Pfizer booster South Africa
CAPE TOWN, SOUTH AFRICA - OCTOBER 02: Preparing the Pfizer vaccine during the vaccination outreach programmes on October 02, 2021 in Cape Town, South Africa. The Northern and Tygerberg health teams ramped up their vaccination outreach programmes as part of the National VOOMA Vaccination Weekend. (Photo by Misha Jordaan/Gallo Images via Getty Images)
  • Third doses of the Pfizer vaccine will start rolling out to the general public in South Africa on or around 28 December.
  • But the six-month interval between the second dose and booster jab means those over the age of 60 will be first in line.
  • The bulk of South Africa’s vaccinated population, those in the 35 to 49-year-old age bracket, will only be eligible for their Pfizer boosters from mid-March 2022.
  • But the Johnson & Johnson booster could be given much sooner and is expected to be approved before the end of the year.  
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South Africa will start rolling out Pfizer booster vaccines at the end of December. But with a six-month interval between doses, most of the population will only be eligible for a third jab from March 2022.

South Africa’s Covid-19 vaccination programme rolled out to the general public in May, with those over the age of 60 being prioritised as a high-risk group. With evidence pointing to waning vaccine efficacy over time, especially with the presence of mutated coronavirus variants, booster doses have been recommended to limit infection and the potential for severe disease.

More than 20.6 million doses of the Pfizer vaccine have been administered in South Africa. A third dose of the two-dose Pfizer vaccine, a booster, was approved by the South African Health Products Authority (Sahpra) on 8 December.

For those aged 18 years and older, Sahpra has instructed that this third dose be administered at least six months after the second dose. Those who are “severely immunocompromised” can get their Pfizer booster just 28 days after their second dose.

“The interval that has been approved is six months, which means we will start to vaccinate anybody who had a second dose of Pfizer, six months after that second dose, and that starts on 28 December,” the health department’s deputy director-general, Dr Nicholas Crisp, said during a media briefing on Friday.

“So, we’re hoping that we’ll either be ready then or within days after that with the [booster] vaccinations.”

Unlike the first round of vaccinations, these boosters won’t be restricted to certain age groups within a clearly regulated start-date. The six-month interval will, however, confine the Pfizer booster rollout to a set of age parameters, with older persons being first in line and those younger needing to wait longer for their third jabs.

“It’s not specifically following the age rollout, it’s following the interval,” said Crisp.

“So, if people who are younger came at the start of their aged rollout and others who are older came only after their subsequent age group had started, it will be the gap between their doses that matters and not the age that matters.”

The interval between the first and second dose of the Pfizer vaccine is 42 days. Taking this gap into account, those aged 60 and over, who got their first Pfizer doses when sites opened on 17 May, will be eligible for boosters from the end of December and into January.

Vaccinations opened to those older than 50 in July. Persons older than 50, who were quick to get their first shots in mid-July, will be eligible for their booster doses from the end of February 2022.

Most vaccine doses have been administered to those in the 35 to 49-year-old age bracket, with around 5.7 million – more than 45% people in this group – having received at least one dose since August. Pfizer booster doses will likely only rollout to this group from mid-March 2022.

More than 5.3 million vaccine doses have been administered to those aged between 18 to 34. For those who received their first Pfizer jabs when sites opened on 20 August, the wait for a booster shot will only end in early April 2022.

But these timelines are only valid while the interval remains six-months; a point which is currently being discussed by the department of health.

“At this stage, what is approved is six months. There has been some discussion around Pfizer intervals being reduced,” said Crisp.

“We know that some countries have gone to [an interval of] three months, but those are countries where the number of primary vaccinations is far in excess of what we’re experiencing. So, we’re not in that position at the moment and we’ll wait and see whether there is good reason to reduce it to either four or three months in the months ahead.”

Much quicker to get a J&J booster, if approved

South Africa’s upcoming rollout of the Pfizer booster also coincides with developments on the Johnson & Johnson (J&J) vaccine. Crisp confirmed that the Sisonke 2 study, which is a follow-on from the original programme that vaccinated around 500,000 healthcare workers with the single-dose J&J, had run its course on Friday.

Sisonke 2 started in November and administered booster doses of the J&J vaccine to healthcare workers as part of a Phase 3B clinical study. With the study now complete, the findings are expected to be presented in the coming days.

“Today [Friday] is the last day of the Sisonke 2 study… and we are anticipating either today or over the weekend an approval from Sahpra on what is to happen with the remainder of the population who were vaccinated with J&J,” said Crisp.

“The initial indication is that it will be a two-month interval between the single dose that had been given and the booster dose.”

The hugely reduced interval period of the J&J booster compared to Pfizer would, if approved in the coming week, make anybody who received a single shot before October immediately eligible for a booster.

(Compiled by Luke Daniel)

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