Vooma vaccinations: The race to beat the fourth wave of Covid-19 and avert 20,000 to 30,000 deaths

One of the challenges of rolling out a national vaccination programme in the middle of a pandemic is that some people die within days of getting the jab. Not from the vaccine, but from the virus which had been insidiously incubating at the time of vaccination, resulting in death before the body could mount an adequate immune response. 

The South African Health Products Regulatory Authority (Sahpra) has investigated 86 deaths that occurred soon after vaccination up to the end of August 2021, and of the 40 fully investigated by mid-September, 13 had been as a result of Covid-19 infection, while the rest were unrelated to Covid. 

We should remember that people continue to die of other natural causes at the rate of about three deaths to every one Covid-death. Nevertheless, my voice of reason becomes a little reedy when a grieving woman tells me that her sister died from the vaccination. Reedy not because I doubt the science, but because the rawness of death confers on the bereaved a certain immunity from contradiction. 

Unfiltered, that news will spread rapidly through physical and digital villages, landing in the homes of those who don’t have a major issue with vaccines, but are just a bit scared of the unknown; scared enough to wait “until tomorrow” before being vaccinated. In their minds, and in the absence of reassuring information to the contrary, the bad news reinforces the stream of misinformation bombarding their cellphones. 

For many in South Africa, these falsehoods are clasped not so much as immutable beliefs steeped in ideology as psychological handholds in the face of uncertainty. Factoids may be false, but they are transmitted with 100% conviction – unlike the guarded language of science which expects the layperson to find comfort in lower statistical probabilities of infection, disease and death. 

Which is why direct rebuttal of anti-vaxxer positions may prove counterproductive. It makes people feel more embattled in the face of so many intersecting stresses of life. They retreat into their networks of trust, buttressed against the cold incursions of science. While we may obsess over Covid-19, it is simply one of the many risks faced by ordinary people in the course of their daily lives, who are concerned with their safety on the streets, coping with domestic violence, or living with hunger and other health conditions like HIV. 

This is probably why we see such a big gap between the high percentage of adults in South Africa who tell interviewers that they will accept the vaccine if they are offered one, and the lower numbers of people who actually come forward for vaccination. 

Strategies for beating the fourth wave

With a fourth wave likely before the end of the year, our national target is to vaccinate 70% of adults – with at least one dose – by Christmas. By mid-October we’ll be halfway there, which means the pace of vaccination must be massively escalated to avert the 20,000 to 30,000 deaths predicted in this wave.

Working with leadership both inside and outside of government, the Department of Health has identified five key strategies to build “demand”. They include: 

1. Intensifying public leadership across all sectors;


2. Making communications simpler and clearer;


3. Ramping up media and marketing strategies;


4. Energising networks of civil society, labour and business; and


5. Encouraging incentives that enhance the value and offset the opportunity costs of vaccination.

One of the challenges in rolling out a national vaccination programme in the middle of a pandemic is that some people die within days of getting the jab. Not from the vaccine, but from the virus which had been insidiously incubating at the time of vaccination, resulting in death before the body could mount an adequate immune response. (Photo: Felix Dlangamandla)