Transcript: Module 1: Introduction to COVID-19 vaccination training

Slide 1: Welcome to the COVID-19 vaccination training for healthcare workers. In this
module, you will be introduced to the covid-19 vaccination training package.
Slide 2: The objective of this training is to provide key information on COVID-19 vaccination
to South African healthcare workers, focusing on vaccinators. The training is based on
information available as of 13 January 2021. As new information becomes available, the
relevant training materials will be updated.
Slide 3: This training has 7 modules. Module 1, which you are listening to right now, will
introduce you to COVID-19 vaccination training. Module 2 deals with storage, handling,
delivery, and waste management of COVID-19 vaccines. Module 3 deals with organising
COVID-19 vaccination sessions. Module 4 deals with AEFI monitoring for COVID-19
vaccination. Module 5 deals with COVID-19 vaccine data management. Module 6 deals with
communication with the community about COVID-19 vaccination. Module 7 deals with
ethical considerations for the COVID-19 vaccination programme.
Slide 4: Each module consists of two parts, with the first part being a lecture video, like the
one you are listening to now, with an accompanying transcript. There may also be
supporting documents for some modules. You are required to download and listen to these
lecture videos, and review any supporting documents, before participating in Part 2. Please
post any question you have on the Discussion Forum on the Knowledge Hub. These
questions will be answered during Part 2.
Slide 5: The second part of each module is an interactive webinar. During this webinar, a
panel of experts will answer the questions you posted for the module on the Knowledge
Hub. Thereafter, a series of multiple choice questions, based on the module content, will be
conducting using voting / polling. After polling, the presenter will explain why correct
answers are correct, and why incorrect answers are incorrect. If there is time at the end,
you will be given an opportunity to raise your hand and ask questions, or post questions on
the chat. Any questions not answered by the end of the session can be posted on the
Discussion Forum of the module on the Knowledge Hub. The panel of experts will then
provide answers to these questions on the Knowledge Hub
Slide 6: Now to get back to Module1. Other than the first objective of Module 1 to
introduce you to the whole course, this module will also give a brief introduction to SARS-
CoV-2 and COVID-19, an overview of COVID-19 vaccines, with a focus on the AstraZeneca
COVID-19 vaccine, and outline the NDoH vaccination strategy for healthcare workers.
Slide 7: Coronaviruses are a large family of RNA viruses which cause a wide range of disease
such as the common cold, Middle East Respiratory Syndrome (MERS), Severe Acute
Respiratory Syndrome (SARS), and COVID-19, which is caused by a new strain of coronavirus
called SARS-CoV-2.
Slide 8: The spike-like protrusions on the envelope give SARS-CoV-2 its characteristic crown-
like appearance. It is this spike protein that the virus uses to attach to and enter host cells,

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that has become the focus of most vaccine development approaches. Other vaccines are
based on the RNA of the virus.
Slide 9: The symptoms of COVID-19 may vary. Common symptoms include high fever, a new
persistent cough, and loss of taste and smell. Less common symptoms include fatigue,
shortness of breath, muscle aches, headache, diarrhea and vomiting. The presentation of
COVID-19 is evolving as more becomes known about the disease.
Slide 10: While most infections are either mild or asymptomatic, anyone can become sick
with COVID-19, regardless of age and health status. People above the age of 60 and those
with underlying medical conditions are more at risk. Complications of COVID-19 include
severe disease and may lead to death

Slide 11: Since the report of the 1st case of COVID-19 in South Africa on 5 March 2020, there
have been over 1 278 000 confirmed cases with over 35 000 deaths associated with COVID-
19. Gauteng Province leads in the number of confirmed cases while the Eastern Cape
Province has recorded the highest number of deaths.
Slide 12: Vaccination is the best tool for the prevention of morbidity and mortality from
infectious diseases. Vaccines provide protection at the individual level, reducing the risk of
infection, and at the population level, by providing herd immunity, which is indirect
protection when immunity develops in a population either through vaccination or through
previous infection. Herd immunity prevents ongoing transmission when an infected
individual enters into a community where most people are vaccinated, thereby protecting
those who cannot be vaccinated, such as babies too young to be vaccinated, or those with a
health condition precluding vaccination.
Slide 13: Before we look at the individual vaccines, it is important to appreciate that since
the beginning of the pandemic, several vaccine manufacturers have been in the race to
develop safe and effective vaccines against COVID-19. COVID-19 vaccines aim to elicit
production of protective levels of antibodies against SARs-CoV-2, and establish
immunological memory in the vaccine recipient, ultimately stopping the transmission of
SARs-CoV-2 and thereby halting the pandemic and preventing the morbidity and mortality
associated with COVID19
Slide 14: Numerous vaccine development strategies are being used in research to develop
an effective COVID-19 vaccine. There are currently over 200 vaccine candidates at different
stages of development, with 10 vaccines approved for use mainly under emergency use
authorisation, as of the 14th January 2021.
Slide 15: The mRNA-based Pfizer-BioNTech vaccine has been authorised for emergency use
by the FDA of the USA and a number of other countries, and has WHO pre-qualification. The
filing for authorization by the South African Health Products Regulatory Authority has not
yet been completed. Clinical trials have shown that the vaccine is very safe and has 95%
efficacy after 2 doses. Rollout has happened in a few countries where early bilateral deals
were made. The biggest challenge for implementation in most low and middle-income

