The rollout of Covid-19 vaccines in South Africa has been plagued by inefficiency, misfortune, and a series of unrealistic aims, resulting in deadlines being repeatedly missed.
South Africa’s initial target was to vaccinate 1.2 million people by the end of March, and 40 million people by the end of 2021.
According to the government update on 1 July, 3,026,636 people have received a vaccine.
While there has been a substantial improvement in the number of South Africans being vaccinated since March, if things progress as they are now, it is likely that government will miss its goal to vaccinate 67% of South Africa’s population by year-end.
According to the Media Hack Collective vaccine calculator, South Africa has administered an average of 22,757 vaccines per day since 17 February.
This number has steadily increased but the calculator shows that, assuming the two-shot Pfizer vaccine is going to be used to inoculate most of South Africa, the number of vaccines administered per day on average has to be over 422,000 assuming a two-shot vaccination — and this number is only increasing with each passing day.
In his address to the nation this past Sunday, President Cyril Ramaphosa acknowledged that South Africa has a shortage of vaccines and added that we are not the only country in the world waiting for its vaccines to arrive.
“I get calls every day from leaders on the continent about the availability of vaccines, [also] from as far afield as the Caribbean,” Ramaphosa said.
“The entire world is crying out for vaccines and we are doing everything we can to make sure the vaccines are here.”
On 24 November 2020, Finance Minister Tito Mboweni confirmed in a Bloomberg webinar that government would invest in the Covax vaccine initiative for R500 million rand. The goal was to see South Africa at “the front of the queue” for the acquisition of vaccines.
This announcement was made after the government had already missed the initial October 9 payment deadline to join Covax.
President Ramaphosa stated that this initial investment was aimed at securing enough vaccinations from Covax to cover “at least 10% of the population” (around 6 million) within the first half of 2021.
Another payment, this time of R327 million was due for payment to Covax on December 15. This deadline was also missed. The Solidarity Fund, which was responsible for the payment, reportedly did not receive the green light from government to initiate the transaction due to an administrative lapse.
Before January there had been no sign of government attempts to procure vaccines or vaccine production besides the Covax initiative.
On 7 January, Health Minister Zweli Mkhize presented the official plan for the South African vaccine rollout strategy
It stipulated a three-stage programme that the government believed would see 67-70% of the population vaccinated by the end of 2021.
This was followed by an announcement that the government had secured 1.5 million AstraZeneca vaccinations and that these would be delivered by February, enabling 750,000 health workers to be vaccinated by the end of February.
Shortly thereafter, on 12 January, President Ramaphosa announced that the government had secured 20 million vaccines. He stated that these would be delivered “mainly” in the first half of the year, though deals were yet to be finalised.
The confirmation of bilateral agreements relieved earlier frustrations relating to South Africa’s total dependence on Covax, which had by February not provided a single vaccine.
The goalposts for Covax were moved from providing vaccinations for 10% of the population within the first half of the year, to 10% by the end of the year.
On 22 January, a further 9 million vaccines were said to be secured in an agreement with Johnson & Johnson and, by the end of the month, Mkhize announced that another 20 million were secured through an agreement with Pfizer.
These reported agreements saw the government move beyond its goal of securing 40 million vaccines, albeit on paper.
The AstraZeneca vaccines were set to arrive on 1 February, and Zweli Mkhize stated that distribution would begin between 10 to 14 days later.
Then came the reports that AstraZeneca — the only vaccine in South Africa at the time — only had a 22% efficacy against mild and moderate cases of the 501.V2 variant that had emerged in the second wave of infections.
The vaccine rollout was halted on 8 February, before it had even begun, though Mkhize said that doses from Johnson & Johnson and Pfizer would start arriving within four weeks.
Mkhize announced a substitute for South Africa’s first phase of vaccine rollouts on 16 February dubbed the “Sisonke study”.
According to the Minister, the rollout would begin that same week with the arrival of 80,000 Johnson & Johnson doses and another 500,000 doses could be expected within the subsequent four weeks.
He also said that 20 million doses of the Pfizer vaccine were expected to arrive by the end of March.
The circumstances surrounding the AstraZeneca vaccine did not cause a significant delay in the rollout, as the Sisonke study commenced on 17 February — 2 days after the AstraZeneca rollout would have begun.
By 11 March, 128,887 healthcare workers had been vaccinated, and Mkhize announced that the initial target of vaccinating 1.2 million healthcare workers by the end of March was unattainable due to vaccine shortages.
The government stated that it anticipated 500,000 doses of Johnson & Johnson and 600,000 doses from Pfizer by 31 March, falling far short of the 20 million doses of Pfizer that, in February, Mkhize said could be expected by the same date.
The Minister of Health maintained that the initial target of vaccinating 40 million South Africans had not been adjusted.
Mkhize’s assertion on 16 February that 500,000 doses of the Johnson & Johnson vaccine could be expected within four weeks was not achieved, with around 160,000 received at the time.
