By Charndré Emma Kippie


A decline in immunity protection

It looks like Health workers in South Africa who have been vaccinated with the Johnson & Johnson vaccine (as per the Sisonke study) are likely to be eligible for another dose. It is said that this may come into action as soon as the South African Health Products Regulatory Authority (SAHPRA) has signed off on the trial’s adjusted protocol.

The Sisonke study kicked off in February and came to an end in May 2021. 496900 healthcare workers were immunised using the Johnson & Johnson Covid vaccination. The study aimed to protect South Africa’s frontline workers, first and foremost. 

Initially, it was thought that one Johnson & Johnson jab, and two Pfizer jabs, would be just for decreasing Covid-19 infections and death rates. However, news of the findings from two studies, published in the New England Journal of Medicine, have recently confirmed a decline in immunity protection levels from the two-dose Pfizer Covid-19 vaccine.

The study indicated that 6 months after taking the BNT162b2 vaccine (Pfizer), antibody-mediated immunity decreased substantially, especially in those who are 65 years of age or older, and those who experience immunosuppression.


Do we need booster shots?

In mid-October Dr Joe Phaahla, who is the South African Health Minister, made an announcement that the Ministerial Advisory Committee (MAC) on Covid-19 Vaccines had strongly suggested that citizens who have a compromised immunity be given additional doses of the vaccine.


This group would include:

  • Long-term oral steroid therapy patients being treated for autoimmune conditions (or receiving treatments for haematological or immune malignancies).
  • Individuals with solid organ or bone marrow transplants, primary immunological disorders, and renal dialysis. 


“The advice is that these categories of patients be offered an additional dose over the prescribed normal, but this must be strictly under the referral by their medical doctor under their supervision”, added Dr Phaahla. 

The Health Minister also spoke on the matter of the frontline workers who were vaccinated under the Sisonke Study. These healthcare workers are to be considered for booster Covid-19 vaccine doses as it has been more than eight months since receiving their first J&J jab.

“The request is receiving attention and we are working with the South African Medical Research Council (SAMRC) on a possible approach,” said Dr Phaahla.

Whether mixing these booster shots with the vaccines already taken is completely safe or not is still up for debate.


WHO Rationale for booster doses

According to the World Health Organisation (WHO) there are a few reasons why countries may need COVID-19 vaccine booster doses:

  • We need to remedy waning protection against the Covid-19 virus
  • The reduced protection against new variant(s) of concern will need to be addressed
  • We must consider the inadequate protection from the currently recommended primary series, for certain risk groups, for which evidence from the Phase 3 clinical trials may have been scarce.  


The rationale for booster doses may differ by vaccine product, epidemiological setting, risk group, and vaccine coverage rates.


Good News for SA Teens 

On 15 October the Minister of Health announced that South African teens would be eligible to receive their jab.

“Today I am happy to announce that we have reached a stage where we are ready to open up vaccination for children between 12- 17 years of age, and the majority of this cohort are in the secondary or high school level”, he said. 

“This follows a recommendation by the Vaccine Ministerial Advisory Committee which was supported by Health MECs and Cabinet. This service will start on Wednesday, 20 October 2021 to allow the necessary preparation on the EVDS and other logistics.

“We believe this will come handy as schools start exams or are advanced towards concluding the academic year and are preparing for the next year. The Pfizer vaccine has been approved by SAHPRA for this age group and will be used for this purpose”, concluded Dr Phaahla. 



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