The number of vaccinations is far below the number of vaccine doses in the country. The available vaccines need to be used urgently.
The vaccine rollout has finally started but far too slowly. The graph below shows the huge gap between the vaccines available in
While the number of vaccinations has been rising slowly, it is far below the number of vaccine doses in the country, at a time when the number of new, reported cases is rising rapidly again.
The graph does not include the additional
The original vaccination plan launched on 5 February was replete with maps and flow diagrams. It said there would be a phased roll out starting with health workers, and then open up to include those with co-morbidities, frontline workers (such as teachers and police) and the elderly. The slick document gave the impression that government planners were on top of things and the prospect of vaccinating the country seemed real.
Four days earlier, on 1 February, the first million doses of the
Yet as doctors pointed out, including the lead author of the study,
The first phase of
The second phase, now fully in the hands of the government, is offering
Yet even those with transport have found themselves having to drive long distances (in one reported case requiring a five-hour drive to make an appointment time announced only that morning). Those without transport, or who did not know where their allocated vaccination site was located, no doubt missed appointments. The elderly in rural areas are particularly at risk of being left out of the rollout.
The government rollout is now aimed only at the elderly - which poses a serious constraint for those health workers yet to register. The government's EVDS online registration system functions as an implacable fire-wall: anyone under 60 trying to register is confronted with the following statement: "Please note that registration for vaccination is currently only open for those that are 60 years and older. Those under 60 years of age will be invited to register at a future date."
During the Sisonke trial, the online system accepted registrations from the elderly and from health care workers. Yet apparently because of complaints about the system allowing people who were not health care workers to register, this facility was removed soon after the government rollout began. This is absurd. The previous system required health care workers to provide details about their medical practice or to agree to bring a letter confirming their status as health workers to the vaccination facility. It was then up to the vaccination site to accept or decline supporting letters. If the system needs tightening to prevent abuse, this should occur at the sites. To alter the registration system to prevent potential abuse is like bombing a hospital to get rid of some roof rats.
The Sisonke trial fell behind schedule when the government paused vaccinations in April after six people out of 6.6 million vaccinated in the US had developed rare blood clots. This raised the spectre of wasted vaccines just as the pace of new Covid-19 infections was picking up again. When it was lifted, the Sisonke team redoubled their efforts, ensuring that most of the J&J vaccines were indeed used. This prompted calls to widen access to vaccines to ensure that
Defenders of the government rollout argue that the slow start was necessary to check the systems. Yet why was the slick vaccination plan not acted on earlier? Why was the online system not designed or adapted to accommodate health workers, the elderly, those with co-morbidities and essential workers?
The online registration system is being used to match appointments to vaccine supply at every site - supposedly to avoid long queues and sites running out of vaccines. Yet there have been no reports of sites running out of vaccines - even those flexible enough to allow 'walk-ins' (those without appointments) and which have accordingly attracted high volumes of people over 60 wanting to be vaccinated. These sites are probably driving the rapid increase in vaccinations over the past few days. Those sites sticking rigidly to the appointment system are a drag on the rollout.
The
It is time for the government to relax its grip on the rollout and allow more flexibility in the system. As Geffen and Low have argued, the
The J&J single-jab vaccine is relatively easy to administer and only requires normal refrigeration.
This is what we need to boost the vaccination program and to ensure that shots in arms catch up with the rapid growth in vaccine supply. With new infections rising fast, we need to redouble the effort to vaccinate as many people as possible. Poorly functioning and overly controlling bureaucratic systems must not stand in the way of saving lives.
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