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COVID-19 vaccine ‘will be a game changer’

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Virology experts in South Africa have allayed fear of COVID-19 vaccines, saying they are a “triumph of science”, and are likely to be game changers. However, they are clear that South Africans have months to wait before rolling up their sleeves.

Given the breakneck speed with which the COVID-19 vaccines have been developed – less than a year since the virus was identified – many in the community are sceptical about having the jab, worried about safety and efficacy.

“There are many who are understandably wary of the safety of the new COVID-19 vaccines,” says Professor Barry Schoub, the chairperson of South Africa’s ministerial advisory committee on coronavirus vaccines. “The development of these vaccines has been rushed through at five to 10 times the speed of other human vaccines.”

In addition, he says, people are worried about the novel formats of these vaccines, such as RNA vaccines and carrier-virus vaccines, which have never been used in humans before.

“Those who are hesitant need to be reassured by the rigour and thoroughness of the safety monitoring at all steps of development,” Schoub says.

During clinical trials, the safety of a candidate vaccine is carefully assessed by an independent data safety monitoring board which would immediately close down a clinical trial should there be any incident of a significant vaccine-related side effect.

“Following successful completion of the trial for safety and efficacy, the vaccine is submitted for licensing,” he says. “It again undergoes rigorous scrutiny by a stringent regulatory authority [SRA] often the Food and Drug Administration [FDA] of the United States (US), and often also a WHO [World Health Organization] prequalification evaluation and inspection. Each country then does its own inspection and evaluation.”

In South Africa, the South African Health Products Regulatory Authority (SAHPRA) also scrutinises the data for safety and efficacy. Only then is the vaccine licensed for use in the general population.

So far, no significant vaccine-related side effects have been recorded for any of the COVID-19 vaccines, now followed up for more than two months, Schoub says, describing them as “a triumph of science”.

South Africa watched as the United Kingdom (UK) began to roll out multiple doses of the first COVID-19 vaccine this week, becoming the first Western country to start vaccinating its citizens outside of clinical trials. This occurred after British regulators gave emergency authorisation to the drug produced by Pfizer and BioNTech. The US, which has just had its deadliest week for coronavirus since April, is also likely to decide this week whether to give the vaccine the green light.

However, experts say South Africa can expect to receive the vaccine for only about 10% of our population, most probably towards the middle of next year. This will also be prioritised with those most in need being first in line.

While the wait may seem long relative to other parts of the world, it’s only a nanosecond in vaccine terms.

It was welcome news for many in the community when out of the gloom of the pandemic came reports of the results of the clinical trials of the three front-runner vaccines. The finding of 95% efficacy for the two mRNA vaccines – Pfizer BioNTech and Moderna – more than exceeded the wildest expectations of the manufacturers and medical science, says Schoub, who is also a virologist and the former director of the National Institute for Communicable Diseases (NICD).

Furthermore, he says, recent studies have shown that the immune response holds for at least three months and hopefully much longer, as future studies may well show. A third vaccine, Astra Zeneca/Oxford, also performed well, achieving 72% efficacy.

Vaccines have been instrumental in treating many viral diseases. One only needs to look at the total eradication of smallpox, the eradication of wild polio in Africa, and very significant control of other vaccine-preventable infectious diseases, says Professor Lucille Blumberg, the deputy director of the NICD.

“In many cases, they have been instrumental in eradicating disease,” she says.

“The vaccine is coming to South Africa, and it will be a game changer. In such a short time, results are promising. We don’t know if it will stop transmission of the virus, but it may stop you from getting it severely. We still don’t know about safety, but so far the data is reassuring,” she says.

Schoub says vaccines could be the answer for the COVID-19 pandemic “once certain criteria are met”.

“Vaccine-induced immunity would need to be durable, at least for a few years, and in addition, a high enough proportion of the population would need to be covered,” he says.

However, being a middle-income country, South Africa doesn’t have the financial resources of the US, UK, and the European Union, which have collectively pre-purchased more than a half of the current total global production of vaccines.

In order to achieve equitable vaccine distribution to middle and low-income countries, a pooled procurement facility called COVAX was formed by the WHO and several partner organisations.

“South Africa has committed to the COVAX facility along with 189 other countries, and expects to receive vaccines for about 10% of our population, probably towards the middle of next year,” said Schoub.

