Limpopo could be SA's first province to reach herd immunity – if its vaccine supply keeps up
- Almost 8% of adults in Limpopo have received at least one dose of a Covid-19 vaccine.
- This is a better vaccination rate than any other province, and well ahead of the national average of 6.11%.
- The province's health MEC says this success is due to good planning, partnering with churches, and equipping community healthcare workers with smartphones and data.
- The province could reach heard immunity by February 2022 – four months earlier than the national plan – if its vaccine supply is uninterrupted.
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Limpopo is leading South Africa's Covid-19 vaccination rollout in terms of doses administered as a percentage of the province's adult population and its effective registration of elderly residents. The province – which also happens to be the country's poorest and most rural – believes it could be the first to achieve herd immunity if it can maintain a steady supply of jabs.
Limpopo has the highest percentage of adults living below the upper-bound poverty line (UBPL) in the country, according to Statistics South Africa (StatsSA). It also has the highest rate of multidimensional poverty among children, according to StatsSA's 2020 report on Child Poverty.
More than 80% of the province's population live in rural areas with limited access to proper services.
Yet Limpopo's vaccination rate, as of Wednesday, stood at 7.93%. More than 86% of the province's elderly population, aged 60 and above, have registered for their Covid-19 jabs compared to the national average of just 51.60%.
These early successes are the result of intense planning around Limpopo's unique and numerous challenges, according to the province's Health MEC, Dr Phophi Ramathuba.
To allay vaccine hesitancy, Ramathuba brought local churches and traditional leaders on board with the rollout, explaining that communities had a greater sense of trust in faith-based organisations than they did doctors or politicians.
"We identified all the kings, of the baPedi nation, the Venda, the Tsonga… when we got them vaccinated it meant that all the people who believe in the traditional leadership came forward," Ramathuba told Business Insider South Africa, adding that vaccines administered to bishops of major churches had the same positive effect.
To solve the problem of rural inaccessibility and limited internet connectivity in Limpopo's villages, the provincial department of health deployed some 9,000 community healthcare workers – equipped with smartphones and data – to conduct door-to-door registrations on the Electronic Vaccination Data System (EVDS). The same plan was applied to the actual administering of vaccines.
"And for those above 90 [years-old], we don't tell them to go to the vaccination site… we go their house and we go and vaccinate them personally at [their] home," explained Ramathuba.
Limpopo extends its unique approach to teacher vaccinations
Limpopo's bespoke approach to the vaccine rollout extends to the education sector. Teachers and staff at South African schools have been included in Phase 2 of the rollout, with vaccinations already having started on Wednesday. While most provinces have set-up specialised sites – in addition to those serving the general population – Limpopo has adopted a time-specific model. To minimise the disruption to schools and vaccination of the elderly, Limpopo has decided to dedicate all its sites to the exclusive vaccination of school staff on Fridays and Saturdays.
The province aims to vaccinate some 61,500 school staffers across 37 sites over the next two weekends, having been allocated its first batch of 38,400 doses of the single-shot Johnson & Johnson (J&J) vaccine.
"Most provinces are [already] implementing their vaccinations of teachers [on Wednesday] and I told my counterparts that they must not panic about Limpopo… I said we can't rush before we iron out all the details," said Ramathuba about a meeting with officials from the national department of health and department of basic education.
"Because when we launch, we don't stop. We go. I said we're launching this vaccination on Friday and we've been allocated 38,400 doses and I can guarantee if they [the department of basic education] bring in those educators we will vaccinate all of them."
Ramathuba is confident that her province's plans, across all phases of the rollout – general population and essential workers – can outpace South Africa's targeted date of herd immunity. This all depends, however, on the rate of supply of Covid-19 vaccines to national government and its provincial allocations.
South Africa hopes to achieve herd immunity by vaccinating 67% of the population – some 40 million people – before the end of May 2022. Ramathuba believes Limpopo will reach this goal by February if the vaccine supply is uninterrupted.
"If the supply is not constrained, we can keep this momentum. If we get sustainable supply, our 481 clinics can vaccinate 25,000 people [a day]… 100,000 in a week. In two months, we would vaccinate almost a million," explained Ramathuba, adding that the addition of public and private hospitals would further increase the province's daily vaccination projections.
To vaccinate the entire adult population by February 2022, Limpopo would need to administer roughly 500,000 single-dose jabs like J&J – or a million two-shot Pfizer doses – every month for the next seven months. But even at its recent peak, administering close to 19,000 doses in a single day, Limpopo would need to increase its vaccination rate by at least 30% to achieve herd immunity by February.
South Africa's vaccine supply is expected to increase dramatically in July, when J&J doses are dispatched from Aspen's production facility in Gqeberha. The use of J&J jabs was suspended at the end of April as a result of contamination concerns emanating from a facility in the United States.
Initial estimates released by the department of health in April aimed to have more than 9 million J&J doses and 16 million Pfizer doses delivered in the third quarter of 2021.
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