How the WCape is managing the vaccination process – Alan Winde

Premier says EVDS has not worked well, but province has now acquired some control over the SMS scheduling system

“Western Cape to introduce system to manage walk-ins at sites, but we encourage residents to wait for their second SMS which will start arriving in greater numbers”

The scheduling system managed through the EVDS, controlled nationally, has not worked as well as it should. 

This has meant that some residents have received SMSs at too short notice, for places too far away from their homes, and many have not yet received any at all. 

This is causing a lack of trust in the system, with residents feeling they have no choice but to go to a vaccination site to get vaccinated without having an appointment. 

This is understandable because these residents are scared of COVID-19 and are desperate to get their life-saving vaccine.  

On the other hand, because of these system challenges, some people have also missed their appointment, resulting in additional vaccine doses at sites available to then vaccinate those eligible residents who walk-in. 

There have also been instances where elderly residents have arrived to get vaccinated and hadn’t registered because they don’t have access to the technology to do so. These residents cannot be left behind if we want an equitable and fair programme.  

I agree that it is wrong to have unused vaccines at a site and not use them on someone over 60, even if they don’t have an appointment, especially when that system isn’t working properly. 

It is also wrong for someone who did wait patiently for their SMS to get an appointment and not be able to get vaccinated because so many walk-ins took up the supply. 

This is the balance we must get right in this vaccination programme, and we must learn through experience.  

The Western Cape has done its very best to manage the programme in line with the EVDS, which remains the only system for registration and scheduling in the country. 

However, given the realities above, we realise that we must be responsive and flexible in our own planning. 

To respond to this challenge, we have engaged with national government and were able to get some control over the SMS scheduling system. 

We are now giving our local teams control over scheduling the number of people per site, based on the available capacity and vaccines. Although we are scheduling appointments, the SMSs will still come centrally (via EVDS). 

By having some control over the scheduling, we are aiming to give between 3 and 7 days-notice, which will increase appointments being met. 

We believe provinces should be given more control over the system because we have a better understanding of our districts and where sites are located relative to where someone lives. 

This improvement in scheduling will also coincide with a major scale up of vaccinations, which I will discuss below, as more vaccines arrive in the Western Cape and more sites open-up. 

This practically means that there will be better appointment management, better communication of appointments and more appointments being scheduled and being met by residents.

This also practically means that our planning for the number of doses at each site every day will increasingly match those being invited and attending for their vaccination.

With this said, we also have to realise that walk-ins are a reality and someone over 60 years old who is eligible for their vaccine should not be automatically turned away. 

To manage this reality, the Western Cape will provide a margin of additional vaccines  to sites (size and projected capacity determined) for eligible walk-ins (residents over 60).

Furthermore, those vaccines that are not administered on the day because of a missed appointment (currently averaging between 5% to 25% of doses) will also be used for someone who is over 60 and who arrives without an appointment. 

We will also soon be opening up mass-vaccination sites in our province where a much larger number of walk-ins will be allowed because of its capacity. 

This information will be following soon, including on the location of these mass-sites. 

I do want to be very clear, though, that those residents who have received their second SMS, and have been invited to receive their vaccine, will be given preference in line with their appointment date and time. This is only fair. 

There is therefore no guarantee, at this stage, that you will get a vaccine as an eligible walk-in, and you may wait a long time for one at a site without success. 

To manage this new approach, we have asked our sites to introduce a queue system, so that eligible residents who walk-in can be assisted in terms of this additional margin created or receive a vaccine from a missed appointment. This will be brought online in the next few days.

It is worth repeating again that as more vaccines arrive, more sites open up, and as the Western Cape gets more control over the scheduling of appointments, so will the number of appointments that are scheduled increase.  

We therefore encourage you to wait for your second SMS, it is coming soon. I guarantee that every person who registered for their vaccine will get vaccinated. 

“The Western Cape is avoiding a stop/start approach to vaccinating, and so is scaling up as more vaccines arrive and more sites open”

The Western Cape has increased the number of vaccines administered this week to an average of 6000 vaccines per day. Yesterday we exceeded this target, vaccinating over 8000 people.   

So far, we have vaccinated nearly 30 000 people with the Pfizer vaccine, under phase 1b and 2, which kicked off on the 17 May.

This programme will be ramped up further, with up to 12 000 vaccines being administered every day next week, starting 31 May 2021, and 24 000 vaccines being administered every day the following week, starting 7 June 2021. 

We will then look to sustain this daily rate throughout the year as we go through subsequent phases (in line with the projected supply pipeline). 

To put it simply, our plan is to get the car on the road, increase its speed, and to not slow down again. 

This approach understands that we do not have all the vaccines we need at the moment and will be getting supply in incremental batches. 

It therefore prevents a stop/start approach to vaccination, which can be highly disruptive.

This supply is starting to increase in the Western Cape and is projected to reach 118 280 Pfizer vaccines this week. This still only covers about a third of people registered.

We are also still awaiting clarity on the arrival of the Johnson and Johnson vaccines from the plant in Gqeberha. We expect their arrival next week, which will increase our supply by over 260 000 vaccines.

“The Western Cape to open 49 sites next week, and 17 sites the week after, mostly in our rural districts”

As this supply increases, we will also be able to open more sites in every district of the Western Cape. 

This week, the Western Cape opened 33 additional public sites, bringing the total number of public and private sector sites to 65. 

Next week, starting 31 May, the number of public sector sites will increase by another 49 sites, mostly in rural districts (outside of Cape Town), bringing the number of vaccination sites to well over 100. 

The following week, starting 7 June, this number will again increase by another 17 public sector sites, again mostly in rural districts. 

One of the factors we had to consider in this approach is that the Pfizer vaccine required cold storage of -70 degrees Celsius. This would make storage and logistics difficult in some of the smaller towns in our province and increase the risk of wastage.

The Johnson and Johnson vaccine, however, requires only 2-4 degrees Celsius storage and would therefore be better for the rollout in rural districts across the province. This was factored into the planning. 

The good news is that the cold storage requirements of Pfizer have been relaxed internationally as of this week, and this will now assist our rural vaccination programme in the weeks ahead. 

The province-wide vaccination programme will see every district covered in our province. 

We plan to have:

  • 70 sites in the City of Cape Town
  • 48 sites in the Overberg District
  • 53 sites in the West Coast District
  • 14 sites in the Central Karoo District
  • 41 sites in the Garden Route District
  • 48 sites in the Cape Winelands District

The Western Cape will be as flexible and responsive as possible, as we learn with experience”

In a programme as big and complex as this, it is important to plan as best you can, but learn from the experience as it unfolds. 

This is a once-in-a-generation operation and we must be prepared to learn from what works and change what doesn’t. 

In this spirit, the Western Cape will continue to be as adaptive as possible, and we promise to communicate with our people as often as possible, so that they remain informed every step of the way.

If we need to change the approach, we will. And we will be honest with you about why.  

We thank every person who is waiting patiently for their vaccine, and for all those not yet eligible, who are helping register those residents who are. Thank you! 

You have my word that we are working around the clock to get this job done.

Issued by the Western Cape Premier's Office, 27 May 2021