But he said that given the parlous state of the economy, the country may not be able in the short term to purchase vaccines beyond that needed for the immunisation of special high-risk groups such as healthcare workers and residents of care homes for the aged.

“When and where the country will be able to immunise the whole population will depend on the availability of vaccines from manufacturers [who need to provide for global demand], and the ability of treasury to find the necessary funds,” he said.

He believes about R2 billion would be needed to purchase the vaccine for 10% of the population. However, the total cost could be substantially higher taking into account the cold chain, which includes storing and transporting vaccines, distribution, additional materials, logistics, record-keeping, and personnel costs.

“While the initial selective immunisation of high-risk groups could be managed relatively easily, immunisation of the entire population in the future will be on an unprecedented challenging scale,” Schoub says.

South Africa doesn’t have a programme in place to target the vaccination of adults, so the more familiar infant and childhood immunisation strategy would need to be scaled up to reach the entire population.

A further challenge to vaccine coverage would come from people refusing vaccination because they are unsure of the safety of these novel vaccines.

mRNA vaccines are a new type of vaccine to protect against infectious diseases. To trigger an immune response, the vaccines put a weakened or inactivated germ into our bodies. They teach our cells how to make a protein that triggers an immune response. That response, which produces antibodies, is what protects us from infection if the real virus enters our bodies.

Eventually, Schoub says, it will be vaccines which will control the COVID-19 pandemic. In the meantime, we need to rely on non-pharmaceutical interventions and we will need to maintain these well after the advent of the vaccine era.

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Anglican ministers break ranks over church’s anti-Israel stance

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“What do you do when the leadership of an organisation you’ve spent your whole working life serving adopts a policy or position that your conscience won’t tolerate?” asks Reverend John Atkinson. He is one of four local Anglican Church ordained ministers who recently spoke out against the Anglican Church of Southern Africa’s (ACSA’s) anti-Israel doctrine.

Atkinson, along with Reverends Dave Doveton, Dudley Greenshields, and Allan Smith also wrote a letter to the United Orthodox Synagogues’ Chief Rabbi Dr Warren Goldstein, thanking him for taking a stand against ACSA’s approach to Israel, especially in the light of his recent open letter to Anglican Archbishop of Cape Town Dr Thabo Makgoba. In that letter, the chief rabbi said the archbishop was “making a terrible mistake that endangers your own church”.

After receiving the letter from the four ministers, the chief rabbi invited them to meet him, which both parties said was very positive. “We wanted the chief rabbi and the Jewish community to know that there are many Anglicans who would find these policies offensive and a contradiction of our faith,” said Atkinson. “We may be sanctioned, but we aren’t afraid. Standing for the truth and against antisemitism is much more important.”

The group believes that ACSA’s anti-Israel resolution “expresses the ideological perspective of a small but influential elite, and by no means is representative of the average Anglican in Southern Africa. This is why we have made public our rejection of anti-Israel decisions and policies in our denomination”.

Between them, the four ministers have about 160 years of service looking after congregations within their denomination. Two of them were lecturers in theological institutions. All of them have a wealth of experience in their chosen professions.

They are close to retirement, so their careers are unlikely to be negatively impacted by speaking out. “It won’t make us popular, but that doesn’t worry us,” said Atkinson. “There are more people who would speak out if their careers wouldn’t be impacted.

“The average Anglican hasn’t thought about the Middle East at all,” he said, so the Jewish community needs to know that it’s not like three million people have turned against Israel. The ministers will therefore work to increase education and awareness.

He was moved by the meeting with the chief rabbi, and hopes that it “will open the way for greater dialogue between our communities and a greater appreciation of the values we share”.

Delving into why they have taken a stand, he said “this crisis of conscience was precipitated by a resolution that was passed at the highest decision-making body in the denomination in 2019 to support the Boycott, Divestment, Sanctions [movement] and call for a boycott of Israel. The resolution also called on local bodies within the church to adopt these measures.

“Since then, the chief rabbi has had discussions with the Anglican Archbishop, only to be rebuffed. This has been of particular concern because of rising incidents of antisemitism in South Africa,” said Atkinson.

In the letter to the chief rabbi, they wrote, “We want to convey our assurance to you that not all Anglicans support the aforementioned [anti-Israel] synod resolution. Indeed, we are appalled that people in our church would even think of proposing such an antisemitic stance and shocked beyond belief that the synod would uncritically and without any debate pass the resolution.”

