News analysis

A Pfizer vaccine delivery in a freezer
A box containing a shipment of the Pfizer-BioNTech Covid-19 vaccine at a US medical centre – selected to receive the vaccine because of its ability store it at ultra-low temperatures. (Photo by Michael Ciaglo/Getty Images)
  • South Africa will be receiving a disproportionately high number of Covid-19 vaccines made by Pfizer – which demands ultra-low temperatures – numbers released by Covax on Wednesday show.
  • More than half of all the early Pfizer doses the initiative intends to distribute in Africa will be headed for South Africa.
  • Overall, SA's share of Covax vaccines stands at 1%, according to an early forecast, but its share of the Pfizer allocation is at 10%.
  • The government plans to use "non-traditional pharmaceutical storage sites" to handle the ultra-low-temperature requirements of the Pfizer vaccine.
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South Africa will be receiving a disproportionately high number of doses of one of the trickiest Covid-19 vaccines to handle, new numbers from the Covax initiative show – even as the country still tries to figure out how to keep it cold.

Covax will allocate nations around the world some 1.2 million doses of the Pfizer vaccine, it said in a per-country breakdown of where early-availability doses will go. That is on top of a far larger numbers of shots of the AstraZeneca/Oxford vaccine, much of which will be made by the Serum Institute of India, which requires only standard refrigeration

Of those Pfizer doses, 117,000, or just about 10%, have been earmarked for South Africa, even though SA's share of the total early Covax allocation is 1%.

Among the Pfizer doses to be distributed across Africa, 52% are due to head to South Africa.

That represents a significant vote of confidence in SA's ability to handle the Pfizer vaccine – which requires storage at minus 70 degrees Celsius – without wasting precious doses.

Exactly how that will be done is not yet clear. As of late last week, a government team was counting on using "non-traditional pharmaceutical storage sites" that can, in theory, maintain such temperatures, but which are not licensed for the storage of vaccines.

That is in anticipation of what may be 20 million doses of the Pfizer vaccine, expected to start arriving in May, according to current government estimates.

Covax expects its emergency allocation of Pfizer shots to be available in the first quarter of the year, while at least some of the AstraZeneca doses it is allocating will arrive up to three months later.

"Given the limited doses, the complexities related to rolling-out a vaccine requiring ultra-cold chain, and to ensure maximum public health impact, a decision was made to limit the number of countries for first deliveries of the Pfizer-BioNTech vaccine in order to enable successful distribution and delivery," said Covax on Wednesday.

Countries assigned Pfizer doses already passed a technical evaluation, though actual delivery is still subject to confirmation of "enforceability of product handling requirements" in each country.

As a region, Africa is due to receive 24% of the early Covax allocations.

None of South Africa's neighbours are due to receive any of the Pfizer vaccine doses. Their total early Covax allocations are:

  • Mozambique: 2.24 million
  • Zimbabwe: 1.15 million
  • Lesotho: 156,000
  • Namibia: 127,200
  • Botswana: 117,600
  • eSwatini: 108,000

Covax is jointly led by The Coalition for Epidemic Preparedness Innovations, Gavi, the Vaccine Alliance, and the World Health Organisation, with UICEF as a delivery partner.

(Additional reporting by Kyle Cowan)

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