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Guiding equitable prioritisation of COVID-19 vaccine distribution and strategic deployment in South Africa to enhance effectiveness and access to vulnerable communities and prevent waste
Ovens, W; Tomescu, S; Harrison, E; Crompton, T; Nooy, A de; Jassat, W; Banoo, S; Pisa, P; Sanne, I.
  • Ovens, W; Right to Care, Centurion. Pretoria. ZA
  • Tomescu, S; Right to Care, Centurion. Pretoria. ZA
  • Harrison, E; Right to Care, Centurion. Pretoria. ZA
  • Crompton, T; Right to Care, Centurion. Pretoria. ZA
  • Nooy, A de; Right to Care, Centurion. Pretoria. ZA
  • Jassat, W; National Institute for Communicable Diseases, National Health Laboratory Service. Johannesburg. ZA
  • Banoo, S; Right to Care, Centurion. Department of Pharmacy and Pharmacology, School of Therapeutic Sciences. Faculty of Health Sciences, University of the Witwatersrand. Pretoria. ZA
  • Pisa, P; Right to Care, Centurion. Department of Human Nutrition and Dietetics, School of Healthcare Sciences, Faculty of Health Sciences, University of Pretoria. Pretoria. ZA
  • Sanne, I; Right to Care, Centurion. Pretoria. ZA
S. Afr. med. j ; 112(2): 87-95, 2022. figures, tables
Article in English | AIM | ID: biblio-1358245
ABSTRACT
Background. In South Africa (SA), >2.4 million cases of COVID­19 and >72 000 deaths were recorded between March 2020 and 1 August 2021, affecting the country's 52 districts to various extents. SA has committed to a COVID­19 vaccine roll-out in three phases, prioritising frontline workers, the elderly, people with comorbidities and essential workers. However, additional actions will be necessary to support efficient allocation and equitable access for vulnerable, access-constrained communities. Objectives. To explore various determinants of disease severity, resurgence risk and accessibility in order to aid an equitable, effective vaccine roll-out for SA that would maximise COVID­19 epidemic control by reducing the number of COVID­19 transmissions and resultant deaths, while at the same time reducing the risk of vaccine wastage. Methods. For the 52 districts of SA, 26 COVID­19 indicators such as hospital admissions, deaths in hospital and mobility were ranked and hierarchically clustered with cases to identify which indicators can be used as indicators for severity or resurgence risk. Districts were then ranked using the estimated COVID­19 severity and resurgence risk to assist with prioritisation of vaccine roll-out. Urban and rural accessibility were also explored as factors that could limit vaccine roll-out in hard-to-reach communities. Results. Highly populated urban districts showed the most cases. Districts such as Buffalo City, City of Cape Town and Nelson Mandela Bay experienced very severe first and second waves of the pandemic. Districts with high mobility, population size and density were found to be at highest risk of resurgence. In terms of accessibility, we found that 47.2% of the population are within 5 km of a hospital with ≥50 beds, and this percentage ranged from 87.0% in City of Cape Town to 0% in Namakwa district. Conclusions. The end goal is to provide equal distribution of vaccines proportional to district populations, which will provide fair protection. Districts with a high risk of resurgence and severity should be prioritised for vaccine roll-out, particularly the major metropolitan areas. We provide recommendations for allocations of different vaccine types for each district that consider levels of access, numbers of doses and cold-chain storage capability.
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Full text: Available Index: AIM (Africa) Main subject: Epidemiology / COVID-19 Vaccines / COVID-19 Type of study: Etiology study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: English Journal: S. Afr. med. j Year: 2022 Type: Article Institution/Affiliation country: National Institute for Communicable Diseases, National Health Laboratory Service/ZA / Right to Care, Centurion/ZA

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Full text: Available Index: AIM (Africa) Main subject: Epidemiology / COVID-19 Vaccines / COVID-19 Type of study: Etiology study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: English Journal: S. Afr. med. j Year: 2022 Type: Article Institution/Affiliation country: National Institute for Communicable Diseases, National Health Laboratory Service/ZA / Right to Care, Centurion/ZA