Explainer: SA’s vaccine roll-out

syringe, healthcare, needle

This is a developing story and we will keep updating it with more information as we know.

When and how SA will procure Covid-19 vaccines? There’s been loads of reporting on this issue, but it can be hard to follow. So we read the best that’s out there from various publications and experts, to distill what you need to know. 

What’s the plan?

SA needs to vaccinate 40 million people to achieve herd immunity.

Government has set aside a budget of R30bn to do so.

It plans to spend it on the following vaccines, according to the Department of Health, Business Insider reported:

  1. AstraZeneca (70% of doses) : R54 per dose
  2. Johnson & Johnson (20% of doses) : R153 per dose
  3. Pfizer (5% of doses) :  R299 per dose 
  4. Moderna (5% of doses) :  R536 per dose

Update: Health Minister Zweli Mkhize told The Sunday Times that South Africa had secured an additional 20 million vaccines doses from Pfizer, the price of which is yet to be confirmed. This brings the total number of vaccines South Africa has ordered to 42 million. Mkhize said the details of more vaccine purchases will be available in due course.

Why are the prices so different?

Globally, vaccines are largely being sold on an open market, which is part of the problem. Prices vary wildly as profit-driven pharmaceutical companies put up their prices, depending on who is buying, and when. Activists are trying to change the situation and group buying mechanisms like Covax have been set up. SA, however, still has to pay its own way in Covax as we’re classified as a middle income country. 

Is it true that we’re paying more than other countries?

Yes. Pharmaceutical companies make governments sign nondisclosure agreements (NDA), but a leaked memo from a Belgian official revealed South Africa being charged about far more than the European Union (EU) for the AstraZeneca vaccine, despite the company’s previous assurances about not making a profit.  We don’t know the full picture yet because of the NDAs but other countries, like the US, have also realised they paid much more. 

Why are we paying more?

Developed countries like those in the EU had the money to invest in some company’s research, and secured lower prices in exchange. 

The EU also used its economic and political bloc power to pre-reserve supplies for itself, before the trials were completed, data reviewed, or approved, head of the Health Justice Initiative, Fatima Hassan reports. Some of these EU agreements are now being investigated. 

Then there’s “vaccine nationalism”: some vaccine manufacturers give preferential pricing and access to the countries they’re from.

Why were the UK and other countries able to roll out vaccines before us?

Money. Nobody knew which vaccines in development would work, so those who could afford it bought a wide portfolio, hoping that one would work out, Business Day columnist Carol Paton reports.  While wealthy countries were able to pre-order numerous vaccines, poor countries could not afford to take that risk.

The risk attached to pre-buying vaccines is one of the main reasons SA did not pre-order directly from manufacturers and joined the Covax initiative.

How will SA pay to immunise 40 million people?

  1. Private medical aids will pay to vaccinate about seven million of their members, PLUS an additional seven million South Africans, as their contribution to the fight. That makes for 14 million of the 40 million. Estimated cost: R7bn ($464m).
  2. SA has ordered stock from the Covax facility for a further 6 million people. Estimated cost: R283m, to be delivered around the second quarter of the year.  This price may vary, and is very likely to go down over time, as Covax gets access to more vaccines. 

So that’s 20 of the 40 million.

And what about the remaining 20 million?

It will have to come from the public fiscus – which is already strained. National Treasury warned last week that it may have to increase taxes to raise the funds for these vaccines. But this would be highly untenable with our already high taxes, so borrowing is more likely. This may push public debt levels close to 100% of GDP sooner than projected, EWN reports.

South Africa is hoping to receive vaccines from other sources as early as February, but they did not disclose those potential sources, citing NDAs that South Africa was required to sign with pharmaceutical companies, Business insider reports

Update: Daily Maverick has reported that National Treasury has said that contracts with pharmaceutical companies are being ‘assessed individually’ and that its two existing contracts with pharmaceutical companies (SII and Pfizer) do indemnify pharmaceutical companies against ‘serious adverse events’

As the market loosens up, self-financing countries should be able to procure their own vaccine stock without difficulty, Business Day reports.

What’s the timeline?

South African healthcare workers will start being vaccinated in February. More vaccines will arrived in the second quarter of 2021, with the goal of receiving enough doses for 10% of the population by the end of 2021, The Globe and Mail reports. But officials said they are hoping to begin receiving vaccines from Covax as early as March.

Update: News24 has however reported that the doses of the vaccines will not arrive in bulk, but rather in batches of 1 million and 3 million, adding that the first shipments of Johnson & Johnson and Pfizer vaccines will only arrive between May and June this year. News24 has also provided a price breakdown of the vaccines, but these may change.

Will I EVER get vaccinated?

If you’re reading this article, you’re probably middle class and probably have access to some sort of medical aid. So yes. You’ll get it for free as it’s deemed a Prescribed Minimum Benefit (PMB).

Did government bungle this?

It’s complicated. Government has been criticised for not negotiating with pharmaceutical companies sooner, as other countries have done. But health minister Zweli Mkhize said that the country could not afford to fork out money (which we don’t have) on vaccines that had not been through all the stages of clinical trials yet.

I’m not a 5G conspiracist but I have some real concerns about getting the vaccine. What do I do?

We hear you. There’s so many unknowns. We’ve covered the major concerns here. Check it out.

With assistance from Aarti Bhana.

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