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South Africa’s Rollercoaster COVID-19 Vaccine Roll-Out

Sep 03, 2021 09:00AM ● By Boitumelo Masihleho

South African President Cyril Ramaphosa getting the Johnson & Johnson vaccine at the Khayelitsha District Hospital in Cape Town.

In the African continent, South Africa was the most drastically affected country by COVID-19, with more than 1.57 million infections. From late November 2020 until February 2021, South Africa experienced a second wave of resurgence in COVID-19 infections, which caused the country to have to re-implement stricter regulations. In January 2021, The National Department of Health Minister, Dr. Zweli Mkhize, announced that South Africa would begin its plan to vaccinate 67% of the population - roughly 40 million people. However, many challenges have halted this ambitious goal.

South Africa received 1 million doses of the Oxford University-AstraZeneca vaccine from the Serum Institute of India (SII) on February 1, 2021. Unfortunately, new information came out that the AstraZeneca vaccine is less effective against the 501Y.V2 variant that was prevalent in South Africa, so the government decided to donate it to the African Union. However, this didn’t change the vaccine rollout. Healthcare workers would now instead receive the Johnson & Johnson, which has proved to have a better efficiency against the COVID-19 501Y.V2 variant.

The South African government secured 12 million doses in total from the global COVAX facility, as well as an additional 9 million vaccine doses from Johnson & Johnson,  for the second quarter of 2021. Dr. Mkhize announced that online registrations for phase 2 of the country’s COVID-19 vaccine rollout will officially open on April 16, 2021. Pfizer has committed 4.5 million vaccines to reach the country by the end of June. On May 2, the first shipment of 325,260 doses of Pfizer vaccines arrived at O.R Tambo International Airport. “The vaccine supply will increase to an average of 636,480 doses weekly from May 31,” said Dr. Mkhize.

In mid-April, after a study from the United States showed that a few women had developed a blood clotting disorder after receiving the one-shot Johnson & Johnson vaccine, South Africa’s mass-inoculation campaign came to a halt. At that point in time, 290,000 South African health workers had been given the vaccine with no reported blood clots. “Based on their advice, we've determined to voluntarily suspend our rollout until the causal relationship between the development of clots and the Johnson & Johnson vaccine is sufficiently interrogated,” Dr. Mkhize said to parliamentarians in April.


A few days later, the Health Minister announced that the vaccine rollout would resume. “Following SAHPRA’s recommendation and the Cabinet’s concurrence, the vaccine rollout will resume through the Sisonke Program on April 28, 2021,” said Dr. Mkhize. “The program has, on hand, all the doses it needs to complete vaccinating 500,000 health care workers through the early access protocol and the teams have been eagerly standing by, looking forward to making up for the lost time by completing this program in the shortest possible time.”

South Africans of various ages have shown a positive attitude towards the various Covid-19 vaccines and want to receive them. Some companies and organizations in South Africa have been able to begin vaccinating their employees who are involved in the health sector but aren’t necessarily healthcare workers. South Africans that have received the vaccination expressed how happy they were with their vaccination experience.

“My employer had been fast-tracking COVID-19 vaccines to be delivered, and finally, in early March, vaccination started. My first dose of Pfizer vaccine was early in March, with no serious side effects, just a swelling of the jab site,” said South African citizen Nomea Masihleho, who works for an international development organization. “Later in March, I got my second dose, that's when I got serious side effects, the day after the jab.  A very high fever of 38°C degrees, headache, and bad body aches. After taking paracetamol and being on bed rest, I started to feel better 24 hours later.”

Nonhlanhla Tshabalala, a data capturer at the Health Economics and Epidemiology Research Office (HE2RO) received the Johnson & Johnson vaccine at Helen Joseph Hospital and she expressed that she had no side effects. “I enjoyed my experience getting vaccinated at Helen Joseph Hospital as I was welcomed by the friendly staff who explained the process throughout and allowed questions to be asked,” explained Lerato Molapo, a research interviewer at HE2RO.

“I am very happy to have been offered the opportunity. The only side effect I experienced was a painful hand and a backache which lasted only one day.”

