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Phase 2 of SA’s Covid-19 vaccine rollout starts: This is how it works

  • All South Africans over 60 are encouraged to register on the electronic vaccination data system (EVDS) to secure an appointment.
  • Once you have registered, you will receive an SMS confirming the details of your appointment.
  • People will not be allowed to choose which jab they get. The Pfizer jabs will be administered mostly in urban areas while the J&J shots are mainly earmarked for rural areas because it can be stored at normal refrigeration temperatures.

South Africa moves to Phase 1B (health workers who have not been vaccinated) and Phase 2 (starting off with people aged 60 and older) of its Covid-19 vaccine rollout today.  

The country has received 975 780 Pfizer doses so far, Health Minister Zweli Mkhize said on Sunday night. South Africa is expecting to receive a total of 1.3 million Pfizer jabs by the end of the month.

ALL THE LATEST ON COVID-19 AND THE VACCINE ROLL OUT

A further 3 million Johnson & Johnson (J&J) doses are expected to arrive by the end of June. The first instalment of 1.1 million doses has been manufactured and is waiting to be released from the Gqeberha plant of pharmaceutical company Aspen — that date depends on the conclusion of a verification process by international regulators that is currently under way.

Mkhize said he hoped to know the date of release by the end of the week.  

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Phase 1B will cover health workers who had not been vaccinated in Phase 1A of South Africa’s Covid-19 vaccine implementation study, known as the Sisonke trial, that ended on Saturday.  

The Sisonke study vaccinated 478 733 health workers. The trial received 500 000 J&J jabs. The remaining 21 267 doses cannot be transferred to this week’s national rollout, but will be used for Covid-19 vaccine research by the South African Medical Research Council (SAMRC). Mkhize said the SAMRC would test jabs on groups, such as people with HIV, people with comorbidities, and pregnant and lactating women.

Phase 1B and 2 will happen simultaneously and in most provinces, Phase 2 will start off with vaccinations in old age homes. 

But what exactly will this rollout look like and how can you get your hands on a Covid-19 shot? We answer four key questions.

1. Who is eligible to get vaccinated?

The national rollout aims to vaccinate 41 million adults across the country, with those most likely to get infected (healthcare workers) and those most vulnerable to falling severely ill (people aged 60 years and older) being prioritised.

So far, the jabs have only been approved for use in people older than the age of 18 by the South African Health Products Regulatory Authority (Sahpra) — so no children can be immunised at this stage.

This will be the largest immunisation programme undertaken in South Africa to date and it’s been broken up into the following three phases:

Phase 1 aims to reach 1.2 million healthcare workers. According to a South African Medical Research Council Press release, the health department defines health workers as all people engaged in actions whose primary intent is to enhance health. This includes all health personnel who are currently working in any department of health office or registered public and private health facility (hospital, clinic, laboratory, pharmacy, care facility) or who provide health services at a community level on behalf of the public or private sector. This definition includes support staff, such as porters, cleaners, community healthcare workers and traditional healers.

For the first part of Phase 1 (Phase 1A), South Africa has been using an implementation study called Sisonke, which ended on 15 May and covered about 500 000 healthcare workers. The remaining 750 000 workers will be vaccinated from 17 May in Phase 1B.

Phase 2 will begin to target high-risk groups and includes 16.6 million people. It will happen at the same time as Phase 1B — at least initially.

Phase 2 is a much larger endeavour than Phase 1 and as it is being rolled out, vaccination sites will be upscaled. People targeted in Phase 2 will have also been broken down into smaller groups: essential workers, people living in crowded areas, people over the age of 60 and people aged 40 and older — with the oldest people who have registered taking first priority.

1. But what about people living with comorbidities?

Research has 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 Centers for Disease Control and Prevention, more than 80% of Covid-19 deaths occur in people older than 65, and over 95% in people older than 45.

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

In South Africa, people older than 40 years 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 who have underlying conditions, such as high blood pressure or diabetes, people who are unaware that they have comorbidities won’t be included, Lesley Bamford explained during an April presentation to union leaders. Bamford is the co-chairperson of the national vaccine coordinating committee.

Phase 3 will reach the remaining 22.5 million adults who are not covered in the first two parts of the rollout.

2. What do you need to do to get a COVID shot?

You can’t get an appointment for a Covid-19 shot without being registered on the government’s electronic vaccination data system (EVDS).

So far, only health workers and people aged 60 and older should register on the system. On Sunday night, Mkhize said 2.1 million people — 914 000 healthcare workers and 1.227 million people aged 60 and older — had registered on the system by Sunday. According to the health department, the country has 1.2 million health workers and a population of 5 million people aged 60 and older.  

The health department will announce when certain groups should register on the system. The platform is currently open to healthcare workers and people aged 60 and above.