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countries is the cold chain requirement of storage at -700C. This is a limitation for South
Africa as we have limited commercial ultra low cold chain storage capacity.
Slide 16: The mRNA-based Moderna vaccine has been approved for emergency use by the
FDA and European Medicines Agency. There is no immediate expectation of dossier filing
with the South African Health Products Regulatory Authority, since the manufacturer has no
presence in South Africa. Clinical trials have shown that the vaccine is very safe and has 94%
efficacy after 2 doses.
Slide 17: The Johnson and Johnson vaccine is an adenovirus vector-based vaccine. It is
currently under regulatory review. It is a single dose product making administration much
easier, and being more cost effective. It will be manufactured at the South African Aspen
facility on a contract basis.

Slide 18: The AstraZeneca vaccine was developed in collaboration with Oxford University
scientists. It is an adenovirus vector-based DNA vaccine hence it is more stable when stored
in moderate temperatures. It uses a harmless genetically modified chimpanzee adenovirus
that is unable to replicate, as a vehicle to transport the spike protein-encoding gene into the
host’s cells. In the host cell, this gene is used by the host cell’s machinery to make spike
proteins, which are presented as antigens to the host immune cells. The host’s immune cells
react by producing spike protein-specific antibody-producing B-cells and cytotoxic T-cells.
The vaccine has been approved for emergency use by the Medicines and Healthcare
Products Regulatory Agency of the UK, the Drugs Controller General of India and the South
African Health Products Regulatory Authority.

Slide 19: AstraZeneca has outsourced the production of the vaccine to various sites globally.
The largest vaccine producer globally is Serum institute of India (SII). SII does not have a
presence in South Africa, but will be registered by its local partner, Cipla. This vaccine is
likely to be widely used globally due to temperature stability, and because of large volumes
that AstraZeneca committed to produce through partners. Clinical trials have shown that
the vaccine is very safe and has 70% efficacy after 2 doses given between 4 to 12 weeks
apart. It has favorable storage requirements of 2–80C.
Slide 20: South Africa has adopted a phased vaccination rollout guided by availability of
vaccines, since the huge global demand cannot be met by the limited availability of vaccines.
Priority will be given to those at greatest risk for contracting COVID-19; those who are
essential in providing continued health services; those who are essential for society to
function; those most at risk of transmitting SARS-CoV-2 to others, such as people living in
close proximity to each other; those 60yrs and older, and those most at risk of serious
outcomes when contracting COVID-19, for example, those with comorbid conditions.
Slide 21: In Phase 1, the limited supply will be prioritised for health workers in both public
and private sectors. In Phase 2, the increased supply of doses will extend vaccination to
essential workers, persons in congregate settings, persons aged 60yrs and older, and
persons aged 18yrs and older who have comorbidities. In Phase 3, there will be an increased
supply of vaccines allowing for routine vaccination of those aged 18yrs and older.

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Slide 22: For Phase 1, three approaches will be used. The first will be a work-based
vaccination programme covering private and public hospitals. The second will be an
outreach work-based vaccination programme involving teams moving from facility to
facility. The third approach will utilise vaccination centres, including remote or facility-based
vaccination centres such as community pharmacies.

Slide 23: In the context of limited supply of COVID-19 during Phase 1, vaccination alone will
not be sufficient to prevent community level transmission. Thus public health and social
measures (i.e. masks and social distancing) should continue to be used. Before, during, and
after vaccination, it is important to continue following standard precautions for infection
prevention and control.
Slide 24: In summary, the COVID-19 vaccine is important for protection against COVID-19.
This training package provides healthcare workers with an overview of what is new or
different for COVID-19 vaccination. South Africa will undertake a phased vaccination
approach beginning with health workers. The AstraZeneca COVID-19 vaccine will be used in
phase 1. Other non-pharmaceutical prevention strategies must be continued. Wearing of
masks, frequent hand sanitisation, observing social distancing and avoiding crowding remain
key prevention strategies for preventing SARS-CoV-2 transmission.
Slide 25: These slides were based on the WHO / UNICEF COVID-19 vaccination training for
health workers Module 1: Introduction to COVID-19 vaccination training. The module
developer is Dr Andrew Musyoki, South African Vaccination and Immunisation Centre, at
Sefako Makgatho Health Sciences University. The module reviewers are Prof Rose Burnett,
Prof Hannelie Meyer and Dr Temitayo Famoroti
Slide 26: The references for this module are listed at the end of the transcript of the
presentation. Thank you for your attention.
References:

Science News. Scientists Propose New Approach to Analyze Genetic Sequences of SARS-CoV-
2 Coronavirus. Available at: [Link]
[Link]

South African National Department of Health. COVID-19 Corona Virus South African
Resource Portal. Available at [Link]

UNICEF. COVID-19 Vaccine Market Dashboard. Available at: