Step up to make the vaccination programme happen

Doomsayers thrive in times of uncertainty, playing on our primal fears of what may be lurking just around the corner. They caricature the efforts of those working on the jigsaw puzzles of the future, pretending that the pieces are all there if you just look hard enough. They resort to ad hominem insults and pounce on the failings of others.

A textbook example is Jonathan Jansen’s article entitled “SA’s vaccine rollout is a disaster” (Sunday Times Daily, May 5). Its opening line is the dire prediction that “it’s time to face an unpleasant truth that you might not get vaccinated for a very long time”. It goes on to accuse government of indifference and constant missteps make perplexingly personal comments about the minister of health and concludes by portraying the corporate sector as the white knight that could rescue us from such ineptitude. A thorough dissection of the article would simply fill our conversation space with more rancour than light, but still, its grimly satisfying call for clarity must be challenged when the reality is both harder to understand and to explain.

That reality is a mix of government torpor, outrageous demands by manufacturers from behind the veil of confidentiality, and the twists and turns of a novel virus seeking to secure its berth in the epidemiology of the future. Even this is an ersatz portrayal of reality. Things have rolled out slower than they should have, but there are hundreds of health managers across the country working day and night to put the systems in place for an effective programme. There is also some logic behind the demands of manufacturers who fear being blown out of the water should masses of people develop serious side-effects that warrant compensation.

Nonetheless, let’s get to the question that everyone is asking, namely: “Where is the vaccine?” It is public knowledge that 51 million doses of the Pfizer and Johnson & Johnson (J&J) vaccines have been procured. Of these, 20 million are Pfizer vaccines which require two doses, meaning that 10 million people can be vaccinated through that order alone. Altogether, we have just enough vaccines to cover every person in SA who is 18 years or older. Inevitably, there will be some wastage as the vials come in packages that have to be used or discarded once they are thawed. However, not everyone will choose to get vaccinated, so we may already have enough.

Based on its international procurement schedule and local manufacture of the J&J vaccine at the Aspen plant in Gqeberha, government announced that the vaccination of people 60 years and older would commence on May 17. But the Federal Drug Administration then put a hold on the worldwide distribution of the J&J vaccine because of some contamination in a manufacturing plant in the US. Once this restriction is lifted, the delivery of vaccines will recommence, hopefully still in time to meet the deadline.

In the meantime, the national and provincial departments of health and the private sector have identified over 3,300 sites for vaccination and are gearing up to vaccinate a quarter of a million people a day by October 2021. Special dispensations have been approved by health professions councils to increase the pool of vaccinators and vaccine types have been allocated according to the cold storage capacity of each site. Commercial distributors (Biotec and DSV) have been commissioned to deliver the vaccines to the primary vaccination sites.

There will inevitably be challenges as the programme rolls out, and the temptation will be to seize on the failures and ignore the progress. Certainly, it is incumbent on government to reduce that temptation by bringing the nation into its confidence, telling the unfolding story of the first implementation of a national immunisation campaign for adults in SA, warts and all.

At the same time, it is up to us to cope better with not knowing what is not yet known. In her book The Cunning of Uncertainty, Helga Nowotny, notes that unpredictability is “written into the script of life”. Yet it rattles us badly. We tend to either withdraw into the laager to wait out the storm or seek a parallel universe of heroes and villains where good and bad choices are fantastically clear-cut.

As the experience of the US shows, we cannot put our faith in the assumed prowess of one sector of society or the other. Despite the open cheque book of the US government and all the systems of business, the immunisation campaign is losing momentum there as it nears the asymptote of those who want to get vaccinated. Here, we will require the mobilising capacity of civil society to drive demand and ensure full access in poorer communities.

In times like these, certainty is an illusion and the call on government to assure us that it is on top of it all simply creates a false sense of security. Certainly, there must be space for criticism, as long as we’re all also asking ourselves what we can do to ensure that every adult in SA gets vaccinated. The gravity of Covid-19 and the unpredictability of our future demands that we step into the void together and give it real substance and direction; all of us — government, civil society and the business sector.

If you are 60 years or older, you can now register online to be vaccinated against Covid-19. Visit here.

Or send the word “Register” to 060 012 3456 on WhatsApp.

Or use the free USSD line by dialling 134*832#. 

This op-ed written by Dr David Harrison first appeared on Times Live on 10 May 2021.

David Harrison is the CEO of the DG Murray Trust.  He is currently leading a multi-donor process of support to the Department of Health to help ensure the success of the COVID-19 vaccination programme.

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