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Covid-19 vaccination in South Africa — boost in youth vaccine uptake urgently needed

Daily Maverick logo Daily Maverick 2022/08/15 Tamsin Metelerkamp

Various health experts weigh in on the current uptake of vaccines and boosters.

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Since December 2021, when the Omicron-driven wave of Covid-19 swept SA, there has been a significant decline in vaccine uptake across the country. This despite the fact that about 49% of the adult population remains unvaccinated.

Vaccine statistics from 9 August 2022 showed that only 722 people had been vaccinated in the previous 24 hours. Just a year before, on 9 August 2021, the number of vaccines administered in the previous 24 hours stood at 19,012.

To understand the situation behind the numbers better, DM168 spoke to health experts about the current uptake of Covid-19 vaccines and boosters in SA — who’s getting them, who isn’t, and why we should care.

The age difference

Vaccine coverage is higher in older people, at 71% (3.9 million) for those 60 years and older, and 66% (3.2 million) for those aged 50 to 59.

However, in the 18- to 34-year age group, about 38% (6.7 million) have been vaccinated. Vaccine uptake for those aged 12 to 17 sits at about 2.6 million.

“Our big challenge at the moment is younger people. We really need to get more of them [vaccinated] before they become sitting ducks for long Covid,” said Nicholas Crisp, deputy director-general in the national Department of Health.

Long Covid is a condition whereby a person continues to suffer symptoms such as fatigue, shortness of breath and cognitive dysfunction for months after the initial Covid-19 infection has passed. It is believed to affect 2% to 3% of people, according to David Harrison, CEO of the DG Murray Trust, a funder of public benefit organisations. “We know that vaccination reduces the risk of long Covid — doesn’t obviate [it] completely, but certainly reduces the risk,” he said.

Places and politics

It is not only age that affects vaccine uptake. Geographic factors also come into play, with some vaccination sites being stronger than others, according to Crisp.

The provinces with the highest vaccination rates among adults are the Free State at 60% and the Western Cape at 57%. KwaZulu-Natal and Mpumalanga have the lowest vaccination numbers.

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Vaccine uptake was more likely to be affected by “big national sentiments” and political trust than the specifics of the vaccine itself, said Harrison. He used the example of the municipal elections in November 2021 correlating with a sharp decline in first-dose vaccinations.

Boosters

The uptake of boosters remains very low in SA, with only about 3.6 million shots administered. People between the ages of 18 and 49 are entitled to one booster, while those over 50 can receive two, according to Harrison. Children aged 12 to 17 are not currently eligible for these shots.

People who are using booster shots are mostly those who need to travel and older people, according to Crisp.

Boosters are important, as they contribute to the building of cellular immunity within the body, he continued. While a person’s first exposure to an alien protein such as that introduced by the Covid-19 vaccine will result in the production of antibodies that die off over time, the second and third exposures stimulate the production of white blood cells that consume the virus.

Vaccine rollout

The Department of Health was integrating the Covid-19 vaccination programme into routine health services, said Crisp, meaning a shift away from mass campaigns to standard availability in all public health facilities.

As of 8 August, the department had a total of 8,886,870 Pfizer doses on hand at distributors, 4,055,700 of which will expire on 30 September and 4,831,170 of which will expire on 31 October.

There are 10,143,000 doses of Johnson & Johnson on hand, with expiry dates falling between June and September 2023.

“[The vaccines] have a limited shelf life. Fortunately, around the world, regulators are testing the vaccines that have been in storage for some time … and they are finding that they’re way more stable than they thought they were going to be, so then it makes it possible to extend the expiry life,” said Crisp. “But eventually all medicines expire, and … you have to destroy them. That’s the real conundrum at the moment.”

Keep getting vaxxed

“Your body’s response to repeated exposure to vaccinations makes you more and more protected,” said Crisp. “So, although you may get infected, your chances of a severe infection and certainly your chances of ending up in ICU or dying are dramatically reduced if you keep vaccinated.”

There was still a risk that emerging variants of the virus could be “troublesome”, said Harrison.

“We could get emergent variants that could cause trouble again, and for that reason, to sustain and to just keep building the Covid immunity at a population level makes sense.” DM168

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R25.

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