ChangeMaker (CM): The Covid-19 vaccine has come onto the market unusually quickly – is it safe?

John Steenhuisen (JS): I am a public representative, not a medical expert or professor of vaccinology. I believe that public representatives should listen to the experts. There is overwhelming agreement in the scientific community that Covid-19 vaccines are safe and will protect against disease and death. Obviously, they are referring to those Covid-19 vaccines that have been approved by globally respected health products authorities such as the US FDA and the European Medicines Agency. Indeed, the rapid fall in infection and death rates in Israel since their general vaccine rollout is testament to this.

CM: Why is vaccination happening so much more slowly in South Africa than in many other developing nations?

JS: The SA government dropped the ball on procuring vaccines. Most other countries that could afford to put in confirmed bulk orders and paid deposits in the first half of last year already. The SA government failed to do this. Therefore, we have no vaccines to roll out. The vaccination “rollout” currently underway is an extension of a trial, using J&J vaccines set aside for trials, and it is being run by trial scientists, not by the SA government. Not one single vaccine has been administered yet by the SA government as part of a general rollout.

We cannot be certain exactly why the SA government dropped the ball so massively on vaccine procurement. Lack of funding is not the reason, as firstly, we are an upper-middle income country that can most certainly afford vaccines. A full rollout to herd immunity in SA is estimated to require R8-16 billion. This year alone, government has chosen to bail out SAA to the tune of R10.5 billion. Secondly, the cost of not vaccinating is much higher than the cost of vaccinating, since vaccinating will allow us to fully open our economies. Israel offered to pay three times the going rate if necessary, to get vaccines early, since they recognised that it is still cheaper than restricting economic activity. More likely, the SA government’s failure is due to incompetence and to a general lack of concern about the wellbeing of ordinary South Africans. Both have their roots in the ANC’s policy of cadre deployment, where public officials are appointed based on political loyalty rather than on ability to deliver.

CM: Why did the national government sell the vaccines we had?

JS: The official reason they gave for selling the one million AstraZeneca vaccines we had was that this vaccine did not protect against mild to moderate infection for the B. 1351 variant which is circulating in our population. But the DA called for these vaccines to be administered on a voluntary basis, as that was the advice of the World Health Organisation and of several leading scientists in SA, including Professor Shabir Madhi, SA’s top vaccinologist, who lead the trials of AZ in SA. The WHO and Prof Mahdi both claimed that the AZ vaccines would still provide some protection to those in the high-risk group, against severe disease and death.

Unofficially, I suspect the reason the government sold these one million vaccines was because they lacked a workable rollout plan and they did not want to be shown up by the DA-run Western Cape, which was the only province with a workable rollout plan.

CM: President Ramaphosa says 30 million Johnson and Johnson vaccines are on the way. When will the elderly start getting vaccinated?

JS: The SA government has said this will be in mid-May. But there is a strong possibility of further delays, since the government has failed to produce a detailed, workable rollout plan. Even with a workable plan, there may be additional delays such as the health minister’s irrational suspension this week of SA’s vaccination programme after 6 people out of 6 800 000 vaccinated with the J&J vaccine in the US developed blood clotting complications. Here, the risks of suspending the administration of J&J far outweigh the risks from continuing. Covid and lockdown both present a massive risk while the risk of blood-clotting is statistically negligible, and SA has no alternative vaccines on offer.

CM: Will you get vaccinated when you can?

JS: Yes, I will most certainly get vaccinated once I have access. I would not want to jump the queue, though, and while vaccines are in short supply, those more vulnerable to Covid-19 must obviously take precedence.