A synod is a council of a church, usually convened to decide an issue of doctrine, administration, or application.

They said they weren’t against the criticism of any state and its policies, “but the one-sided diatribe against the government of Israel elected by the people of Israel and the total alignment with certain militaristic organisations bent on the destruction of the Jewish homeland is beyond belief”.

It had caused “much grief and disappointment, as it casts a slur on all of us. The simplistic analysis ignores the role of other countries and organisations who play a direct and indirect role in geopolitics and conflict in the region, and one suspects is meant to advance a propagandistic narrative and shut down other points of view. Certainly, no representative of the Israeli state was invited to give their perspective at the synod.”

The ministers said that “to lay all the blame on the Israelis amounts to scapegoating, which as you are all too painfully aware, is a classic hallmark of the scourge of antisemitism”. They were also deeply disturbed by the resolution calling on them to boycott Israeli companies. “What a terrifying reminder of the horrific genocidal acts against the Jewish community in Europe,” they wrote.

They disagree with the assertion that the present state of Israel isn’t tied to “the historic Jewish nation recorded in the sacred scripture that we as faith communities share. We believe that it’s a thinly veiled attempt to undermine Israel’s right to exist, and is against the historical record. This, too, is a mark of antisemitism.”

They questioned why a church which is based thousands of kilometres away from the conflict “should be so committed to the promotion of one narrative and the total exclusion of the other. If our church is so concerned about the lives of Palestinians, why was it silent about the deaths of 3 383 Palestinians in Syria? We believe the answer is obvious.

“We would like to assure you that we will remain faithful and vocal about Israel’s right to exist and defend itself against attack,” they said. “We will continue to engage with other Christians on these issues to ensure that the pro-Palestinian narrative isn’t the only voice that is heard.”

“The significance of their letter struck home to me powerfully,” Goldstein said. “It shows that there is another voice within the Anglican Church and the Christian community in South Africa, so many of whom love and support Israel and appreciate its role in the world.

“We can easily make the mistake of thinking that certain politicians or religious leaders speak for the country when they come out with such anti-Israel vitriol,” he said. “This letter is indication of a much broader movement of South Africans who have a completely different view. It’s important for us to know that we have many allies and friends across the length and breadth of this country. That’s why I wanted to meet with this group who wrote to me, to express to them on behalf of our community how much we appreciate their friendship and their partnership in getting this message out.

“I’m sure that their letter will encourage others to come forward. Often people feel intimidated and don’t want to speak out. We need to create an environment in South Africa where all citizens can come forward and show their support. There is an enormous groundswell of the silent majority of South Africans who support Israel. I met this group to encourage them to get the message out so that more people can come forward and express their true views.”

Going forward, the ministers will work to “encourage the support [of Israel] in the Anglican population and beyond”, according to Atkinson. “The Jewish community can assist us in this endeavour by communicating with Christians they know about Israel and the Jewish perspective of the Middle East.”

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The miracle of the maroon handkerchief

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Seventy-eight years ago, a Jewish man gave his 17-year-old daughter a maroon handkerchief as a way to remember him. She never saw him again – he died in the Holocaust. But she survived, went to America, and recorded her testimony in 1984.

Fast forward to 2020, and 14-year-old King David Linksfield pupil Noa Nerwich is asked to write a poem for a competition based on a Holocaust survivor’s testimony. She came across Ruth Halbreich’s recording, which includes mention of the handkerchief. Nerwich wrote a poem about the handkerchief and won the competition.

A year later, Halbreich passed away. Shortly thereafter, her grandson, Reg Tigerman, came across the poem in a newsletter he received, and realised it was about his grandmother. But that’s not all: soon after that, he also found the maroon handkerchief. He made contact with Nerwich [who is now 15], bringing a story that has spanned generations and continents full circle.

Speaking to the SA Jewish Report from Los Angeles, Tigerman says, “When I discovered the poem, I was shocked. Ruth, who we affectionately called Nanny, had just passed away a few months ago. The maroon handkerchief had been a topic of conversation within our family because my wife and I revisited her testimony right after she died and talked about trying to find it.

