South Africa suspends Oxford/AstraZeneca vaccine roll-out

South Africa has temporarily suspended the use of the Oxford/AstraZeneca vaccine just a week after receiving its first major shipment after new research concluded that the vaccine offers “minimal protection” against mild-to-moderate illness caused by the dominant B.1.351 South African variant found in the country.

The suspension, following currently un-peer reviewed research from a relatively small trial of 2,016 patients conducted by the University of the Witwatersrand and Oxford University, is a blow to the continent’s hopes of quickly rolling out the vaccine to overcome the pandemic.  

AstraZeneca has promised to offer its vaccines at affordable prices for developing world countries, and unlike other vaccines, which require ultra-cold storage unavailable in large parts of the continent, the doses can be stored at normal fridge temperatures.

Last week, the WHO reported that the South African variant is believed to have spread to nine other Africa countries.

One million doses of the Oxford/AstraZeneca vaccine, produced in India, arrived in South Africa on February 1st, and another half a million were expected later this month.

Covax, the global initiative to source Covid-19 vaccines for developing nations, aims to start shipping nearly 90 million doses to Africa this month, millions of which are expected to be Oxford/AstraZeneca doses, which require an emergency listing from the WHO.

AstraZeneca says it believes its vaccine can protect against severe disease, while UK vaccines minister Nadhim Zahawi said that the vaccine prevented against “severe disease” from the strain first identified in South Africa.

Shabir Madhi, professor of vaccinology and leader of the trials at the University of the Witwatersrand, told Sky News it was likely the vaccine would still be used there given similarities to the J&J vaccine, which can reduce severe disease.  

“The J&J vaccine in South Africa against the variant has been shown to reduce moderate to severe disease by 57%, and severe disease by as much as 89%. So I think there might still well be a role for the AZ vaccine, at least in terms of protecting against severe disease.”

Malawian President Lazarus Chakwera said on Sunday in an address to the nation that the country plans to go ahead with plans to import the vaccine. The country expects to receive its first consignment of 1.5 million doses at the end of February for roll-out in March, arguing that the efficacy rate was still high enough to save lives.  

South African health minister Zweli Mkhize said his government would now await further advice on how best to proceed with the AstraZeneca vaccine in light of the findings, and said the government would offer vaccines produced by US companies Johnson & Johnson and Pfizer in the coming weeks.

Johnson & Johnson vaccines are manufactured at a new facility in Port Elizabeth owned by local pharma company Aspen, but the amount destined for the home market had previously been unclear. A senior health official told SABC that the first J&J doses could now arrive around the end of the week, compared to previous estimates for a second quarter delivery.

“At best, South Africa’s already delayed vaccine distribution plan will be set back by several weeks,” writes Virag Forizs, Africa economist at Capital Economics.

“The government appears to be pushing to purchase 20 million additional vaccine doses from Johnson & Johnson, on top of 9 million already secured, with an accelerated roll-out. Vaccinations using AstraZeneca doses will probably be postponed until efficacy against severe cases is shown (which was not studied in the latest trial). There are some positive signs from other vaccines using similar technology.”