Vaccine rollout delayed but not derailed

The COVID-19 vaccine rollout is on track to start as soon as next week say community medical experts in spite of the curve ball wrought by the immediate suspension of the newly acquired and much anticipated Oxford/AstraZeneca vaccine.

South Africa’s COVID-19 vaccination rollout will now take place with vaccine doses from Johnson & Johnson.

There was a sense of despondency in the community this week when the government stopped the Oxford/AstraZeneca vaccine rollout, seemingly bringing hope to a grinding halt. This after researchers found it offered minimal protection against mild to moderate COVID-19 disease caused by the country’s dominant coronavirus variant.

On 7 February, Health Minister Dr Zweli Mkhize publicly announced (shortly after addressing the Jewish community in a webinar with Chief Rabbi Dr Warren Goldstein) that South Africa would temporarily halt its Oxford/AstraZeneca vaccine rollout plan. It would instead conduct an implementation study that would assess how different vaccines (Pfizer, Johnson & Johnson, and possibly Oxford/AstraZeneca) compare in protecting against severe COVID-19 disease.

Community experts say there is a lot to be hopeful about as scientists, in spite of the latest setback, devise a plan to vaccinate the population in the shortest time possible.

“The main aim is to prevent severe illness and hospitalisation,” said Professor Barry Schoub, the chairperson of the Ministerial Advisory Committee on COVID-19 vaccines and emeritus professor in virology at the University of the Witwatersrand (Wits).

“The trial data doesn’t yet tell researchers how well the Oxford/AstraZeneca vaccine protects against severe disease, hospitalisation, and death. So, guided by scientific evidence, the Oxford/AstraZeneca rollout is being suspended not cancelled until we have more scientific data. In the meantime, we are getting other vaccines – in the next couple of weeks – to start the rollout,” he said.

The Oxford/AstraZeneca vaccine “may still well prevent severe infection. We still have to find this out,” Schoub said.

“The good news is that we have scientific depth and expertise in this country that picked up this particular variant to begin with. Then we were able to conduct clinical trials to demonstrate that this particular vaccine didn’t work so well. Imagine if we had ordered vaccines for the entire adult population.”

He assured the SA Jewish Report that “the vaccine rollout is on track”.

“It will be starting very soon,” Schoub said. Several studies are in progress to investigate the use of the Oxford/AstraZeneca vaccine in combination with the Johnson & Johnson jab.

The clinical-trial data that came to light at the weekend showed that the Oxford/AstraZeneca vaccine wasn’t as effective in fighting the 501Y.V2 variant. Dr Mkhize said on Wednesday, 10 February, that the government’s process of procuring vaccines preceded the discovery of the new strain of the virus.

While the halting of the rollout may have thrown scientists an unwanted COVID-19 curve ball, experts this week said it was now a matter of re-assessing the national vaccine strategy and reconfiguring ways to best to deal with a virus intent on wreaking havoc.

As the Wits Professor Shabir Madhi, the trial’s principal investigator, put it to Daily Maverick “The findings suggest that as a global community, we need to recalibrate our thinking around the pandemic and expectations of COVID-19 vaccines.”

Meanwhile, experts have stressed that there are no safety issues with the Oxford/AstraZeneca vaccine, the questions are all linked to its efficacy against the 501Y.V2 variant.

“It’s important to reassure people that the SARS-CoV-2 vaccines are safe,” said Professor Lucille Blumberg, the deputy director at the National Institute for Communicable Diseases.

“We need to prioritise health workers and those in the general population who are at risk for severe illness from the variant.”

She said the Johnson & Johnson vaccine “has been shown to be beneficial”.

“The focus in the first phase of the vaccine rollout needs to be on reducing severe illness and death from COVID-19. The target group needs to be the at-risk group: those over 60 years of age, and those with co-morbidities. Studies to date support the use of the Johnson & Johnson vaccine for this purpose even in infections caused by the variant of the virus circulating in South Africa. There needs to be further evaluation in this regard for the Oxford/AstraZeneca vaccine.”

The government has allowed for an implementation study of the Johnson & Johnson vaccine.

Professor Glenda Gray, the principal investigator for the Johnson & Johnson trial and the president of the South African Medical Research Council, said this vaccine, administered as a single shot, doesn’t protect against “the sniffles” but has a “high efficacy against severe disease and death”, also in regard to the new variant.

Apart from the 1.5 million doses of the Oxford/AstraZeneca vaccine already in South Africa, Dr Mkhize said the government had secured nine million doses from Johnson & Johnson. It has secured 12 million vaccine doses from the COVAX initiative, and 20 million from Pfizer.

There are 35 other vaccines in late-stage human trials.

“The way forward,” said Professor Schoub, “is to make good, scientific-based evidence decisions”.

It’s also crucial to continue to implement health protocols including washing hands, wearing masks, and social distancing.