More than 4,000 people, including the homeless, those who have lost their identity documents and informal settlement dwellers, have received their Covid-19 vaccinations as part of a push by the University of Pretoria to immunise undocumented communities in Gauteng.

The university's community-orientated primary care (COPC) research unit is leading the drive with partners from the international community, local NGOs and religious community leaders as well as the departments of health and local government.

Under the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ)/UP project, vaccination has been open since October at clinics in Ekurhuleni, Johannesburg and Tshwane. There are also pop-up vaccination sites in informal settlements and inner-cities for homeless people.

There are plans to roll out the programme to other provinces.

Prof Debashis Basu, who heads the university's public health medicine department, said undocumented people include South Africans who have lost their documents, people from surrounding countries with expired documents or without documents, the homeless and those living in informal settlements.

“There are also many people who are employed, living in formal housing, who do not have identity documents.

Basu said UP’s approach entails working with people in geographic areas where informal settlements have been mapped in detail and where access to fixed vaccination sites is limited.

“We go to the communities where easy access can be provided, rather than asking them to come to formal facilities.

“As part of our comprehensive care, we issue people with a patient-retained booklet called ‘Road to Linked Care’. The book acts as their identity in terms of their medical and vaccination records.

“We seize the opportunity to create awareness of other high-burden diseases such as tuberculosis and HIV, and to identify social needs that might be addressed at the primary healthcare level.”

The government’s Covid-19 vaccine rollout programme is designed to register people with their unique identification information.

“Unfortunately, this excludes a large number of people without the necessary documents. And they are often at great risk and in need of vaccination and health care,” said Basu.

He said undocumented people are reluctant to access health services, including vaccination.

“There is a long culture of stigma and exclusion. They do not trust the system and are afraid that they will be reported to the police, then apprehended and deported.”

Basu said the national health department has recognised this challenge and is partnering with UP in rolling out the vaccination programme.

So far, more than 4,000 people have been vaccinated in Gauteng through the programme.

“We are initiating a structured course to address vaccine hesitancy and behaviour change through motivational interviewing, which entails guidance on lifestyle changes towards improved personal health,” said Basu.

Prof Jannie Hugo, director of the COPC research unit at UP, said if undocumented communities do not participate in the vaccine rollout, “the pandemic will continue to disrupt lives and livelihoods”.

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