JOHANNESBURG (AP) – South Africa is considering giving a COVID-19 vaccine that is still in the testing phase to health workers, after the implementation of another shot was suspended, indicating preliminary data only minimally effective may be against the mutated form of the virus that dominates. the country.
The country scrambled on Monday to come up with a new vaccination strategy after discontinuing the use of the AstraZeneca vaccine – which is cheaper and easier to deal with than some others and which many had hoped would be crucial in ending the pandemic. to combat developing countries. Among the possibilities being considered: mix the AstraZeneca vaccine with another or give Johnson & Johnson’s single-dose vaccine, which is nowhere authorized to be used, to 100,000 health professionals while monitoring its effectiveness against the variant.
The sudden change in strategy was prompted by preliminary results in a small study that showed that the AstraZeneca vaccine is only minimally effective against mild to moderate cases of the disease caused by the variant.
There is reason to hope that the Johnson & Johnson vaccine can do better in the country. Initial results of an international test of the vaccine showed that it is 57% effective in South Africa to prevent moderate to severe COVID-19. This was less than in other countries – the rate was 72% in the US, for example – presumably due to the worrying variant. It was even more effective – 85% internationally – in preventing the most severe symptoms.
‘We can not wait. We already have good local data, ” said Dr Glenda Gray, director of the South African Medical Research Council, which led the South African part of the global trial. She stressed that clinical trials show that the J&J vaccine is safe. Like AstraZeneca’s, it’s also easier to handle than the super-frozen vaccines from Pfizer and Moderna.
South Africa seems to be responding to her call. She said the country was urgently considering plans to ‘carry it out and evaluate it in the field’.
South Africa’s vaccination strategy is being monitored worldwide because the variant that was first detected here and is now dominant is spread in more than 30 countries. Officials say this form of the virus is more contagious, and there is evidence that it may 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 upsurge, cases and deaths in South Africa have recently started to decline, but it is still fighting one of Africa’s most serious outbreaks, with more than 46,000 deaths. It is worrying that another rise will come in May or June when the Southern Hemisphere enters its winter.
“Our scientists need to get together and quickly find out what approach we are going to use,” Health Minister Zweli Mhkize said on Sunday night, announcing that the use of the AstraZeneca vaccine, which is currently the only one in South Africa, has been suspended. Deliveries from others, including those made by Pfizer and BioNTech, are expected soon.
The suspension derailed South Africa’s vaccination plans just one week after the country received its first 1 million doses of vaccine. This came after the early results of a small clinical trial showed that the shot offers only minimal protection against mild to moderate cases of COVID-19 in young adults, according to an announcement from the University of the Witwatersrand, which conducted the test. .
The AstraZeneca study involved 2,000 healthy volunteers with a mean age of 31. Scientists usually see larger studies before they draw conclusions, and experts believe that the vaccine can still prevent serious diseases – and this will help a lot to slow down the pandemic and avoid hospitals. of overwhelmed with patients.
“Vaccines that are effective against the more serious forms of disease may not affect milder forms. Therefore, there is optimism that serious diseases can still be prevented by vaccines,” said Peter Openshaw, a professor of experimental medicine at Imperial College London. , said.
But the results were disappointing enough that South African officials decided to postpone the vaccination, which was supposed to put health workers at the forefront in mid-February.
The pre-study was not judged by the peer – the gold standard in scientific studies – but was still a reality test, ‘said Professor Shabir Madhi, who conducted the trial. “We were euphoric. We need to recalibrate our expectations. ”
Now the country wants to shift gears. It can eventually continue with the administration of at least one dose of AstraZeneca in the hope that it will protect against serious diseases and death of the variant. It is also considering combining the shot with one from another vaccine. Most of the vaccines tested require two doses; Johnson & Johnson is an exception.
An experimental study began in Britain last week to investigate whether doctors could safely mix the doses of the AstraZeneca vaccine and match the shot Pfizer made.
A further complication is that the doses of AstraZeneca in South Africa have an expiration date for April, which makes it difficult to administer two doses within such a short period of time.
Last week, Sarah Gilbert of Oxford University, who helped develop the AstraZeneca vaccine, said researchers were currently modifying their vaccine by inserting a genetic sequence from the new variant.
South African experts conducted clinical trials on the effects of the variant known as B.1.351. This variant quickly became more than 90% here.
The variant has lowered the protection level of virtually all of the vaccines, but most vaccines show satisfactory efficacy to protect against serious cases and death caused by the version, Madhi said. Trials of the Novavax vaccine, for example, have shown reduced but still good protection against the variant, he said.
“It’s not all ruin and gloom … we do have vaccinations that work,” Madhi said.
Still, he added, ‘This virus will probably be with us for the rest of our lives. It is unlikely that it will 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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