Practical solutions to the vaccination problem

Vaccinologist points the way to victory over Covid-19

WE all know what we need to do: get vaccinated. This was the message from Phumelele Makatini, chief executive and principal officer of the Building and Construction Industry Medical Aid Fund, in conversation with epidemiologist and vaccinologist Professor Charles Shey Wiysonge on the second episode of her online show Tea with Phumi.

“There are a lot of myths around vaccines as a whole, but I think there is more hesitancy around Covid-19 vaccinations than vaccinations in general,” said Professor Wiysonge.

“During the Covid-19 pandemic, we have heard more about vaccinations in the public domain than at any time before. The barriers to Covid19 vaccination uptake range from supply and availability to psychosocial factors. Even in one country, we might find that there is more of a certain challenge in one region than in the rest of the country. Challenges cover a wide range and may vary as time goes on. We may find that when the challenges of availability and access are solved, we are confronted by psychosocial factors.”

Wiysonge says we have a long way to go, but we also need to celebrate what we have achieved. “In the beginning we had quite a problem with access, supply and availability. Now we have a steady supply and more vaccination sites have been opened. Now people from the community need to come,” he says. He told Makatini that there is a different solution to each barrier, as there is no onesize-fits-all solution. For example, when South Africa had supply and availability problems, it was up to our government to negotiate and sign contracts with vaccine manufacturers directly, to obtain vaccines through the African Union, or to obtain them through the Covax facility.

We have passed that stage, and now have enough vaccines available in the country.

However, in terms of access, there are parts of the country where people may have to travel long distances to get to vaccination sites, which can for many be prohibitive. Vaccination therefore needs to be brought to the people.

Having vaccination sites close to where people are situated is vital.

Bringing vaccines to the people Wiysonge believes the most immediate solution to barriers is innovative thinking.

“This includes vaccination sites at places such as taxi ranks, or grant queues for the aged. I think the government and the private sector are doing a lot to bring vaccinations to the people, but we need to do more to ensure that people don’t have to travel long distances to get their jabs. We also need to have more vaccination stations open on weekends.”

He says we also need to consider more convenient hours and look into the possibility of vaccination options such as trains or long-distance buses. “Why not extend vaccination hours into the evenings so that people who can’t do it during the day, can have their jabs after hours?”

Wiysonge agrees that vaccine hesitancy is a real problem. “When the vaccinations are as accessible as possible, people need to accept the value of this treatment. We need to be able to give the right information. We know that there has been a lot of misinformation. We know there are myths around vaccines. People also keep changing the goal posts. When you clarify one concern, they bring up another one,” he says.

But according to him, we need to understand the hesitancy, listen very carefully to what the concerns are and provide adequate responses in the form of solutions and accurate information.

“I’m sure if we do that, the majority of people will accept the vaccine.”

The repercussions of failing to overcome vaccination barriers are severe, says Wiysonge. On the individual level, vaccinations protect the vaccinated person, but if we can vaccinate sufficient numbers, we can stop the transmission of infections. This is what we often refer to as herd immunity.

“For that we need to have a very high vaccination percentage. At first, we used to talk about 67%, but of course knowing that not everybody in the country is eligible for vaccination, we need very, very high coverage in the adult population – maybe 90%, even 95%. In that way we may reduce or even stop the transmissions. There would be protection at the individual level, but also at community level.

“For this to happen, people need to have the right information and we all have to play our part to make sure that people are literate about vaccinations,” Wiysonge says.