Covid-19 vaccine South Africa
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  • South Africa will have a Covid-19 vaccine by mid-2021, with government carefully weighing up key criteria for successful local application.
  • Cost, the ease of administration and storage, and the number of doses remain important questions which still need answering.
  • Despite payment issues, Prof Karim says the COVAX programme is South Africa’s best chance of acquiring a suitable vaccine.
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The greatest viable defence against the Covid-19 pandemic could be available in South Africa by mid-2021. A vaccine will need to meet South Africa’s unique set of requirements and rushing to purchase the first available option may not be in the country’s best interests despite pressures imposed by the pandemic.

This is the view of professor Salim Abdool Karim, who serves as the chair of the ministerial advisory committee on Covid-19, and has played a prominent role in South Africa’s response to the pandemic. As the world struggles to contain second waves of infections, a successful vaccine serves as the only light at the end of tunnel.

In recent months, great strides have been made towards developing and distributing Covid-19 vaccines. South Africa, too, is playing its part albeit at a slower pace than what was initially hoped for. South Africa is currently hosting clinical vaccine trials by Johnson & Johnson alongside a partnership between AstraZeneca Plc and the University of Oxford.

Government has also committed R500 million towards the global COVAX programme, which is aimed at providing developing nations with affordable access to vaccines when they become available. During his national address on Thursday 3 December, President Cyril Ramaphosa reiterated South Africa’s commitment to the COVAX initiative despite government missing the first payment window.

“We are participating in the World Health OrganiSation’s Covid-19 Global Vaccine Access Facility – known as the COVAX facility – which aims to pool resources and share vaccine development risk and thus ensure equitable access to vaccines when they become available,” said Ramaphosa.

“We are encouraged that the Solidarity Fund will be making the initial contribution of R327 million towards this vaccine procurement on behalf of our country.”

Professor Karim explained that, in addition to the cost-effectiveness of the COVAX programme, government would need to take a careful look at all the available options and resist the urge to rush in prematurely.

“We have to make a very careful decision about which vaccine is appropriate and best suited to South Africa,” says Karim.

“We have four vaccines [of] which the results have become available. There are eight more vaccines where the results are going to come out in the next several weeks. Among these eight, where we don’t know results yet, are some excellent candidates.”

Some of the frontrunners in the race to distribute vaccines include Moderna, the University of Oxford and AstraZeneca, Pfizer and BioNTech, and Johnson & Johnson. While these advanced trials have reported positive efficacy rates, Karim has noted three main criteria that need to be met for the vaccine’s South African application.

“Firstly, there’s a vaccine in there that is a single dose [and] a single dose is a big advantage for us, rather than having to get two doses,” explains Karim in pointing out the optimistic prospects of vaccines which are still in the trial phase, with results not yet known. “If you have a single dose, you need half the medical care infrastructure. If we choose a vaccine that is two doses, that will double the cost [because] we’ve got to buy twice as many vaccines.”

The second criteria noted by Karim involves seamless integration with South Africa’s already-existing inoculation platforms. South Africa has made extensive use of protein-based subunit vaccines and already has the infrastructure in place to roll-out appropriate Covid-19 treatments. A vaccine, midway through its clinical trial, developed by GlaxoSmithKline is one such protein-based subunit treatment.

“[We need vaccines] that use platforms of technology that we are widely familiar with. We have our existing vaccine infrastructure that uses those same platforms, for example, the protein subunit,” says Karim.

The cost-factor, beyond the expensive two-dose option, remains a major concern for all developing nations, including South Africa. Karim adds that this is why partnering with COVAX is the best option.

“We’re not going to be buying a vaccine, for example, Moderna, which sells for $35 (R531) a dose. Instead, we’ll get the first doses of vaccines through COVAX and that will be sometime near the middle of next year [2021],” says Karim.

Bur Karim stresses that, while acquiring a vaccine should remain a priority, South Africa would need to choose wisely according to these three factors.

“We choose on the basis of two characteristics, safety and efficacy. And [there are] three characteristics that we need to weigh up. Cost, the ease of administration and storage, and the number of doses,” explains Karim.

“It doesn’t help that people, who are not familiar with the complexities of the vaccine selection process, think ‘we want a vaccine now’. That’s not going to happen, it’s just not going to happen.”

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