How SA navigates the AstraZeneca vaccine will have ‘global repercussions’
JOHANNESBURG – With the World Health Organisation (WHO) concluding that there is still a major role for the Oxford/AstraZeneca vaccine, the principal investigator in the South African (SA) trial said on Tuesday that the vaccine will probably protect against severe Covid-19, hospitalisation and death caused by the 501Y. V2 mutation of the virus first identified in South Africa.
Given that it is the cheapest and the most readily available Covid-19 vaccine available globally at present, South Africa is likely to be faced with having no vaccine or one that will probably protect against death and hospitalisation, the principal investigator in the Oxford/AstraZeneca trial, Professor Shabir Madhi, said on Tuesday.
Madhi and Professor Glenda Gray, the president of the South African Medical Research Council and the principal investigator in the Johnson & Johnson emergency vaccine trial, were the panellists at a webinar hosted by Maverick Citizen editor Mark Heywood. The webinar was sponsored by the Konrad Adenauer Stiftung. “There is still a major role for the AstraZeneca vaccine, the WHO said. There is a reason for that,” Madhi said.
“If South Africa becomes reckless in dealing with the AstraZeneca vaccine it will have global repercussions. This vaccine will be the cheapest and the most readily available. The toss-up might be between no vaccine and a vaccine that likely will protect against death and hospitalisation.”
Gray agreed, saying if it can stop deaths and stop health facilities from being overrun, the vaccine should be given to high-risk patients.
On Sunday, Madhi said the trial to test if the vaccine protected against mild and moderate disease caused by the coronavirus found that it only offered 22% protection for infections caused by the 501Y.V2 strain of the virus that was first identified in South Africa and currently is the dominant strain in the country. He said the goal of the study was to see if it would offer 60% protection, and it did not. The trial participants were relatively young, with a median age of 31.
Madhi, however, stressed that the efficacy of the vaccine in preventing severe Covid-19, hospitalisation and death caused by the 501Y.V2 strain had not been evaluated.
He said South Africa was heading towards the first anniversary of the first confirmed case of coronavirus infection in the country.
“I was sceptical that we would have a vaccine in a year. It usually takes 10 years. But we have seven vaccines that have been approved. Most are highly efficacious against the original virus. Even the lowest had more than 50% efficacy. Many of the others are up t0 95% efficacious. This first generation of vaccines were a phenomenal success. They are highly efficacious in preventing disease.
“Until recently we were in the honeymoon period. Nothing was going wrong. All of the ducks were lining up in a row.”
He said all the vaccines that are currently available globally have been declared safe and work against the original virus. He said all of them also trigger an immune response that prevents severe disease and possible hospitalisation and death.
Madhi said at this stage, there are 35 other vaccines in late-stage human trials.
Explaining why it was possible for the world to produce vaccines against the coronavirus so quickly, he said much of the scientific community had diverted their attention to develop Covid-19 vaccines and understanding the virus.
“The vaccines we see today are piggybacking on other vaccines technology and technology to treat cancer.”
He added that clinical trials usually take place in series with pauses between the different phases, but because of the funding that was made available and the effort dedicated to it, companies were able to run parallel streams of studies.
“This doesn’t mean that there were shortcuts,” Madhi said.
Gray also emphasised that a huge injection of public money had accelerated vaccine development.
She said where the world finds itself at the moment, as mutations of the virus emerge, was an important phase.
She said that in evaluating the role of a vaccine, it is important to remember that it has a personal health benefit as well as economic and public health benefits.
She said the vaccines currently available do protect against severe Covid-19, hospitalisation and death. They have an economic benefit as they would allow teachers to return to the classroom, workers to return to the workplace and will keep the economy going and protect the health system.
“We still have a lot to celebrate. We have vaccines that stop death and hospitalisation. Isn’t that what we are looking for?”
Madhi said the immediate priority of a vaccine should be to prevent hospitalisation and dying, but then also to prevent multiple waves of a pandemic and to make people less infectious.