South Africa is scaling back its Covid-19 vaccination drive and may have to destroy doses because of a lack of demand from citizens even as the country heads into a fifth wave of infections.

Take up has slowed to the point where keeping some sites running is unaffordable, said Nicholas Crisp, deputy director-general at the department of health and the person in charge of the program. Covid-19 vaccinations will need to be incorporated into South Africa’s standard medical programs, which means these specific shots will be less accessible, he said.

“No one is arriving” to get shots, Crisp said in an interview on Monday. “The numbers are just terrible.”

Only about half of South Africa’s 40-million adults are fully protected, about a year after doses were first made available to the public. While government was heavily criticized before that for being slow to secure vaccines, hesitancy is now its biggest problem. The 18 to 39 age group is the most reluctant, Crisp said.

The country failed to meet its original target of inoculating about two-thirds of adults by the end of 2021, as well as its plan to consistently administer about 300 000 vaccines a day. In the 24 hours to Monday evening, South Africa processed 49 285 shots.

The slow pace means the country may be forced to destroy a lot of vaccines because they are going to expire. Crisp said the government has unsuccessfully tried to donate the excess supply.

South Africa has made people over 12 eligible for Covid-19 vaccinations and the government uses Johnson & Johnson shots and those made by Pfizer Inc. and BioNTech SE in its programmes.