The vaccine rollout is progressing well despite setbacks, the third wave is here – our view on the way forward

I am following up on my last post in mid-May. Amidst the emergence of the Third Wave of COVID-19, coupled with the recent news of the?likely?disposal of two million Johnson and Johnson (J&J) doses allocated to South Africa, we are undoubtedly in a complex phase of the pandemic and the vaccine rollout. People are anxious. We understand this, and want to unpack the issues to provide comfort. On the whole, we are encouraged that the pace of progress is largely in line with the stated goals of the Mass Vaccination Programme.

The Third Wave is here. You need to exercise extreme caution; and get vaccinated

Without population-level immunity, and sufficient shifts in individual behaviour, a third wave was always anticipated. It is now here, and well established in multiple provinces including Gauteng, Free State, North West and Northern Cape, where hospital beds are already showing high occupancies.?

Given the escalation in daily new cases in certain provinces, you must therefore remain highly?vigilant?and adhere strictly to mask and social distancing protocols. Wherever possible, stay home and isolated. If you need to venture out, always try stay outdoors and in?well?ventilated areas. Even those who have been vaccinated remain?at some risk. Those over 60, those with high Body Mass Index and those living with multiple chronic conditions, particularly HIV, hypertension and diabetes, face significant risk of severe consequences of infection.?

Beyond prudent personal behaviour, you need to get vaccinated. Experience from countries with advanced vaccination programmes?–?including the United Kingdom, USA, Israel and Canada?–?provides strong evidence of the efficacy of vaccines in reducing?hospital admissions,?death?and spread of infection. Our early data on Discovery clients and members who have been vaccinated suggests?similar levels of effectiveness.?

The Mass Vaccination Programme is largely achieving what it set out to do, in spite of setbacks

We said the process would be bumpy given its scale and complexity; and teething problems have emerged as expected. Having said that, the rollout itself has been largely excellent, and constraints have predominantly been as a result of delays in vaccine delivery – first with regards to the Oxford AstraZeneca vaccine and now in relation to Johnson & Johnson (J&J) doses – outside of our control and that of other countries. We will overcome this.?

In spite of these setbacks, the Government-led programme has seen encouraging progress. It started in mid-May as planned, with a sizeable ambition to vaccinate those over 60 (approximately five million people) and one million healthcare workers by mid-Winter. This required secured vaccine doses for six million people and a vaccination rate?of?approximately?130,000?per day to complete this. The current snapshot is promising: we are currently vaccinating?90,000?per day; and vaccine supply is sufficient to vaccinate the elderly and vulnerable by end August, just a few weeks out given constraints in vaccine delivery. To date, more than 1.4 million South African residents have been vaccinated through more than?400?vaccination sites in operation across the country in a collaborative effort between the public and private sector.

As context, South Africa has been entirely reliant on the supply of Pfizer-BioNTech vaccines. This is as a result of the delay in the delivery of the J&J vaccine following concerns around manufacturing issues the Emergent?BioSolutions?plant in Baltimore. With the Federal Drug Administration (FDA) in the US now having recommended the disposal of affected J&J doses, two million doses that were assigned to South Africa are likely to be disposed of. Notwithstanding this, with 5.7 million doses of the Pfizer-BioNTech vaccine scheduled for delivery in May and June,?and further deliveries scheduled for July,?there should be sufficient Pfizer-BioNTech supply to achieve the target of vaccinating the elderly and vulnerable by?August.?

In addition, in order to honour their contract with SA, J&J will undoubtedly source additional?stock, to make good on the?scheduled deliveries. We await confirmation on the timelines for delivery of these doses.?In the interim, a special batch of approximately 300,000 J&J doses has been cleared for shipment to SA.

Discovery’s direct contribution to the national effort continues; and is being accelerated

Our objective at Discovery is clear: we simply must get as many people in South Africa vaccinated as quickly as?vaccine supply allows.

The vaccination site at our head office in Johannesburg, 1 Discovery Place, is currently the largest national private sector site. It is contributing over?15%?of all Gauteng vaccinations administered to-date; and approximately?12%?of the private sector vaccinations administered nationally. Based on the success of this site, we are intending to scale it up by a further?50%. We are also applying our learnings from 1 Discovery Place to bolster vaccination capacity countrywide, with the aspiration of vaccinating 40,000 individuals per day when all of our associated sites are at full capacity.?

?In addition to the four additional sites in Johannesburg, Pretoria and Cape Town we have opened since 1 Discovery Place, Discovery has focussed its efforts on establishing further mass vaccination sites. These include Gallagher Estate with the ability to vaccinate 5,000 individuals per day; with a target go-live end June subject to securing sufficient supply of vaccines. Additionally, a mass site in Cape Town?and another in KwaZuluNatal are currently under consideration.??

The Department of Health’s vaccine management system, EVDS, allocates members of various medical schemes to our sites; and we are proud our sites cater for this inclusivity. Having said that, our focus remains on accelerating reach and rollout so that all of our eligible members are covered as quickly as possible.?

?Discovery Vaccination Portal is now integrated with EVDS

Discovery’s Vaccination Portal has been designed to work in support of EVDS with additional functionalities to enhance and streamline the vaccination journey for Discovery clients and members.?

I am pleased to report that the Discovery Vaccination Portal is now integrated with EVDS, meaning that Discovery clients only need to register on the Discovery Vaccination Portal – and your registration will be automatically captured on EVDS.?You will then receive communication from EVDS confirming registration.

?What does this means for you?

?Those over the age of 60 years and waiting for their first dose

In light of the fact that there are over five million people over the age of 60 years, it is going to take some time for everyone in this cohort to be vaccinated. Please rest assured that, provided you are registered on the Discovery Vaccination Portal or on EVDS, you will be scheduled for your vaccination over the coming weeks.?

?Although some vaccination sites have made provision for walk-ins, these slots are limited and queues are often longer than those at sites working on scheduled appointments. Discovery vaccination sites,?such as 1 Discovery Place,?function on the basis of scheduled appointments only and do not accommodate walk-ins.

?Those over the age of 60 and waiting for their second Pfizer-BioNTech dose

The interval between the first dose and second dose of the Pfizer-BioNTech vaccine is 42 days (six weeks). While this was originally communicated as 21 days, Pfizer has amended its protocol globally as a result of emerging evidence showing a 42-day interval triggers a superior immune response.?

?Please note you will not be able to access your second dose if you arrive before this interval has elapsed; and you will automatically be registered for your second dose and do not need to register again. When it’s your time to receive your second dose, you will receive an appointment via SMS from EVDS for a particular site. Alternatively, you can use the Discovery Vaccination Portal to?book an appointment at a Discovery-managed?vaccination site.?

?Those under 60 years of age

Those under 60 are not yet eligible for vaccination. Once there has been sufficient coverage of Phase 2, Phase 3?will involve vaccinating the remaining adult population of approximately?22.5 million people, further prioritised according to the evolving national prioritisation framework. The National Department of Health will announce when registrations will open to people in younger cohorts over the coming weeks. Registration on Discovery’s Vaccination Portal will open slightly prior to this.

?Conclusion

The Mass Vaccination Programme is likely the most complex project the country has ever been tasked with, and there will be the inevitable challenges, but the direction and rate of acceleration of vaccinations is excellent. It is imperative that you stay cautious during this third wave, get vaccinated when you can, and stay supportive – leadership in government and the private sector are working incredibly hard to fill the gaps and ensure the Programme is successful.?

I want to assure you that Discovery will do what is required to support the national effort and protect our members.?

I will keep you informed of developments as we progress.?

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