Opinion: An interdict on teen vaccination will harm basic education and violate the rights of learners
Taking antiretrovirals to prevent HIV infection is available in the form of pills, vaginal rings, and injections. (File photo: Nasief Manie/Spotlight) More than 1.6 million teenagers between the ages of 12 and 17 in South Africa have been vaccinated against COVID-19 since vaccine rollout opened up to teenagers in late 2021. Continued vaccine rollout has contributed to the growing sense of “returning to normal” with the National State of Disaster being lifted on 4 April 2022 and schools reopening fully on 7 February 2022.
Despite the well documented benefits to and safety of vaccines for adolescents, the African Christian Democratic Party (ACDP) and its partners Free the Children, Save the Nation NPC, Caring Healthcare Workers Coalition and COVID Care Alliance seek to stop the rollout of COVID-19 vaccines for adolescents urgently. But in a context where the majority of learners attend schools with infrastructure problems and serious overcrowding, vaccines remain a critical tool to keep learners safe and prevent outbreaks of infection at schools.
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The case and its shortcomings
The High Court of South Africa (Gauteng Division, Pretoria) will today and tomorrow (28 and 29 April 2022) hear a case brought by the ACDP and its partners against the National Department of Health and the South African Health Products Regulatory Authority (SAHPRA), who are both opposing the application.
One of the major oversights of the ACDP’s case is that they have failed to recognise the impact of COVID-19 on schooling, and how vaccines act as a crucial tool to protect learners from the worst impacts of a virus that has already wreaked havoc on their lives and educational outcomes for more than two years.
Arguing that the vaccine against COVID-19 threatens children’s best interests and the right to bodily integrity, the ACDP and their partners are trying to interdict health authorities from vaccinating adolescents. COVID-19 vaccines, these applicants argue, carry more risks than benefits to adolescents, who – they claim – are not affected by the virus in serious ways.
Citing refuted evidence about the risks of myocarditis and neurological side effects allegedly associated with vaccines from discredited doctors in the United States and the United Kingdom, the ACDP claims that teenagers’ lives and rights are under threat from continuing the rollout of vaccines.
A human rights-based approach
When interrogated in light of the latest scientific evidence and a children’s rights-based approach, these arguments do not hold up.
SECTION27 has intervened as amicus curiae (friend of the court) in the case to introduce evidence on the detrimental impacts of school closures on learners’ wellbeing, with evidence from Professor Tom Moultrie, a Professor of Demography and Director of the Centre for Actuarial Research at the University of Cape Town; Dr Sara Black, an academic at the Centre for Education Rights and Transformation at the University of Johannesburg and Dr Shaheda Omar the Clinical Director of the Teddy Bear Clinic for Abused Children.
SECTION27’s submissions raise a basic education focused, rights-based approach arguing that an interdict to the vaccine roll-out would infringe a learner’s right to equality, basic education, health and basic nutrition.
Claiming that children are not affected by COVID-19, as the ACDP and its partners do in their papers, is not borne out by the facts. While the majority of serious cases, hospitalisations and deaths from COVID-19 have been experienced by older age groups and people with unmanaged comorbidities, the virus has affected children clinically.
The latest National Institute for Communicable Diseases (NICD) COVID-19 Hospital Surveillance Update Report (DATCOV) shows that since March 2020, more than 15 500 children between the ages of 10 and 19 have been admitted to hospitals around the country with COVID-19, and over the same period, 412 children of the same age group tragically died in hospital from COVID-19.
The risks associated with vaccination, the national health authorities have shown in their papers, are much smaller and more manageable in comparison to adolescents getting sick from the virus itself.
Vaccinating for continued schooling
Over and above the very real clinical risks COVID-19 poses to children, the virus has also disrupted children’s ability to attend school and socialise, and has resulted in widespread detrimental educational and mental health outcomes for young people. Learning has been heavily disrupted, with learners’ well behind previous cohorts’ levels of literacy and numeracy, despite efforts to trim and catch up the curriculum.
Schools are important social safety nets for children, with 9 million learners receiving daily meals at school through the National School Nutrition Programme (NSNP), as well as other important social support. In addition, schools are crucial to the psychological and developmental wellbeing of learners.
As such, when schools closed or adopted rotational timetables to try curb the COVID-19 spread in schools, learners were hard hit. And the learners hardest hit were those from socio-economically disadvantaged areas, many schools in these areas experience overcrowding and infrastructure challenges which make it more difficult to prevent an outbreak.
As we go into the winter months, scientists predict that there is a high probability of another wave of COVID-19 infections (testing numbers over the last week suggest that such a wave may already be starting). In the event that another substantial wave does develop and the country is forced into future lockdowns or school closures, the access to nutrition via the NSNP would likely be disrupted and children could go hungry.
SECTION27 introduced evidence from Professor Shabir Madhi, Dean of the Faculty of Health Sciences at the University of the Witwatersrand, who supports the rollout of vaccines on the basis that it could prevent future disruptions to schooling. In his affidavit Madhi states:
“Despite the widespread force of past infection, the vaccination of children aged between 12 and 18 would still be beneficial in reducing the risk of children being infected, and passing on the virus, both to each other, and to adults…This is particularly important in the school environment, where every attempt should be made to avoid large clusters of cases that could precipitate further disruptions of schooling. A key way to mitigate that risk would be by ensuring that the majority of children are indeed vaccinated against Covid. In my opinion, this would strongly advance the best interests of children.”
Learners who are poor and attending under-resourced and overcrowded public schools stand to lose the most in a scenario where vaccination is interdicted. The already highly unequal basic education system in South Africa could become even more uneven.
Vaccine hesitancy
The ACDP’s campaign to derail vaccinations for adolescents occurs in a context of persistent vaccine hesitancy. Widely representative surveys imply that many people would like to get vaccinated but haven’t done so yet. Barriers to accessing vaccines, such as transport costs and vaccine site opening hours which do not accommodate people who work or attend school, remain major obstacles to people getting the vaccines they have a right to.
Many teenagers, specifically learners, would like to get vaccinated but face very difficult challenges accessing vaccine sites. An interdict like the one sought by the ACDP would make it even more difficult for teenagers who want to get the vaccine but face obstacles to their getting one.
Recent surveys of unvaccinated people indicate that mistrust of government’s messaging about COVID-19 vaccines is an important factor driving vaccine hesitancy. In this context, the ACDP’s case – and their concurrent campaign on social media – does more than just propose an interdict on vaccine rollout for teenagers; it contributes to increased mistrust of government messaging about vaccines and may cloud public perception around vaccination.
In this context, where mistrust is high, and myths and misinformation about vaccines abound, it’s important to reiterate the facts: vaccines are safe and effective at preventing severe cases and hospitalisations from COVID-19, for both adults and teenagers.
Overcrowding in many classrooms is another fact which cannot be understated and, in the context of widespread infrastructure challenges at schools, vaccines are a crucial tool that can be used – alongside other non-pharmaceutical interventions like ventilation and mask wearing – to protect learners in South Africa’s most disadvantaged schools.
From a children’s rights perspective, continuing vaccination against COVID-19 is a constitutional imperative.
*Chaskalson is a research and advocacy officer at SECTION27. Sujee is an attorney in the education rights programme at SECTION27.