“My mom, who was going through Nanny’s things, did end up finding it. So, not only did Noa write a poem inspired by my grandmother’s testimony, which is an honour in and of itself, but she picked up on an item she mentioned at the very end of her testimony (proving that Noa was paying very close attention), and it was something that a lot of time and attention had been spent on recently. It was a series of dayenus [it would have been enough]. A true miracle. It felt like the world was telling us how important Ruth and her story is, and how important it is to continue to share her story.”

According to the United States Holocaust Memorial Museum, Halbreich was born in 1926 in Warsaw to a well-to-do family of three sisters and one brother. In 1939, their father fled with them to the Russian part of Poland, where he continued his work in the paper business. She, her father, and one sister crossed back into Warsaw, but her mother and two other siblings were sent to Siberia.

Halbreich and her family moved into the Warsaw ghetto in 1940. When the Germans started sending people from the ghetto to the camps, she and her sister were sent outside the ghetto to live in a convent. After the Warsaw ghetto uprising, Halbreich and her sister were sent to a slave labour camp in a small town in Germany. They were liberated in April 1945. She found out that her father had died in the ghetto in 1943, fighting in the underground. She met her husband, a fellow Holocaust survivor, at a displaced-persons camp. She also found out that her mother and two siblings had survived in Siberia.

In her testimony, Halbreich says, “The uprising was in April 1943. My father had left the ghetto in the trucks carrying merchandise. I met him in his office. He gave me a handkerchief of his to remember him by. My father’s biggest wish was to be able to save his children, and he was able to do this. He went back into the ghetto, and no one really knows what might have happened to him.”

A million miles away from that time and place, Nerwich entered the 21st Annual Holocaust Art & Writing Contest run annually by Chapman University and The 1939 Society (a community of Holocaust survivors, descendants, and friends). “The brief was for a piece of creative writing based on the testimony of a Holocaust survivor,” she told the SA Jewish Report.

The poem describes the handkerchief as the only thing Halbreich has left from her father as her world is destroyed, and how it symbolises the flames of destruction and her father’s deep love.

“Hearing her story and writing the piece itself was an enriching experience,” says Nerwich. “I was thrilled when I was awarded first place, a first for King David High School. I always smile just thinking about my poem. However, a small part of me always wished that Ruth would be able to read the poem and know that her story is being shared, that she is being heard.”

So, when she received the email from Tigerman on 15 July, “it changed my life. I read it and re-read it because I was sure my eyes were deceiving me,” says Nerwich.

She was shaking as she read the email. “I felt a deep sense of loss to learn that Ruth had passed away, but I was also deeply moved to learn that her family had the gift of this poem and that Ruth’s story continues to be told. Seeing the actual picture of the maroon hankie – the last memory that Ruth had of her father, the piece of fabric that guided her throughout the horrors she endured – is an image that will be permanently engraved in my mind.”

She says she chose to reflect on this story in her poem “because I could relate to Ruth. I’m a very sentimental person. Just like Ruth’s dad gave her a red handkerchief, my dad made me red roses out of Lego, which I keep in my room. So, the fact that she mentioned the maroon handkerchief that her dad gave her really resonated with me. It made it so much more real. It’s a symbol of her story, and what she and so many others went through.”

Her mother, Daniella Nerwich, says she felt breathless when she read Tigerman’s email. “All this really shows the value of Jewish education. We are so fortunate that King David creates opportunities like this [to enter the poetry contest]. This just shows how it can be so far-reaching. So huge credit must go to King David for creating this opportunity. It has been life changing.”

Because of the pandemic, Nerwich was unable to travel to the United States to collect her prize, but Tigerman’s message has made up for that disappointment. They hope to meet in person one day, and possibly even work together to share the story of the maroon handkerchief as a form of Holocaust education.

Says Tigerman, “While my grandmother didn’t often share her story (she would if you asked, but she wasn’t very proactive about it), my grandfather [Siegfried Halbreich] was a regular speaker. He was a survivor of multiple concentration camps over the course of five and a half years. He served as president of The 1939 Society, the organisation that published Noa’s poem, and was a founder of the Los Angeles Holocaust Museum. Everyone’s story is worth telling and remembering, which has made the oral histories and recorded testimonies so important.”