On 24 March, Medical Research Council president Professor Glenda Gray stated that the Sisonke trial aimed at 500,000 vaccinations by the end of April, as opposed to the initial phase one target of 1.2 million by end March.
President Ramaphosa announced on 25 March that the second phase of South Africa’s vaccine rollouts would begin in May.
On the same day of the president’s announcement, Acting Minister in the Presidency Khumbudzo Ntshavheni stated that the target for the end of April was still 1.2 million and that the rollout was on its way to reaching it, contradicting Gray’s statement from the previous day.
With just over 200,000 healthcare workers being vaccinated at the time of Ntshavheni’s announcement, this implied that around a million vaccines would have to be administered to healthcare workers in 36 days.
To achieve this would require 27,778 vaccinations a day, as opposed to the 5,700 daily doses the country was administering at the time.
President Ramaphosa said in a media briefing on March 29 that the end goal of 40 million vaccinated South Africans by the end of the year remained set.
Misfortune struck again on 16 April as South Africa’s vaccine rollout was halted due to concerns over blood clotting caused by the Johnson & Johnson vaccine.
Despite the delay caused by the Johnson & Johnson vaccine, the goal of vaccinating 1.2 million healthcare workers by 16 May was affirmed by the government, and vaccinations once again resumed on April 28.
The aim was to start the second phase of South Africa’s vaccine rollout on 17 May, allowing those over the age of 60 to get their shots.
The first batch of 325,000 Pfizer vaccine doses was received on 3 May and the target of 1.2 million vaccinations by 16 May was readjusted to 500,000 vaccinations. This new goal was also missed.
Phase two of the vaccine rollout commenced on 17 May as per the government’s schedule.
Mkhize stated that 4 million Pfizer doses were expected by June, as well as 2.2 million Johnson & Johnson doses.
Government aims to have 16.6 million South Africans vaccinated by 3 October, which is 94 days from now.
President Ramaphosa stated in his address this past Sunday that the vaccines are now starting to arrive at an adequate rate, admitting that there has been a shortage until now. He also said that he aims to have the daily vaccinations reach 300,000.
This is in line with the 288,000 daily vaccinations required to reach the 16.6 million goal by 3 October, assuming the goal is to fully vaccinate people using the two-shot Pfizer vaccine.
Yesterday, 30 June, over 120,000 people received their vaccinations, which is a positive indicator of the rollout expansion.
At the moment the education sector is at the centre of the program, with 238,315 staff being vaccinated so far, with the goal being set at 582,000 vaccinations by 8 July 2021
Vaccinations for people over 50 are set to begin on 15 July, with over 50% of people over 60 already vaccinated.
Registrations for people aged 50 and over are now open on the EVDS portal.
The table below summarises South Africa’s vaccine deadlines since October last year and shows how many were met.
|Vaccine rollout deadlines|
|Month(s)||Deadline set||Deadline met|
|October to December 2020||10% of population vaccinated from Covax by mid-year||No — 3,026,636 vaccinated by 30 June|
|Covax payment by 15 December||No — Administrative lapse|
|January||67% of population (41 million) vaccinated by end 2021||Will need over 422,000 shots per day to reach|
|1 million AstraZeneca received by Feb||Yes|
|750,000 health workers vaccinated by 28 Feb||No — 70,527 vaccinated by 1 March|
|February||AstraZeneca rollout by 15 Feb||No — Doubt over vaccine efficacy against 501.V2 variant|
|Phase 2 to begin in March||No — Began 17 May|
|J&J and Pfizer to arrive by 8 March||Yes — 80,000 J&J on 16 Feb|
|500,000 J&J by 16 March||No — 160,000 received by 16 March|
|20 million Pfizer by 31 March||No — First 325,000 Pfizer received on 3 May|
|Rollout to begin on 17 February||Yes|
|March||500,000 J&J by 31 March||No — still 200,000 doses short on 9 April|
|600,000 Pfizer by 31 March||No — First 325,000 Pfizer received on 3 May|
|500,000 vaccinations by 30 April||No — 318,670 by 3 May|
|1.2 million vaccinations by 30 April||No — 318,670 by 3 May|
|May||1.2 million vaccinated by 16 May||No — 479,768 by 19 May|
|500,000 vaccinated by 16 May||No — 479,768 by 19 May|
|Phase two to begin on 17 May||Yes|
|June||16.6 million by 3 October||Will need over 288,000 shots per day to reach|
|2.2 million J&J by end-June||No — last received was 1.2 million between 24 – 27 June|
|4 million Pfizer by end-June||No — last received was 1.4 million between 24 – 27 June|
|July||582,000 educators and staff by 8 July||Possible if 120,000 daily vaccinations maintained|
|Age 40+ vaccine registrations to start on 1 July||No — changed to over age 50+|
|Age 50+ vaccine registrations to start on 1 July||Yes|
|Age 50+ vaccinations to start on 15 July||TBD|