JOHANNESBURG (AP) – South Africa is considering giving a COVID-19 vaccine that is still in the testing phase for healthcare professionals, after suspending the launch of another injection that preliminary data indicates may be minimally effective against the mutant form of the country’s dominant virus.
The country was struggling on Monday to come up with a new vaccination strategy after suspending the use of the AstraZeneca vaccine – which is cheaper and easier to handle than others and which many hoped would be crucial to fighting the pandemic in developing countries. development. Among the possibilities that are being considered: mixing the AstraZeneca vaccine with another or giving the Johnson & Johnson single dose vaccine, which has not yet been authorized for use anywhere, to 100,000 health professionals, monitoring its effectiveness against the variant.
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 are reasons to expect the Johnson & Johnson vaccine to perform better in the country. The initial results of an international test of the vaccine showed that it is 57% effective in South Africa in preventing moderate to severe COVID-19. This was less than in other countries – the rate was 72% in the United States, for example – probably due to the worrying variant. It was even more effective – 85% internationally – in preventing the most serious symptoms.
“We cannot wait. We already have good local data, ”said Dr. Glenda Gray, director of the South African Medical Research Council, who led the South African part of the global trial. She stressed that clinical trials show that the J&J vaccine is safe. Like AstraZeneca, it is also easier to handle than Pfizer and Moderna’s super-frozen vaccines.
South Africa appears to be responding to his call. She said the country is making urgent plans to “implement and evaluate it in the field”.
South Africa’s vaccination strategy is being observed globally because the variant first detected and now dominant here is spreading in more than 30 countries. Officials say this form of the virus is more contagious and evidence is emerging that it can be more virulent; Recent studies have also shown that it can infect people who have survived the original form of the virus.
After a second outbreak, cases and deaths in South Africa have started to decline recently, but it is still battling one of Africa’s most serious outbreaks, with more than 46,000 deaths. He fears that another peak will occur in May or June, when the southern hemisphere country enters winter.
“Our scientists must get together and quickly find out what approach we are going to use,” said Health Minister Zweli Mhkize on Sunday night, announcing the suspension of the use of the AstraZeneca vaccine, which is currently the only one available in South Africa. third parties, including the one made by Pfizer and BioNTech, are expected soon.
The suspension disrupted South Africa’s vaccination plans just a week after the country received its first million doses of the vaccine. It came after the first results of a small clinical trial showed that the injection offered minimal protection against mild to moderate cases of COVID-19 in young adults, according to an announcement by the University of Witwatersrand, which conducted the test.
The AstraZeneca study involved 2,000 healthy volunteers with an average age of 31 years. Scientists often like to see larger studies before drawing conclusions, and experts say the vaccine can still prevent serious illnesses – and that would go a long way in slowing down the pandemic and preventing hospitals from being overwhelmed with patients.
“Vaccines that are effective against the most severe forms of the disease may not affect the milder forms, so there is optimism that the serious disease will still be prevented by vaccines,” said Peter Openshaw, professor of experimental medicine at Imperial College London.
But the results were disappointing enough that South African officials decided to postpone the launch of the vaccine, which should be given to frontline health professionals from mid-February.
The preliminary study was not peer-reviewed – the gold standard in scientific studies – but it was still “a reality check,” said Professor Shabir Madhi, who conducted the test. “We were euphoric. We must recalibrate our expectations. “
Now, the country is trying to change gears. He may end up continuing to administer at least one dose of AstraZeneca in the hope of protecting against serious illness and death from the variant. He is also considering combining the injection with another vaccine. Most vaccines tested require two doses; Johnson & Johnson is an exception.
An experimental study began last week in Britain testing whether doctors could mix and match doses of the AstraZeneca vaccine with the injection made by Pfizer.
An additional complication is that doses of AstraZeneca in South Africa expire in April, making it difficult to administer two doses in such a short period.
Last week, Sarah Gilbert of the University of Oxford, who helped develop the AstraZeneca vaccine, said the researchers are currently working to adjust their vaccine by inserting a genetic sequence for the new variant.
South African experts have conducted clinical trials on the effects of the variant, known as B.1.351. This variant quickly became more than 90% dominant here.
The variant reduced the level of protection offered by virtually all vaccines, but most vaccines have satisfactory effectiveness in protecting against severe cases and death caused by the version, Madhi said. Tests with the Novavax vaccine, for example, showed decreased, but still good, protection against the variant, he said.
“Not everything is disgrace and sadness … we have vaccines that work,” said Madhi.
Still, he added: “It is likely that this virus will stay with us for the course of our lives. It is unlikely to be eradicated soon. “
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Associated Press medical writers Maria Cheng in London and Lauran Neergaard in Alexandria, Virginia
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