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07 October 2021 | Story André Damons
Dr Nicholas Pearce, Head of the Department of Surgery in the Faculty of Health Sciences at the UFS, Prof Adrian Puren, Acting Executive Director of the National Institute for Communicable Diseases (NICD), Prof Glenda Gray, President and CEO of the South African Medical Research Council (SAMRC), and Dr Angelique Coetzee, Chairperson of the South African Medical Association (SAMA), were the panellists at the University of the Free State (UFS) Thought-Leader webinar, themed Why vaccinate?

Panellists at the University of the Free State (UFS) Thought-Leader webinar, themed Why vaccinate, felt it was critical for everyone in South Africa to get vaccinated in order to return to a sense of normality and to a university environment where lectures and learning not only happen in the lecture room, but in the ‘informal’ academic environment. 
Large numbers of the community need to be vaccinated to halt the progression of the pandemic and to maintain non-pharmaceutical interventions. 

Dr Nicholas Pearce, Head of the Department of Surgery in the Faculty of Health Sciences at the UFS, Prof Adrian Puren, Acting Executive Director for the National Institute for Communicable Diseases (NICD), Prof Glenda Gray, President and CEO of the South African Medical Research Council (SAMRC), and Dr Angelique Coetzee, Chairperson of the South African Medical Association (SAMA), were the panellists. This was the fifth webinar (28 September 2021) in the series, which is part of the Free State Literature Festival’s online initiative, VrySpraak-digitaal. 

Critical that everyone get vaccinated to return to a sense of normality

Dr Pearce indicated that patients seemed hesitant to present to both private and state health-care facilities during the COVID-19 pandemic. This resulted in patients presenting in the final stages of cancer (stages 3 and 4 as opposed to stages 1 and 2). “The quicker we are able to exit the COVID-19 pandemic – and we will probably never totally eradicate it as it might become endemic – we can go back to treating other medical conditions that are currently not being optimally managed,” said Dr Pearce.

He is also concerned that the impact of the pandemic on other medical diseases (such as mental issues) will only become visible over a number of years. We must be careful that we do not forget about the non-COVID diseases, according to Dr Pearce. 

Dr Pearce said it was critical that everyone be vaccinated in order to return to a sense of normality. The COVID-19 protocols of social distancing and the wearing of masks have left a mental toll on us as a society. He said depression and suicide are on the rise, and if we want to go back to a sense of normality, a large number of people need to get vaccinated.

The economic problems caused by COVID-19 are huge, as a large number of people have stopped their medical aids in the Free State. Some of the other economic problems due to COVID-19 is that a larger number of the younger population got infected during the third wave, which means that many breadwinners lost their lives. In the medium and long term, this is going to have huge economic repercussions. 

Vaccine acceptance increased among South African adults

Armed with figures from a recent study by the Centre for Social Change at the University of Johannesburg (UJ) in collaboration with the Developmental, Capable and Ethical State research division of the Human Sciences Research Council (HSRC), Dr Coetzee illustrated the importance of getting vaccinated. 

The study found that even though hesitancy dropped by 5%, vaccine acceptance increased to 72% among South African adults.

She said according to the study, South Africa faces two significant challenges. “First, if all 72% were actually vaccinated, we would still be 8% short of the government’s target of 80%. So, we know that government has secured significant vaccines to vaccinate the entire adult population and that the supply of vaccines should no longer be a concern as we had seen earlier this year. What we need to do is to convince some of the people who are currently hesitating about the value of getting vaccinated.”

Acceptance among the older age group has risen substantially by 11% when comparing the results from round three (December 2020 to 6 January 2021) with round four (June 2021 to July 2021). Said Dr Coetzee: “But what is still concerning is that the acceptance among those aged 18 to 24 years has actually declined from 63% to 55%.”
The second challenge that came to the fore, continued Dr Coetzee, is one of access. “We have said many times before, vaccines should be brought to the people, and not the other way around. Finally, we are now seeing that this is starting to happen, but I think it is too slow – especially in the rural areas – and maybe a bit too late. Let’s see what is going to happen going forward.”

According to Dr Coetzee, the message must be clear: We need to vaccinate to save the health-care workers and to save lives and maintain the non-pharmaceutical interventions. She said it does not matter how many times people are told to get vaccinated, they still want to take their chances with the virus. 

Aim higher to achieve herd immunity

According to Prof Puren, the threshold for herd immunity of about 67% vaccinated adults in South Africa now seems to be more mythical. “We should be aiming higher than that, meaning 90% or higher in terms of the proportion of the population being vaccinated in order for us to have a more endemic control,” says Prof Puren. 

“A large number of people in South Africa have been infected with COVID-19, but there is still a significant proportion of people that have not experienced this virus. Herd immunity is about the indirect effect of protecting those individuals who are susceptible. So, it’s a particular threshold of the number of people who had an immune response.” 

