The National Department of Health (NDoH) plans to reinvigorate its Covid-19 vaccination campaign, zooming in on booster doses. This is as a second case of the XBB.1.5 sub-variant was detected in the Western Cape. 

Department Spokesperson, Foster Mohale, said it would increase its communications and encourage those who still need to be vaccinated, as well as those who are hesitant to go for their boosters.  He confirmed the announcement of the implementation date for additional boosters would be made by early February.

Details to be finalised

The Vaccination Ministerial Advisory Committee (VMAC) would soon make adjustments to the qualifying criteria for booster shots, as well as timeframes between shots.

The department intends to add a fifth dose for people who are 50 years and older, and a fourth dose for people who are 18 to 49 years of age towards the end of the month.

For now, it remains confident based on the advice from the VMAC, that children aged 12 and under do not need additional booster shots. This especially applies to those who are at low risk of severe disease.  

The total number of booster vaccines administered to people who are considered to be immunocompromised up to the 16th of January 2023, is only 24 175. The Western Cape leads the way.

NICD recommendations

The National Institute for Communicable Diseases (NICD) currently recommends that individuals receive a booster dose every six months, especially among older people and the immunocompromised. However, this may change as data become available. This is because data shows that antibody responses following vaccination decrease over time, and therefore booster doses should be given based on the latest guidelines to maintain high levels of immunity.

It remains unclear whether the COVID-19 vaccine should be given on a yearly basis like the flu vaccine.

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Fast and easily transmissible

COVID-19 vaccines remain effective against the XBB.1.5 sub-lineage and remain an important preventative measure against severe illness. 

However, COVID-19 fatigue and the relaxation of control measures may be contributing to the decrease in the booster vaccine uptake.  

As it stands, the total number of booster vaccines is just over 4.1 million across the country. Gauteng tops the list with just over one million while the Northern Cape occupies the bottom spot with only 82 652. The data also shows that the most booster vaccine doses administered in South Africa are Pfizer.

The NICD urged individuals to become aware of how easily the sub-variant can be spread.  

XBB.1.5 has been shown to have a growth advantage in the USA and Europe compared to previous lineages.

Why is it so transmissible?

Although there remains uncertainty in the data, Dr Nicole Wolter from the NICD explained that the growth advantage was thought to be due to a substitution (F486P) in the spike protein that increases the binding of the virus to the human ‘ACE2 receptor’ and therefore could increase transmission of the virus.

The ‘ACE2 receptor’ is a functional receptor on cell surfaces through which SARS-CoV-2 enters the host cells and is highly expressed in the heart, kidney, and lungs, and then shed into the plasma.

She confirmed that at this stage, the country is in a position that is less at risk of a spike in infections because there are no major changes in our epidemiology in terms of the rates of positive cases of the newly discovered sub-variant.

Maintaining high levels of immunity

According to the NICD, the South African population has a high level of immunity. This is either from previous infection, vaccination, or both infection and vaccination.

However, as COVID-19 antibodies wane over time it remains important to boost antibody responses through vaccination to maintain immunity. This is especially important for older people, and individuals with underlying conditions who are at a greater risk of severe disease.

Parents and guardians are also advised to check that children and adolescents are up to date for all other vaccine-preventable diseases to ensure they are protected.

XBB.1.5 remains unpredictable

“We do not yet know whether XBB.1.5 will result in an increase in infection rates that will result in a substantial increase in hospitalisations and deaths in South Africa. There are a number of countries around the world where XBB.1.5 has been detected and has not resulted in an increase in infection rates,” she said.

The NICD reports that there are a number of Omicron lineages and sub-lineages that are currently circulating in South Africa. This has been the case for the past few months.

Wolter noted that in addition to SARS-CoV-2, respiratory illness is also caused by other pathogens. Individuals with respiratory symptoms that have signs of severe illness should immediately seek care. Presenting early for care will assist in diagnosis and treatment.

Check out the latest vaccine statistics here. – Health-e News