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COVID-19 vaccination could be compulsory at workplace

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As vaccination becomes more freely available in South Africa, questions arise such as can you make vaccination compulsory and can you dismiss someone if they refuse? Do you have to allow time off to get vaccinated, and what happens if an employee has an adverse reaction? These questions and many more are new to our labour law, and will be subject to litigation over the next many years.

In terms of the department of employment and labour’s latest regulations, the minister has recognised that employers may in terms of their own internal rules make COVID-19 vaccination compulsory.

Obviously, the compulsion must be subject to certain oversight, and must be reasonable in all circumstances. The employer would have to take into account their own operational requirements, and must be able to justify that in terms of these requirements, they would expect employees to be vaccinated against COVID-19.

Over and above this, each case must be carefully explored, discussed, and subject to proper consultation, taking into account the employee’s circumstances. These circumstances can include medical, religious, bodily integrity, and any other factor reasonably raised by the employee or the employee’s representative.

Obviously, each particular employer would develop a set of guidelines and rules which would be read with the disciplinary code and would be properly implemented after consultation with the employees or their representatives.

These rules must be made subject to the above-mentioned criteria, and would probably be differently implemented in accordance with the operational requirements of the position of the actual employee.

For instance, if a buyer for a company has the duty to travel abroad and can do so only if vaccinated, then there would be a compulsion to be vaccinated. It would be incumbent upon the employer to explore whether there are other ways of doing the job or whether an employee is willing to accept another position which doesn’t require vaccination.

It’s absolutely vital for every employer to read the regulation, and to advise all the necessary parties within the next three weeks of their intention to make vaccination mandatory and which employees will be affected.

Obviously, even once vaccination has been made mandatory, it would be subject to the employees being able to obtain the vaccination, and might require the employer to help obtain them. The employer’s policy will take into account various factors such as consultation with all the representatives at the workplace, and will respect bargaining council agreements and any other collective agreements with trade unions.

If there is an informal committee representing the staff and/or a workers forum, these bodies must also be consulted.

The minister of health has published draft regulations for the establishment of a no-fault compensation fund for injuries caused by the COVID-19 vaccination. The Vaccine Injury Compensation Fund will be established in terms of the regulations as an amendment to the regulations of the Disaster Management Act of 2002.

Although this compensation fund for vaccine injury hasn’t been formed yet, the various ministers involved are taking into account commentary from the public, and will be getting legal advice from parliament’s legal advisors.

The injury must be related to vaccination. An injured person may not institute a claim through the court process against the national or provincial government until the claim has been adjudicated by the relevant panel through the compensation fund.

Only if the person is dissatisfied with the outcome of the adjudication or the amount awarded can that person lodge an appeal, and the appeal must be determined by the relevant decision maker. Only after pursuing a claim with the scheme can a person look to the courts if that person is still dissatisfied.

Businesses are urged once again to warn their staff that protocols are in place, and breach of COVID-19 rules and regulations will lead to spread of infection and almost inevitably disciplinary action.

I’m involved in no less than a dozen cases where employers have reported and taken action against recalcitrant employees. It’s time, once again, to reiterate the fundamental, basic rules such as social distancing, mask wearing, and sanitising. Over and above this, any staff member exhibiting symptoms must report these symptoms to their health officer or senior management, and should immediately take sick leave.

The consequences of a staff member remaining silent could be loss of their position and more seriously, the spread of infection.

Employers will have to educate staff about the value of vaccination along with normal social distancing, masks, and hand sanitising. Education in these circumstances, I believe, will be the strongest factor in convincing all staff to get vaccinated.

A consolidated direction on occupational health and safety measures in certain workplaces was gazette on 11 June 2021. This contains new requirements with regard to vaccination.

It’s clear from this that an employer must give employees time off to be vaccinated. The employee may be required to provide proof of an appointment to be vaccinated. Time off shouldn’t be regarded as sick leave, but should be given as a form of special leave.

If there are negative effects from vaccination, the employer will grant paid sick leave in terms of the Basic Conditions of Employment Act. If the sick leave has been exhausted, there could be a claim in terms of the Compensation for Occupational Injuries and Diseases Act. Employees will produce the vaccination certificate thereafter, and a medical certificate if they’ve had complications.

  • Michael Bagraim is an attorney specialising in labour law, and advises nationwide on the restructuring and management of labour forces. He is also a Democratic Alliance member of parliament.

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