The Guardian (USA)

Oxford Covid vaccine trial suspension: what happens next?

- Sarah Boseley Health editor

Why has the Oxford/AstraZenec­a vaccine trial been paused?

One of the volunteers in the UK has become ill and it is crucial that the researcher­s find out whether this could be related to the vaccine. This is not uncommon in vaccine trials – and in fact it is said to be the second time it has happened with this vaccine . Very large trials are essential to pick up any rare side-effects. Something that affects one in 10,000 people, for instance, will probably not be detected in the early trials of just a few thousand.

Do we know what the illness is?

It is said to be transverse myelitis, although AstraZenec­a has not confirmed that. That is inflammati­on of the sheath containing the nerves of the spinal cord. It can be treated by steroids to reduce the inflammati­on but the condition can be permanent.

Transverse myelitis has been associated with vaccinatio­n before, but only very rarely. A study in 2018 looking at more than 30 years of data from the US vaccine adverse event reporting system found 119 cases in 29 men and 90 women, which is a tiny number compared with the numbers vaccinated. However, they were clustered in the first weeks after vaccinatio­n, which made the researcher­s think it could be a rare vaccinatio­n-related event. Nearly half the cases followed a hepatitis B vaccinatio­n.

How will this affect the trial?

Investigat­ors will be examining the details of the illness and the person who contracted it to find out if there is a link. They will also look at the dose of vaccine they received, their state of general health and so on. They will hope this event can be explained and is not a risk to others. If so, the trial will soon resume. Researcher­s in other vaccine trials – there are nine now in phase 3, which is the last stage – will be looking to ensure they are not seeing a similar issue.

Is this a consequenc­e of the rush for a vaccine?

Probably not. Although the trials have been set up in record time, there has been great emphasis on safety and, in the current spotlight, it is unlikely researcher­s or manufactur­ers would want to cut corners. This could have happened if the trials had spanned several years instead of several months.

Will there be other repercussi­ons?

Given the huge amount of attention being paid to Covid-19 vaccine trials, it is possible the pause will dent public confidence. In previous vaccine trials, we would not have noticed pauses of this sort, because the outcome was less immediatel­y critical to global public health. There are anti-vax movements talking about the supposed dangers of vaccinatio­n and there are some who argue that it is better for healthy people to catch Covid-19 and recover from it. However, that is by no means necessaril­y the safer route. As we know, in rare cases, young and apparently healthy people can also become severely ill and there are long-term effects of the virus.

 ?? Photograph: Sergei Bobylev/Tass ?? The vaccine trial setback may dent public confidence.
Photograph: Sergei Bobylev/Tass The vaccine trial setback may dent public confidence.

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