Covid-19 Vaccines
As soon as the world started speaking about Covid-19 vaccine distribution, we received the first calls and questions about funding and distribution of Covid-19 vaccines to AMS members. As our president has now provided more clarity, we can summarise what is known so far. Covid-19 is evolving and information changes daily, so please bear in mind that this was up to date at the time of writing.
Our members asked us questions such as: "Will AMS pay for the Covid-19 vaccine?" - "Why does it take so long to get the vaccine into the country?" - "I have seen headlines about government's procurement process for Covid-19 vaccines - can't you procure vaccines for AMS directly to ensure all of us have access to them?"
Unfortunately, medical schemes can't secure, buy and administer vaccines directly. The process is as follows:
Getting vaccines into the country
A vaccine manufacturer (e.g. Johnson & Johnson, AstraZeneca, Pfizer/BioNTech or Moderna) develops different vaccine candidates. These go through intense development and clinical trials and once the trials confirm the effectiveness and safety, the manufacturer will apply for approval from the South African Health Products Regulatory Authority (SAHPRA). Approval is granted once SAHPRA is satisfied that the medicine meets the highest standards. Then a single exit price (SEP) needs to be determined by the Pricing Committee with the National Department of Health (NDoH) which then needs to be approved by the Minister of Health before general distribution to the public can begin. This process takes months, if not years. Special circumstances do allow for non- registered medicines to be sold, but these come with additional recording and monitoring requirements of patients. We anticipate Covid-19 vaccines will be treated as a special circumstance.
We are charting new territory. Never before has the country been faced with the prospect of fast-tracking an unknown drug for immediate mass distribution in a crisis. The logistics are daunting. For 40 million people to receive a drug that is not yet in the country, that is in high demand and is in short supply worldwide, is no mean feat.
Further, even if the vaccines are effective, they may not necessarily suit a country like South Africa. The Pfizer/BioNTech vaccine, for example, requires refrigeration at -70 degrees Celsius which, with our country's healthcare infrastructure, cannot be guaranteed, not even in private hospitals or pharmacies.
The President informed the nation on 11 January 2021 that the Government is looking to obtain vaccines through three channels: The World Health Organization's COVAX facility, through the African Union's vaccine initiative and through direct engagement with vaccine manufacturers. Without participating in these initiatives, South Africa would not be able to compete against the much larger, wealthier nations or access stock at affordable prices.
Health Minister, Dr Mkhize, has stated that the Government is aiming for herd immunity, meaning about two thirds of the population need to have acquired antibodies, and are therefore negotiating to purchase around 40 million doses. Government will be the sole purchaser of the vaccines and the NDoH will allocate it to provincial health departments and the private sector. Once available, vaccination of frontline health workers will be prioritised followed by essential workers and high-risk persons and only later the general public as per age and risk categories. This process is no different to other countries.
Roll out strategy
The President instituted a specialised national coordinating committee of experts, consisting of government and private sector, including medical schemes, to support the acquisition, funding and distribution of vaccines. AMS is participating through Discovery and is actively engaged in industry discussions to expedite the roll out strategy.
The President announced that 20 million doses have already been secured to be delivered mainly in the first half of the year.
The Serum Institute of India (SII) will provide the first batch of 1.5 million doses of the Oxford/AstraZeneca vaccine by February. These doses, with hopefully more becoming available soon, will be used for the 1.25 million healthcare workers. Please refer to the website for the full roll out programme.
Where can I go to get the Covid-19 vaccine?
As in the case of other vaccines, Covid-19 vaccines will be purchased and administered by licensed pharmacy clinics, hospitals, dispensing doctors, outreach services and workplaces.
As soon as vaccines become available, we will inform you by SMS or email, as we do every year for other vaccines. Please always ensure we have your up-to-date contact details. We will then also provide you with more information about the vaccination process, i.e. where you can go to get vaccinated, which vaccines will be available, how many times you would need to go for follow-up jabs, etc. Please remember healthcare workers will be prioritised and we will have to follow the roll out plan.
Will AMS pay for the Covid-19 vaccine?
The AMS Board of Trustees agreed in 2020 to fund Covid-19 vaccines - before it was even clear which vaccines would be available in the country. The Council for Medical Schemes recently included the Covid-19 vaccine in the Prescribed Minimum Benefit regulations. It is therefore very clear that AMS will fund the Covid-19 vaccine for all members, once available, in accordance with protocols when issued.
Will medical schemes subsidise vaccines for all citizens? In line with the country's normal pricing policy, whereby State obtains medicines at a lower price than the private sector, it is being suggested that the private sector will pay a higher price for the vaccines which will help cross-subsidise non-medical scheme members. Herd immunity cannot be achieved by the private sector alone, therefore it is in all our interests to ensure as many people are vaccinated as possible to break the chain of infection and end the pandemic.
At the time of writing, there is no finality on the choice of vaccine, rollout, cost or funding. Rest assured that your Board will take decisions in the best interest of all its members.
We urge you all to keep up the good work of avoiding closed spaces, crowded areas and close contact with others. Continue sanitising and wearing your masks, remain calm and vigilant. Keep perspective, remember, so far 2 people out of every 100 people have been reported infected. 98 people have not been infected, let's keep it that way.
Published: January 2021.