How to up the jab rate, according to SA’s Covid-19 experts

Covid vaccinations almost halved in the last week of November compared with the same period the month before, and more than half of adults in SA — about 57%, or 22.8-million — are still not immunised.

But early signals this week suggest the highly infectious Omicron variant could boost demand, with 154,154 vaccinated on Friday compared with 115,337 the previous Friday.

Wits University vaccinology professor Shabir Madhi said a combination of apathy and hesitancy contributed to the earlier lack of demand.

“I suspect many people don’t believe there is an urgent need for vaccination, especially younger age groups who have been relatively spared,” he said. 

“The hesitancy is fuelled by mixed messaging from government and earlier by its advisers, casting doubts about how vaccines would protect against even severe disease due to Beta. This is compounded by misinformation that has run rampant.”

Department of health spokesperson Foster Mohale said:  “We have enough vaccines, human resource and vaccination sites.” He blamed fake news and misinformation for the slow rate.

Infectious-disease specialists warned the vaccine mandates were not a silver bullet without good access and communication.

Professor Ian Sanne, a member of the Covid ministerial advisory committee, said: “I would make Covid-19 vaccines mandatory for participation in any community spaces where people congregate. This would include sport, tertiary education and perhaps even secondary education institutions, workplaces and to get on airplanes, trains and taxis.

“The policy could accommodate those who do not wish to be vaccinated but they would need to demonstrate weekly Covid-test negative status.”

Professor Francois Venter from the Wits faculty of health sciences said mandates would boost vaccines. “It has been remarkably effective, even in super-individualist and vaccine-iffy countries like France.”

But mandates would push up numbers only where they were applied, such as workplaces or restaurants, he said. “Vaccine access needs to be more convenient, a tent at every supermarket and taxi rank,” Venter said.

Professor Jeremy Seekings, director of the centre for social science research at the University of Cape Town, said the national and provincial departments of health “could do more to improve access to vaccination in poor neighbourhoods”.

“[The government’s] biggest enduring failure is in confronting vaccine misinformation.”

The Sunday Times asked Covid experts what three steps they would take to boost vaccine uptake

PROFESSOR IAN SANNE

Head of health organisation Right to Care

1. Make vaccinations more accessible. Bring the vaccine effort to the villages of deep rural Mpumalanga, Limpopo and the Northern Cape. Provide extended hours at vaccination sites, in the same way we saw increased uptake of HIV services among men by extending evening hours and into weekends.
2. Provide visible and consistent messaging on the benefits of vaccines.
3. Encourage vaccination through settings of congregation, such as places of worship, sporting events and education.

PROFESSOR GLENDA GRAY

President of the Medical Research Council and co-principal head of the Sisonke 1 & 2 implementation trials, vaccinating health-care workers nationally

1. Make vaccinations a requirement to get on with everyday life, like in France. You need to be vaccinated to take an Uber, to go into a restaurant or access public areas.
2. Introduce workplace vaccine mandates, starting with the hospitality and tourism business, which is fragile and highly affected by Covid. Staff should all be tested or have to show negative PCR tests regularly.
3. Appeal to religious leaders to encourage their congregations to come forward for vaccination, as they have influence in communities.

PROFESSOR SHABIR MADHI

Dean of the Wits faculty of health sciences and co-principal investigator on two Covid vaccine trials

1. Continue efforts to vaccinate 90% of people older than 50 and anyone with underlying immunosuppressive medical conditions.
2. Give all single-dose J&J recipients a second dose of vaccine, either J&J or Pfizer, as the single dose is inferior compared with two doses in protecting against severe Covid.
3. Immediately boost people older than 60 and anyone with immunosuppressive underlying conditions who received two doses of Pfizer — without creating obstacles such as requiring a medical certificate.  

PROFESSOR FRANCOIS VENTER

Divisional head Ezintsha, Wits faculty of health sciences

1. Give 5% or 10% off every grocery bill at major supermarkets to anyone who shows proof they are over 60 and have been vaccinated.
2. Double the pension payout the following month for anyone who produces proof of vaccination.
3. Encourage retailers, rewards programmes, et cetera, to tell people they can double their points if they send proof of vaccination in December.

DR NOMATHEMBA CHANDIWANA

Senior research clinician at Ezintsha

1. Ditch any barriers to registration and appointments, and have vaccine sites in more accessible areas such as malls and schools.
2. Concentrate on the most vulnerable and give them booster shots, including people older than 65 and people with comorbidities.
3. Incentivise where you can for people to get vaccinated. For example, medical aids and wellness schemes could give you more points like they do for HIV testing and pap smears.