The Western Cape government is pressing ahead with preparations for the first phase of the Covid-19 vaccination, but still does not know where it is going to get the R1.7-billion it says the programme will cost.

"Financing it is a significant priority," said Finance MEC David Maynier, who is waiting to hear which portion the national Treasury would cover, and where the province would have to reshuffle money.

He was addressing the provincial legislature's ad-hoc committee on Covid-19 in a virtual sitting.

The province still does not know who will cover the estimated R231 in needles, syringes and other costs per vaccine, associated with the massive programme it estimates will cost about R1.7-billion.

The Western Cape Health Department is hoping that it can start its Covid-19 vaccinations by at least 15 February or sooner.

It is eagerly awaiting the final approvals from the South African Health Products Regulatory Authority which is testing samples from the consignment of the AstraZeneca vaccine which arrived on Monday.

In the meantime, the Western Cape has identified 378 sites for the public sector and 41 sites for the private sector health workers who will get their doses first.

Curators and facilities representatives are receiving training, as are 1 995 vaccinators who are being trained via podcasts and videos.

The consumables such as needles and syringes are being procured for their work stations, which will also have to have an emergency kit for a possible adverse reaction on hand.

The province has calculated that it will cost about R231 per vaccine for administrative costs which will include the consumables.

Dr Keith Cloete, head of the Department of Health in the province said that in addition to the vaccination programme, the department will have to carry on treating people during the third and fourth wave and catching up on delayed elective surgeries.

So for the health department, the hope that the vaccines bring for health workers will be tempered with managing an even heavier workload until the goal of population immunity is reached.

The province's Covid-19 cases have reduced significantly, but there were still about 2 330 acute patients in hospital with Covid-19 related conditions - with 1 398 in public hospitals and 932 in private hospitals.

The finer details of giving the vaccinations are also being ironed out, which includes printing the vaccination cards, and health workers getting their SMSes with their appointments and vaccination venue.

Cloete said the worst case scenario in getting the vaccine should be mild flu-like symptoms like a runny nose or scratchy throat.

One-million doses of the AstraZeneca Covishield vaccine arrived at Oliver Tambo International Airport on Monday, and an additional 500 000 doses are expected toward the end of February, or the beginning of March.

Twenty-million doses of the Pfizer vaccine are on order and the contract is expected to be signed soon. The arrival date is unknown.

Cloete said other doses could start arriving mid- to late February, subject to regulatory and indemnity clauses that still have to be examined.

The production date for additional doses for Johnson & Johnson to be manufactured in Port Elizabeth is not known yet.

The goal is to vaccinate about 40-million South Africans to build population immunity.

"Possibly by about April big numbers will start coming into the country. And once big numbers come in, [there] is the ability to start vaccinating at scale."

He said the Western Cape Department of Health received confirmation for 35 000 doses twice for its department of health employees - which is 70 000 doses for people employed by the department.

The private sector was allocated 58 000 doses for the first dose, and the same number for the second dose.

"So if you take that together we have currently sufficient doses for more than 90 000 healthcare workers in this province," he said.

The third category is thousands more healthcare workers, and the province has requested more vaccines for the province, including 4 000 healthcare workers employed by the City of Cape Town, about 3 000 Community Health Workers, as well as for student healthcare workers and mortuary workers.

The province want the vaccines to be brought to the Cape Medical Depot, and the vaccine will be distributed from there.

Ninety-three vaccine fridges are expected to be delivered this week, and the vaccine card is being printed.

The facilities for vaccinations have to be accredited, as do the people who will give the vaccinations.

"We anticipate arrival in the middle or towards the end of next week," said Cloete.

He predicts the second phase will be more difficult because it will involve registering at least two million people, and mass vaccination sites will be needed.