JOHANNESBURG (AP) – South Africa is considering giving a COVID-19 vaccine still in testing to health professionals, after suspending the rollout of another shot whose preliminary data may be only minimally effective against the mutated form of the virus that dominates the country.
The country was struggling on Monday to come up with a new vaccination strategy after it discontinued use of the AstraZeneca vaccine – which is cheaper and easier to handle than some others and which many had hoped would be crucial in ending the pandemic. developing countries. One of the options being considered: mixing the AstraZeneca vaccine with another vaccine or giving a single Johnson & Johnson vaccine, not yet approved for use, to 100,000 health professionals while ensuring its effectiveness against the variant is being checked.
The abrupt change in strategy was prompted by preliminary results in a small study that showed that the AstraZeneca vaccine was only minimally effective against mild to moderate cases of the disease caused by the variant.
There is reason to hope the Johnson & Johnson vaccine will fare better in the country. The first results of an international test of the vaccine showed that in South Africa it is 57% effective in preventing moderate to severe COVID-19. That was less than in other countries – 72% in the US, for example – probably because of the worrying variant. It was even more effective – 85% internationally – to prevent the most severe symptoms.
‘We can not wait. We already have good local data, ”says Dr. Glenda Gray, director of the South Africa Medical Research Council, which led the South African portion of the global trial. She emphasized that clinical studies show that the J&J vaccine is safe. Like AstraZeneca’s, it is also easier to handle than Pfizer’s and Moderna’s frozen vaccines.
South Africa appears to be responding to its call. She said the country has urgent plans to roll it out and evaluate it in the field.
South Africa’s vaccination strategy is being watched worldwide as the variant that was first discovered and is now dominant is spreading in more than 30 countries. Officials say this form of the virus is more contagious, and there is some evidence that it may be more virulent; recent studies have also shown that it can infect people who survived the original form of the virus.
After a second wave, cases and deaths in South Africa have recently started to fall, but it is still battling one of Africa’s worst outbreaks, killing more than 46,000. There is concern that there will be another peak in May or June, when the land in the Southern Hemisphere enters winter.
“Our scientists need to get together and quickly figure out which approach we are going to use,” said Health Minister Zweli Mhkize Sunday evening, announcing the suspension of the use of the AstraZeneca vaccine, which is currently the only one available in South Africa. . Deliveries from others, including those from Pfizer and BioNTech, are expected shortly.
The suspension messed up South Africa’s vaccination plans just a week after the country received its first 1 million doses of the vaccine. It came after the initial results of a small clinical trial showed that the injection offered only minimal protection against mild to moderate cases of COVID-19 in young adults, according to an announcement from the University of Witwatersrand, which conducted the test.
The AstraZeneca study involved 2,000 healthy volunteers with a mean age of 31 years. Scientists generally like to see bigger studies before making any conclusions, and experts say the vaccine could still prevent serious illness – and that could slow the pandemic significantly and avoid hospitals. do not get overwhelmed by patients.
“Vaccines that are effective against the more severe forms of disease may not affect milder forms, so there is optimism that serious illnesses are still prevented by vaccines,” said Peter Openshaw, a professor of experimental medicine at Imperial College London. .
But the results were disappointing enough that South African officials decided to delay the introduction of the vaccine, which would be given to primary care health workers from mid-February.
The preliminary study was not peer-reviewed – the gold standard in scientific studies – but was still “a reality check,” said Professor Shabir Madhi, who led the trial. ‘We were euphoric. We need to realign our expectations. “
Now the country wants to switch. It may eventually proceed to administer at least one dose of AstraZeneca in the hope that it will protect against serious illness and death from the variant. It is also considering combining the injection with an injection from another vaccine. Most vaccines being tested require two doses; Johnson & Johnson is an exception.
An experimental study began last week in Great Britain to test whether doctors could safely mix and match doses of the AstraZeneca vaccine with the injection of Pfizer.
An additional complication is that AstraZeneca doses in South Africa have an expiration date in April, making it difficult to administer two doses in such a short period of time.
Last week, Sarah Gilbert of the University of Oxford, who helped develop the AstraZeneca vaccine, said researchers are currently modifying their vaccine by inserting a genetic sequence from the new variant.
South African experts have conducted clinical studies on the effects of the variant, known as B.1.351. That variant quickly became more than 90% dominant here.
The variant has lowered the level of protection afforded by virtually all vaccines, but most vaccines have satisfactory efficacy in protecting against severe cases and death caused by the version, Madhi said. For example, trials with the Novavax vaccine showed reduced but still good protection against the variant, he said.
“It’s not all doom and gloom… we have vaccines that work,” Madhi said.
Still, he added, ‘This virus will likely be with us all our lives. It is unlikely to be eradicated anytime soon. “
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Associated Press Medical Writers Maria Cheng in London and Lauran Neergaard in Alexandria, Virginia.
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