Prof Puren said there will have to be a breakthrough in infections. Vaccines do work, they are effective. It is possible for us to achieve endemic control, and vaccines are the critical component to do that. 

Important benefits of vaccination are to gain control of the academic year

“The questions about the benefits of mandatory vaccination at university – to prevent hospitalisation and deaths.  With vaccination, you also impact isolation and quarantine challenges. If you have good coverage of vaccinations, institutions will not have to keep closing classrooms, or hostels. It will help keep the workforce open. 

“One of the important benefits of vaccinations is to gain control of the academic year. All the universities have suffered, having to move to online learning where a lot of students don’t have the luxury and privilege of having data available to them all the time.”

“The issue of hybrid learning is important, and you will still see a lot of hybrid learning going on as we go into different surges. But students still need interaction, they still need face-to-face teaching, and they still need the interaction, the socialisation. We have to maximise the university experience,” said Prof Gray.  

In answering the question – would it be beneficial for employees and institutions to formulate and implement a vaccination policy – Prof Gray said it was a critical move to open up academic institutions.  

She agreed with Prof Puren that the 70% is almost mythical, and that a higher level of vaccination will be needed to start controlling the pandemic. 

“Why should we vaccinate? Why should we try and control the transmissions in our country? We have to do that, because we need our economy to start, we see how we have been affected by being on the red lists of certain countries. This affects our economy, our tourism, and jobs. A lot of people have lost jobs. If we want to interface with the rest of the world, we are going to have a discussion around making sure citizens are vaccinated.”


• The recording of the webinar can be found here  

 Passcode: nJv%p7Rp

News Archive

Nuclear Medicine on the forefront of cancer research
2017-07-10

Description: Nuclear Medicine on the forefront of cancer research Tags: Nuclear Medicine, cancer research, Dr Je’nine Horn-Lodewyk’s, tumour detection method, cancer, Department of Nuclear Medicine 

Dr Je’nine Horn-Lodewyk’s tumour detection method
could be the cost-effective breakthrough needed to decrease
the mortality rate in breast cancer patients.
Photo: Anja Aucamp

The field of Nuclear Medicine in South Africa and the rest of the world are expanding rapidly due to the development of hybrid cameras and new radiopharmaceuticals. These developments have a huge impact on the diagnosis and therapy of cancer.

The most advanced of these cameras, Positron emission tomography combined with normal CTs (PETCT), are not yet widely available in South Africa due to the cost of the cameras and the radiopharmaceuticals. A more cost-effective alternative can be of great benefit. To achieve this, the focus should be on developing new radiopharmaceuticals that can be used with the current cost-effective gamma cameras, according to University of the Free State researcher, Dr Je’nine Horn-Lodewyk from the Department of Nuclear Medicine.

Fluorodeoxyglucose (18F-FDG), a radiolabelled glucose analogue, is currently the radiopharmaceutical most commonly used in PET/CT imaging for mainly oncology indications. Although it is considered the gold standard for imaging in several malignancies, it does have certain disadvantages. An 18F-FDG PET/CT diagnostic imaging study can cost between R25 000 and R35 000 for a single patient in the private sector. The 18F-FDG is also more radioactive, which requires much stricter handling and shielding to avoid high radiation dosages to staff and patients.

Successful research potential innovative solution
In the search for the ideal radiopharmaceutical for tumour detection, the South African National Nuclear Energy Corporation (Necsa) developed a local synthesis process for ethylenedicysteine-deoxyglucose (EC-DG). EC-DG is also a glucose analogue similar to FDG. They succeeded in labelling the compound with Technetium-99-metastable-pertechnetate (99mTcO4-), the most common nuclear medicine isotope used for approximately 95% of nuclear medicine procedures, creating 99mTc-EC-DG.

In partnership with Dr Horn-Lodewyk, this compound was successfully used in various animal models and clinical scenarios, resulting in approval by the Medicine Control Council to use it in a human study. Research is also planned in order to investigate diagnostic accuracy in other cancers like lymphoma.  The end result of this research can produce a radiopharmaceutical that is cost effective, does not require the use of costly specialised equipment, has no significant side-effects, no special patient preparation, renders late imaging possible, and has decreased radiation risks.

Dr Horn-Lodewyk is grateful for the support of her mentor, Prof Anton Otto, as well as Dr Gert Engelbrecht, Head of the Department of Nuclear Medicine, Prof Jan Rijn Zeevaart from North-West University’s Preclinical Drug Development Platform and Necsa, and Judith Wagener from Necsa. This innovative research would also not have been possible without the financial assistance of Dr Glen Taylor and Eleanor van der Westhuizen in the Directorate of Research Development.

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