID number or *134*832# if you don’t have an ID number to register.

There is also a WhatsApp service: WhatsApp the word “Register” to 0600 123 456 and follow the instructions.

By Sunday, 2.1 million people in South Africa – 914 000 out of 1.2 million healthcare workers and 1.227 million out of five million of people older than 60, had registered on the EVDS system.

This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.

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