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With 7m doses set to expire, DOH tries to boost sluggish vaccination campaign

With a third of South Africa’s vaccination doses expiring midyear and less than half of adults vaccinated, the national Department of Health is trying to boost uptake by allowing mix-and-match shots and reducing the period between vaccination and booster, writes MedicalBrief.

The country has 21m vaccine doses of Johnson & Johnson (J&J) shots and Pfizer/BioNTech vaccines on hand, with 7m Pfizer jabs expiring by midyear, said Health Deputy Director-General Nicholas Crisp. Less than half (42.3%) were fully vaccinated, government statistics show, and the seven-day moving average of daily vaccinations stands at 64,200, down from the August peak of over 241,000.

The decrease in uptake could lead to some of the country’s Covid vaccine doses expiring before they’re used, Crisp says. “The challenge [with doses expiring] starts at the end of March but June and July are the biggest challenge. So we have time to pick up pace and, if we don’t use our doses fast enough, to see if our neighbouring countries can use any of that stock.”

Nearly one in five people (18.93%) don’t return for their second dose of the Pfizer vaccine, DOH data shows. Of those between 50 and 59 years, only 7.7% don’t go back within 42 days, while of those between 18 and 34 years, 30.12% don’t get their second shots within the required period.

In the hope that shorter waiting periods between jabs will close this gap, people can now get a second dose of the Pfizer vaccine 21 days after the first dose, instead of the previous 42 days, and Pfizer booster shots will be administered 90 days after a second dose, instead of 180 days.  Everyone of 12 years and older can now also get a second Pfizer jab 21 days after their first jab (instead of the previous 42 days).

In addition, DOH said while people should ideally stick to the same vaccine, fully vaccinated adults can now choose whether to get the J&J or the Pfizer vaccine when they have a booster dose. The decision regarding which vaccine to administer as a booster should be guided by vaccine availability.

Crisp said that the DOH had stopped short of recommending a mix-and-match strategy, because while it was safe, the evidence that it offers superior protection to boosting with the same vaccine was insufficient. However, SA Medical Association Gauteng chair Mark Human welcomed the decision to allow mix-and-match vaccination.

“For several months top virologists have been calling for heterologous boosters, and it is no secret that many doctors have done it. Complementary immunity from different types of vaccine will probably give you a broader spectrum of immunity,” he said.

Wits University vaccinologist Shabir Madhi said the change is long overdue, as a mix-and-match strategy is likely to offer better protection against infection and severe illness than repeated doses of the same vaccine. The two vaccines are based on different technologies, and each elicits a different response from the bodyʼs immune system, he said.

 

Business Day article – SA vaccine rules to ease with 7-million shots set to expire (Restricted access)

 

News24 article – Covid-19: Reduced waiting time between doses, boosters in shake-up of SA's vaccination programme (Open access)

 

See more from MedicalBrief archives:

 

Vaccine rollout: SA government has made three mistakes

 

Discovery analysis: Pfizer vaccinated SA adults have 94% lower risk of death from COVID

 

Benefits of mix-and-match approach to COVID-19 vaccines

 

Mixing COVID-19 vaccinations gives better immune response — Oxford trial

 

COVID antibody levels boosted sixfold with mixed AstraZeneca-Pfizer shot

 

 

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