Sadly, South Africa experienced a third wave of increasing COVID-19 cases, with 13,575 new cases, which represents a 23.2% positivity rate in one day. Gauteng province, the country’s economic hub, where 25% of the population live, was the epicenter. Due to this, President Cyril Ramaphosa announced tighter lockdown restrictions, banning the sale of alcohol and an early curfew. Many people went back to working from home, or simply not being able to work at all, and therefore go without an income.

“We’ve simply failed the people of South Africa by not ensuring that they were timeously vaccinated. The vaccine program that’s underway has struggled to meet even the revised targets set by the National Department of Health,” said the director of the South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Shabir Madhi, in an interview. “Constraints in the supply of vaccines have obviously been a challenge. Countries like South Africa have been unable to gain access to adequate numbers of COVID-19 vaccines. This has been due to the inequitable distribution of vaccines around the world.

The tighter lockdown restrictions lasted a month and did work in reducing COVID-19 positive cases, so the president put the country to Alert Level 3, where the sale of alcohol was allowed, there was no more travel restriction to Gauteng and included a later curfew. South Africa is still under Alert Level 3 as of the publishing of this article. All those vaccinated will be placed on a national register and provided with a vaccination card. Those who qualify will be sent a notification through SMS, with a unique code, informing them of the time and place where their injection will be administered. People between the ages of 35 and 49 years were allowed to register and go get vaccinated in mid-July and the country saw the enthusiasm of the 35-49-year-old cohort but did see some hesitancy from the male population.


Gauteng Premier David Makhura said fewer men in the province were taking the Johnson & Johnson or Pfizer vaccines than expected when speaking to Leticia Mhlongo at Devon Abattoir outside Springs in early August. “ I don't know why we have fewer men who are taking the vaccine. We have plans to reach more men,” he said. “I want to assure men that there are many of us men who have vaccinated and are still alive. We are happy that many health workers were vaccinated.”

The changes in the Ministry of Health did not have much of an impact on the South African rollout plan as people thought it would, but the civil violent unrest in mid-July certainly did. At this point, the country has vaccinated just 7% of its population and may not achieve its herd immunity goal. COVID-19 vaccine rollouts in KwaZulu Natal ad Gauteng were halted as there were reports of pharmacies and vaccination sites. Once vaccination resumed after the unrest calmed down, there was a decline in the enthusiasm to get vaccinated from the 35-49-year-old cohort. 

The final phase of South Africa’s vaccine roll-out will target 22.5 million members of the population between the ages of 18 to 34 years old. The registration for this age group has recently opened up as of August 20, and more than 560,000 people aged 18 to 34 registered for vaccination on the first day they were eligible, and 81,000 of them were vaccinated on the same day. On August 29,  South Africa received 2.2 million Pfizer doses donated by the US through Covax, in addition to the 5.6 million donations received in July. 

By August 29, the total number of vaccines given reached 11,648,000, and 5.45 million South Africans were fully vaccinated, largely due to the youth of the country’s enthusiasm to get vaccinated.


The 18-34 years old cohort have been extremely excited to be vaccinated with many of them sharing their experience on social media, and influencing other people to register and get vaccinated as soon as possible. 


Recently appointed Health Minister Dr. Joe Phaahla says the government is trying to ensure as many people as possible are vaccinated against Covid-19 before introducing booster shots. He said rates of vaccination would determine the severity of the fourth wave. South Africa has been confirmed as a new hub for African vaccine manufacturing by The World Health Organization. Aspen will begin manufacturing vaccines solely in October, while the Biovac Institute in Cape Town was appointed to manufacture the Pfizer-BioNTech covid-19 vaccine for distribution within Africa.

This article is made possible by Resolve Philly.




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 Boitumelo Masihleho is a South African digital content creator. She graduated with a Bachelor of Arts from Rhodes University in Journalism and Media Studies and Politics and International Studies. She's an experienced multimedia journalist who is committed to writing balanced, informative and interesting stories on a number of topics. Boitumelo has her own YouTube channel where she shares her love for affordable beauty and lifestyle content. 

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