How to boost the Covid-19 vaccine rollout

Government has got a few things right, but there’s so much more it can still do

By Nathan Geffen and Marcus Low

18 August 2021

Illustration: Lisa Nelson

A few weeks ago South Africa’s Covid-19 vaccine rollout seemed well set. We were consistently administering over 200,000 doses on weekdays and well over a million a week. We got up to over 250,000 doses a day at one point. Then the daily numbers began to decline. On Monday 16 August, about 160,000 people were vaccinated.

After many missteps and a slow start, government has got a few things right. The age threshold has gradually come down from over 60 to 35, and it appears that from next week any person over 18 can start getting vaccinated. Many sites now allow walk-ins (people without an appointment), the health department has committed to doing more vaccinations on weekends, and at least some efforts are now being made to provide vaccinations at more convenient places such as SASSA paypoints.

As we write this, nearly eight million people have had at least one shot. This is by far the biggest vaccine rollout in South Africa’s history.

But it’s not good enough.

The health department’s approach continues to lack urgency – as is clear from the low levels of weekend vaccinations and its poor communication efforts. But Covid is an emergency. Every cent and ounce of effort invested in getting vaccines into arms saves lives and takes us a step closer to ending lockdowns.

No, we can’t eradicate Covid, but we can slow it down dramatically, to the point where we can cope with it, give the economy a chance to improve, and lead our lives more or less the way we did before March 2020, perhaps with a bit more attention to not spreading our germs. The vaccine rollout should be the government’s most important short-term task. Absolutely nothing compares to it in urgency.

What needs to be done?

  1. We’re inundated with reports of empty or low-volume vaccination sites. Open them up to everyone over 18 now. Why wait another day? We have a large amount of vaccine stocks; let’s use them. There should be priority queueing for people over 60 and frail people.
  2. Stop the uncertainty about walk-ins. Every site should be encouraged by the national department to open for walk-ins, and should be able to advertise when it allows them and how it manages them.
  3. The weekend scale-up has not really happened. The reasons are unclear. Is it a matter of money? It shouldn’t be; no expense should be spared scaling up the rollout. Perhaps it’s a failure to advertise which sites are open?
  4. As we previously wrote here the health department needs to set up many more vaccine sites at shopping malls, SASSA paypoints and taxi ranks. Add to that universities, technicons, gyms and shebeens. Dispatch mobile vans offering vaccines. This would be a good way to increase numbers especially on weekends. Some of this is already happening. It needs to be scaled up.
  5. Nobody should be denied a vaccine because they don’t have an ID or passport number. Government must allow all undocumented people to be vaccinated. The EVDS system should enable vaccination, not prevent it.
  6. Game has offered a discount for people who are vaccinated. More retailers should follow this example.
  7. Get communities involved: HIV treatment scaled up in the late 2000s because of youth groups in townships (often organised by the Treatment Action Campaign). People going door-to-door in townships encouraging vaccination and answering questions from hesitant people could make a big difference.
  8. Government communication is poor. Frankly, our colleagues at Bhekisisa, with a much smaller budget than the state, are doing a better job communicating daily vaccine information, walk-in sites etc. No wonder there is so much vaccine hesitancy and misinformation. Government needs to up its game, tackle the vaccine denialists much more forcefully, and communicate more forthrightly on the benefits both individually and to all of society if more people vaccinate.

Geffen is the editor of GroundUp. Low is the editor of Spotlight.