Better to first vaccinate elderly with COVID-19 vaccines: S African expert

Fakir Hassen
·4-min read

Johannesburg, Feb 8 (PTI) A leading South African vaccinologist has proposed that the first vaccines which have become available should also be given to the elderly and those with comorbidities, rather than only on health care workers who might not derive maximum benefit from it.

Professor Shabir Madhi, Director of the Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit at the University of the Witwatersrand, who is also the Chief Investigator of the Oxford/AstraZeneca trials in South Africa, said on Sunday that results from the trials showed that the AstraZeneca vaccine was less effective against mild and moderate forms of the B.1.351 coronavirus variant that were first identified in the country.

Speaking again on Monday evening on national TV amid the global concern around the AstraZeneca vaccine for COVID-19 not being effective, Madhi said there was definitely a third wave of COVID-19 infections coming during the South African winter within the next few months and the focus had to shift to saving lives through vaccination and preventing health care facilities from being overwhelmed again.

'The manner in which to do that is to target our immunisation with COVID-19 vaccines to those individuals that are at greatest risk of developing severe disease,' Madhi said.

'So we cannot have an 'all welcome' approach for all who want the vaccine in the context of having limited supplies available. We need to maximise our ability to immunise individuals that have underlying factors for severe risk disease, including the elderly,” the expert said.

Madhi said the plan to prioritise only health workers in the first phase should be reviewed, although they should be given an opportunity to be vaccinated.

'But the reality of this opportunity is that they should also be aware that it is unlikely that they are going to be protected against mild infection, as well as some moderate infections.

'What we need to avoid is having health care workers who think that because they have been vaccinated they are protected against being infected by the virus, because that is not the case. What it would do is that it would protect them against developing severe disease or significantly reduce their risk,” Madhi said.

The expert advocated that older health care workers, especially those with comorbidities (having more than one illness or disease at the same time), should be a bigger priority.

'For a 20 or 25-year old health care worker with no comorbidities, the chances of that individual developing severe disease is nominal. The chances of that person being infected in hospital is quite high depending if they are looking after COVID patients or not, but they are not going to derive much benefit by receiving the AstraZeneca vaccine, as opposed to a health care worker who is 60 years old, (and) has got hypertension and diabetes,'Madhi said.

'That individual is the one we need to target, and the same thing goes for the rest of the population – those are the individuals to whom we need to get the vaccine to as soon as possible so that we can reduce the number of deaths that can occur from COVID-19 in the country,” the expert said.

Madhi’s comments came even as South African authorities frantically revise their original plan to use a million AstraZeneca vaccines received from the Serum Institute of India, starting next week.

Health Minister Zweli Mkhize announced on Sunday night that the country would no longer use the vaccines from India as global research into its efficacy continues. The Ministry has also entered into discussion with the manufacturers for options after discovering that the vaccines delivered last week will expire in April this year.

Professor Salim Abdool Karim, head of the Ministerial Advisory Committee on COVID-19, said on Monday evening during a World Health Organisation broadcast that the planned rollout to health care workers in the first of three phases of immunisation would not be significantly delayed because Johnson and Johnson vaccines are due to be delivered by next week.

South Africa reported a further 2,435 infections and 110 COVID-19 deaths overnight, bringing the totals to 1.48 million and 46,290 respectively as it battles a new variant of the contagion, which is now dominant in the country. PTI FH MRJ MRJ