The South African government presented its strategy for rolling out vaccinations against Covid–19 in 2021 as a comprehensive plan designed by technocratic experts working with the country’s leading scientists. This imagery built on the government’s prior claims that its responses to Covid over the previous year ‘followed the science’. In 2021, as in 2020, this framing functioned ideologically to justify projects of expanded government control over the economy and the health sector. This article shows how the objective of the vaccination roll-out ‘plan’ was not simply to vaccinate people, but to build key foundations of the proposed ‘national health insurance’ system, including patient registration and procedures for channelling patients (and corresponding financial flows) between public and private health care providers. But the imagery of planned efficiency projected through PowerPoint presentations masked the reality that there was no detailed plan and most of the proposed roll-out scheme was unworkable. We contend, following James Scott, that this was an example of high modernist hubris and aesthetics that confused visual imagery with operational order. Almost every aspect of the supposed vaccination ‘plan’ was subverted, as scientists excluded from government advisory structures disputed aspects of vaccine procurement and use, people ‘walked in’ to vaccination sites where health care workers implemented informal systems to manage them, provincial governments failed to conform with national instructions, and special interest groups lobbied for privileges. The result was that a somewhat disorderly but more effective vaccination roll-out replaced the dysfunctional, overly ordered system set out by government planners.

南非政府提出了其在 2021 年推出针对 Covid-19 疫苗接种的战略，这是一项由技术官僚专家与该国领先科学家合作设计的综合计划。该图像建立在政府先前声称其在过去一年中对 Covid 的反应“遵循科学”的基础上。2021 年和 2020 年一样，这一框架在意识形态上发挥作用，证明政府扩大对经济和卫生部门控制的项目是合理的。这篇文章展示了疫苗接种“计划”的目标如何不仅仅是为人们接种疫苗，而是为拟议的“国民健康保险”系统建立关键基础，包括患者登记和引导患者的程序（以及相应的资金流动) 公立和私立医疗保健提供者之间。但是，通过 PowerPoint 演示文稿预测的计划效率的形象掩盖了一个现实，即没有详细的计划，而且大多数提议的推出计划都不可行。跟随 James Scott 的脚步，我们认为这是高度现代主义狂妄自大和美学的一个例子，混淆了视觉意象和操作顺序。几乎假定的疫苗接种“计划”的每个方面都被推翻，因为科学家将疫苗采购和使用方面的争议方面排除在政府咨询结构之外，人们“走进”疫苗接种点，在那里医护人员实施非正式系统来管理他们，省级政府失败了以符合国家指示，并游说特殊利益集团争取特权。