With the first COVID jabs beginning to roll out, South Africa has announced its plan to reach two-thirds of the population once doses reach its shores. The country is hoping to secure direct deals with manufacturers by February. Shots via the procurement mechanism, COVAX, are expected by the beginning of the second quarter of 2021. Here’s a look at who will get it and how.
Resource details:
Publication title: Covid-19 Vaccine Rollout Strategy
Author(s): Department of Health
Publication date: 3 January 2021
What the strategy is about:
This past year has seen hundreds of vaccines in development worldwide in response to the growing coronavirus pandemic. In December of last year, a handful of these jabs began to release results showing their efficacy and safety in phase 3 trials, which are usually considered the final stage in a series of tests before companies can begin seeking regulatory approval. During this time, South Africa’s ministerial advisory committee on COVID-19 vaccines developed a strategy to ensure equitable access to vaccines. This strategy outlines the country’s plans for the rollout of a COVID-19 jab, including how the shot can be purchased and who the priority groups for vaccination are.
Key take-aways from the plan:
Why vaccines matter
- Vaccines are an important part of stopping the spread of COVID-19 in a country.
- This is because they offer protection to an individual, by reducing a person’s risk of infection or the severity of their symptoms, and also at a population level.
- This population-level protection is often referred to as herd immunity and happens when enough people have developed an immune response — in the form of antibodies and killer cells — to fight off the virus that there is a low risk of the virus continuing to spread within that community.
- This immunity can be developed either through receiving a vaccine or by previously having been infected.
- Achieving herd immunity helps to protect those who have not been vaccinated or who have not been previously infected by limiting how much the virus can spread within a population.
- South Africa is aiming to vaccinate 67% of its population to achieve herd immunity.

How South Africa’s rollout will work
- The national health department will coordinate the vaccine rollout with provincial health departments and the private healthcare sector.
- Structures will need to be established at a district level by the provincial health department to manage the mass rollout.
- The vaccine will be given out in three phases beginning with frontline healthcare workers, followed by other essential workers and high-risk groups before trying to reach the wider population.
- Distribution of doses will become less targeted as more vaccines become available.

How South Africa will get vaccines to people
- The vaccine will be delivered using three platforms during phase one:
- Work-based programmes: Best for hospital-based staff, especially at district level private and public hospitals.
- Outreach-based programmes using mobile teams moving between facilities: Best for primary healthcare providers, community health workers, and private medical centres.
- Vaccination centres, particularly in remote areas: Ideal for independent healthcare workers.
- During phases two and three the same programmes will be used, with the addition of vaccinations at public primary healthcare facilities.
READ MORE: Who should get the COVID-19 vaccine first in South Africa?
How South Africa will choose a COVID-19 vaccine
- The country will be guided by the following criteria:
- Does a supplier have stock available?
- Is the vaccine safe, effective and of good quality?
- How easy is it to use and how many doses are required?
- Can it be easily stored and distributed?
- Does the supplier have capacity to produce the volumes needed for South Africa’s rollout?
- How much does it cost?

How South Africa will ensure that a vaccine is safe and effective
- Manufacturers must submit documents and data for their vaccine candidate to the South African Health Products Regulatory Authority (SAHPRA) for approval.
- The regulatory body has put in place steps to help expedite the approval process once these documents have been received.
READ MORE: What do the latest COVID vaccine results mean?
How far along is South Africa in the procurement process?
- During the development stages of some candidates, the department of health began meeting with vaccine producers in China and Russia.
- Since last year the department, along with the ministerial advisory committee, has met with Pfizer, Astra Zeneca, Johnson & Johnson, Moderna and Cipla.
- Many of these manufacturers required that non-disclosure agreements be signed where no information about the offer can be shared until it is accepted by the South African government.
- South Africa is part of a global initiative called COVAX which aims to help ensure equitable access to a COVID-19 vaccine.
- Through this agreement, the country is expecting to begin receiving its allocated shares of the jab within the second quarter of 2021. COVAX has advised that they are trying to bring the delivery date forward to the first quarter, but this has not been confirmed.
- COVAX has primarily been focused on reaching agreements with vaccines that would be most suitable for developing countries, such as AstraZeneca and Johnson & Johnson’s jabs.
WATCH: COVID-19 Vaccine Rollout Strategy for South Africa
Aisha Abdool Karim was a senior health reporter at Bhekisisa from 2020 to 2022.