To sign up, go to vaccine.enroll.health.gov.za and follow the instructions. The process should take about three minutes to complete.

You will need:

Access to the internet

Your ID number, passport, an asylum seeker or refugee number

Your contact information, primarily a cellphone number

Your work or home address

The department has launched two alternative ways to register:

WhatsApp the word “register” to 0600 123 456 and follow the instructions.

Dial *134*832*your ID number or *134*832# if you don’t have an ID number to register

Your cellphone number will be used to communicate with you about the details of your appointment.

You can also register in person at vaccination sites, according to Bamford’s April presentation.

Mkhize says 7 707 SMSes containing appointment details have been sent to healthcare workers and 4 288 to people aged 60 or older.

3. Where can you go to get vaccinated?

Once you have registered, you will receive an SMS confirming that your registration has been successful.

An SMS with details of your appointment will follow — but this could take between two and three weeks, the Western Cape health department said on Thursday. In the Western Cape, old age homes will, for instance, be covered first in Phase 2. Withing two to three weeks after 17 May, people aged 60 and older who don’t live in old age homes will receive an SMS with information on where and when they will receive their vaccinations.

You will be directed to a vaccination site that is closest to where you stay or your place of work.

More than 2 000 sites have been identified across the country, President Cyril Ramaphosa said at the end of March. A further updated list including more than 3 000 potential sites was presented to Parliament on 28 April. These places include hospitals, community clinics and pharmacies, retail outlets and some larger sites, like stadiums and conference centres.

The sites are being reviewed by the South African Pharmacy Council in collaboration with the national health department to ensure they meet all requirements prior to going online.

The requirements include being able to properly store the jabs and having the appropriate people to safely administer them, Vincent Tlala, CEO of the South African Pharmacy Council, told Bhekisisa.

Tlala said certificates were issued to public and private hospitals, community health centres, primary health clinics, retail pharmacies, mobile clinics and occupational health clinics.

Some of the 92 sites that were used for the Sisonke study will also be used for the national rollout.

The review process is ongoing and more sites are expected to be added as Phase 2 progresses.

You can find the vaccination sites in Gauteng, along with the dates on which each site will open below. The information was released by the KwaZulu-Natal department of health.

Bhekisisa will publish an updated map as more sites go online for the wider rollout.

Retail pharmacy Dis-Chem has also identified 32 vaccination sites nationwide, according to a press release. The first 11 of these sites will be active from 24 May. Staff at Dis-Chem’s sites have undergone training and are expected to administer 600 shots each day, says the group’s chief executive officer, Ivan Saltzman. Fifty more people could be vaccinated at Dis-Chem’s in-store clinics each day as long as there is stock.

He explains: “Should government stock be readily available, the group will be able to vaccinate approximately 800 000 people each month.”

4. Can you choose which vaccine you get?

Short answer: No.

For now, South Africa’s national rollout will use both the J&J jab along with Pfizer’s shot — although we will initially only have Pfizer shots available (until the J&J jabs are released from Aspen’s plant in Gqeberha).

There are differences between the two jabs which will influence how they get distributed across the country. For instance, the shots have different cold chain requirements and are also packaged with a different number of doses per pack. 

Pfizer doses will mainly be used in metros, as these sites can reach a larger number of people and Pfizer requires freezers that aren’t always readily available in rural areas. Pfizer arrives in packs of 1 170 doses that will be stored at -20°C at sites in South Africa, but the doses can only be kept at that temperature for two weeks. Once the packs are opened and the vials are thawed, the doses can be stored in a fridge at between 2 and 8 ? but only for five days. Larger sites are therefore ideal for the use of the Pfizer vaccine because in urban areas where there are more people, doses can be used more quickly and are therefore less likely to become unusable.

Because Pfizer requires two doses three weeks apart, vaccinators need to be able to follow up with each vaccinee to return for the second shot — and that is often easier to do in urban areas.

The J&J shot, on the other hand, requires only one dose, minimal follow-up and can be stored at normal fridge temperatures between 2 and 8 °C for three months. The jab will therefore largely be used in rural areas.

Once you have been given an appointment and assigned to a facility, you will not be able to select which jab you receive.

As the national rollout will kick off with Pfizer shots only, most initial sites are likely to be in urban areas.

5. Does anything change if you’re on medical aid?

In November 2020, the Council for Medical Schemes (CMS) listed COVID-19 vaccines as a prescribed minimum benefit. That means all medical schemes must pay for their members’ Covid-19 jabs. Your medical aid is therefore not allowed to ask you to pay for the vaccination and then claim back the money — the scheme has to pay the provider directly.

South Africa’s biggest private medical scheme, Discovery Health, has launched an online registration system called Vaccination Navigator which is similar to the health department’s EVDS. Members of the scheme must register on both portals.


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

 

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