South Africa’s Johnson & Johnson vaccine roll-out is still in limbo

On Sunday, Bhekisisa reported that out of the 31 million doses of the Johnson & Johnson (J&J) Covid-19 vaccine procured by South Africa, the first two batches of 1.1 million and 900,000 cannot be released until the US Food and Drug Administration (FDA) gives the go-ahead. 

In a Daily Maverick webinar, Dr Nicholas Crisp, deputy director-general at the Department of Health and the man in charge of the government’s Electronic Vaccination Data System (EVDS), explained the processes and time frames involved when a vaccine is released to a country or purchaser. 

Crisp said once the FDA gives permission for use, South Africa’s regulator has to first verify that it is a “bona fide vaccine”. The National Control Laboratory then checks the potency of the vaccine, whether it has been contaminated or compromised and the level of protection the vaccine offers the public. 

 

The National Control Laboratory takes samples from every batch and vets the paperwork.

“That is a safety measure that we will not compromise on, and we have to be patient for those three to four days that it takes,” said Crisp.

The time-frame also depends on the size of the batch and how many samples need to be taken. Once this process is completed, the EVDS has to ensure logistics are in place, including staff rosters and the correct needles and syringes. Crisp said the EVDS had “been ready for some time, and we are anxious to scale-up our vaccinations”.

Providers have said that they can “double” the 70,000 daily vaccinations “very quickly”. The EVDS, which is currently only available in English, allows the department to keep track of everything that happens within the national vaccination roll-out, said Crisp.

Currently, only healthcare workers and people over the age of 60 qualify to be vaccinated in the roll-out. 

“The minister was given recommendations by two ministerial advisory committees and there were discussions in government [about] how to prioritise who to register first,” Crisp said. 

“In the Sisonke programme – which preceded this and where the EVDS was used for management of that process – we were only targeting healthcare workers. 

“Now we are targeting the remaining healthcare workers, plus all the persons over 60.” 

This portion of the population was prioritised for two reasons: age itself is a risk factor for severe illness and for hospitalisation and morbidity and mortality, and there is an abundance of comorbidities in that group already, said Crisp. 

In conversation with Maverick Citizen journalist Estelle Ellis on Sunday, Crisp addressed “vaccine envy”, and people who have registered for a vaccine but are still waiting to receive their jab. 

“We need to see the big picture to understand why [people] are waiting for an appointment,” said Crisp. 

Just over 3.2 million people have registered in the EVDS, and 1.1-million people have been vaccinated, he said. This means that there are 2.1 million people waiting to receive their jab. 

Using the EVDS, Crisp and the rest of his team are able to monitor every vaccination site and can see where the queues are long and where they are moving slowly. In rural areas, especially “far-flung” rural areas, it has been slower, said Crisp: “This is largely due to lack of access to vaccination points.”

He explained that a person’s position in the queue is determined by the date of registration, location and proximity to a vaccination site. 

“We might not have a site that is anywhere near where you [live] and until there’s a site 10km in an urban area or 30km in a rural area from where you stay, you will not be scheduled.” 

As the national roll-out gains momentum, the public will find that vaccination sites will become more accessible, he said. 

You can log on to the EVDS and change your location if you have recently moved house, as well as change the date and time of your appointment, without losing your spot in the queue, said Crisp. 

“Once you’re registered we’re not going to forget you, and even those who were registered as healthcare workers under Sisonke are now queued into the national roll-out.” 

Crisp said he is confident that the EVDS is ready to begin the J&J roll-out as soon as the vaccines are available for use. 

“We are doing everything we can to find other vaccines, other ways to purchase [vaccines] and to find vaccines that other countries may not be using,” said Crisp. 

But there’s science to this as well and it must be ensured that the vaccine South Africa chooses is going to have the required immune response. 

“And the science keeps changing.” 

Crisp urged healthcare workers and those who are over the age of 60 to register for the vaccine and to help others to register. 

“My neighbour’s health is my health, and if we are unable to protect one another, we are going to suffer together as a community and prolong the agony.” DM

If you are a healthcare worker or are aged 60 or older, you can register for a vaccine here.

The updated list of sites that are reporting vaccinations to the EVDS can be found here.

The daily Covid-19 vaccination report can be found here.