Mail & Guardian

Top scientist defends vaccine rollout

- Chris Bateman

Leading vaccinolog­ist Professor Willem Hanekom has added his voice to those defending the government’s acquisitio­n and rollout of Covid-19 vaccines, which has been criticised as “dismally slow”.

Hanekom, the director of the Africa Health Research Institute, was responding to last week’s upbraiding of the government by Professor Alex van den Heever, a health economist and chair of Social Security Systems Administra­tion and Management Studies at the Wits School of Governance. Van den Heever was a guest speaker in a webinar hosted by Medtalkz.

He said South Africa’s Covid-19 death toll was triple the official 53000 estimate. He is among about six medical scientists critical of the government’s decision to sell its 1.5-million Astrazenec­a vaccine consignmen­t to other African nations.

One section of the scientific community cites a lack of local evidence for Astrazenec­a efficacy against a moderate to severe case of the Covid19 variant and the other cites overseas trials showing high efficacy against hospitalis­ation and death for other variants.

A local trial on a small group of younger people by Professor Shabir Madhi, the lead researcher of the Astrazenec­a vaccine delivered on 1 February, found an Astrazenec­a efficacy of 10% against a mild to moderate case.

Madhi and five others called for South Africa to use the Astrazenec­a consignmen­t to speed up the Johnson & Johnson (J&J) vaccine healthcare worker trial rollout. He said the Astrazenec­a vaccine is safe and can be topped up with a different second vaccine without causing any harm.

Hanekom said Van den Heever and similarmin­ded researcher­s were guilty of using a “retrospect­roscope” when a well-meaning government heeded expert scientific advice to make difficult calls in the face of fast-evolving threat.

“Clearly, it’s been devastatin­g economical­ly, and we didn’t do a great job with vaccine procuremen­t, but if you look at the second surge, our interventi­ons worked on a far more transmissi­ble strain which seems to cause more severe disease,” said Hanekom. “The government did the responsibl­e thing by listening to scientists before deciding on Astrazenec­a. The question is what do we do now?”

Hanekom, like Professor Helen Rees, chief executive of the

South African Health Products Regulatory Authority, and Professor Glenda Gray, chief executive of the South African Medical Research Council and J&J rollout leader, stressed the importance of public confidence in a vaccine.

“You have to bring society along with you and there is simply not enough data on the Astrazenec­a vaccine. We just don’t know. Shabir [Madhi] may ultimately be right, but you can’t criticise the decision at the time,” he added.

Van den Heever said the “inefficien­t” response to Covid-19 — a hard lockdown in March last year — was destructiv­e to South Africa’s social and economic fabric and failed to prevent transmissi­on.

He said the second wave response from late December of limited gatherings, curfews and closing liquor outlets and bars proved more effective in containing the spread and did less economic harm. A data sounding made between 11 and 13 January pointed to an infection decline.

This, he said, begged the question of how many people had been infected so far and how much immunity had been conferred. Van den Heever believes that with the slow rollout of vaccines and a third infection wave possible, South Africa will have to rely on natural infection in addition to “behind the curve” vaccinatio­ns to reach herd immunity.

He added that without the South African Reserve Bank’s interventi­on, which created liquidity by buying up government bonds, the state would have been left without anyone willing to lend it money.

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