South Africa 'could SELL its Oxford Covid vaccines'
South Africa could SELL its Oxford Covid vaccines, health minister says after abandoning the jab following controversial study that claimed it wouldn’t stop people falling ill with country’s variant
- South Africa is turning its back on the vaccine it helped to trial and not using it
- A million doses already delivered to the country; another 500,000 ordered
- Health minister said scientists are still deciding what to do with their stockpile
- They will instead start rollout with the Janssen (Johnson & Johnson) jab
The South African government could sell off its stockpiles of the Oxford/AstraZeneca Covid vaccine, the country’s health minister has admitted.
Zweli Mkhize said flogging the million doses that have already been delivered to the country from a factory in India was ‘an option’.
South Africa is abandoning the UK-made vaccine after a controversial study claimed it wouldn’t be able to stop mild or moderate Covid cases caused by the country’s new variant of the disease, which has evolved to get past older forms of immunity.
Officials said they would pivot the country’s efforts to using the Janssen vaccine – made by pharmaceutical giant Johnson and Johnson – which was more successful.
J&J’s jab was trialled in South Africa during the rise of the variant and the scientists found it was still 57 per cent effective at stopping moderate bouts of Covid.
By comparison, a trial of AstraZeneca’s vaccine on people with an average age of 31 reportedly found it may only prevent 10 per cent of infections caused by the new variant.
The study was controversial, however, because it hasn’t been published, was done on fewer than 2,000 people and did not measure how well the jab prevented severe illness or death, nor how well it worked in older people.
Fears about the South African variant are circulating in Britain, where 170 cases of it have been found and other versions of the virus have developed similar potentially vaccine-resistant mutations.
But Professor Jonathan Van-Tam, England’s deputy chief medical officer, has tried to put the concerns to bed by saying he does not expect it to spread widely.
South Africa was one of the key locations for clinical trials of the Oxford and AstraZeneca coronavirus vaccine but the country is now turning its back on the jab after a study – controversial because it was small and only involved healthy young people – suggested it might not protect against the new variant (Pictured: A woman receives the Oxford jab as part of a trial in Johannesburg in November)
Zweli Mkhize said flogging the million doses that have already been delivered to the country from a factory in India was ‘an option’
Mr Mkhize said in a news conference today that his country was considering selling the vaccine supplies, Reuters reported.
He said: ‘Why not sell the AstraZeneca to other countries? Well it’s an option… we will consider it.
‘First our scientists will tell us what we do with it, can we use it within the time that’s available… before it expires.’
He added: ‘If not, can we swap it with anyone else, because we’ve discussed it with COVAX and with AVATT [the African Union’s vaccine task team], so we will see what we will do.’
The doses that had been delivered to the country will expire by the end of April, but officials there have suspended the use of them in the wake of the study.
Although they insisted the refusal to use the jabs was ‘temporary’, ministers only have until April to either use or give away the doses before they must be binned.
Allowing a million doses to sit in stockpile until they expire would likely anger world leaders at a time when vaccine supplies are scarce and the virus is still rampant.
Real name: B.1.351
When and where was it discovered?
Scientists first noticed in December 2020 that the variant, named B.1.351, was genetically different in a way that could change how it acts.
It was picked up through random genetic sampling of swabs submitted by people testing positive for the virus, and was first found in Nelson Mandela Bay, around Port Elizabeth.
What mutations did scientists find?
There are two key mutations on the South African variant that appear to give it an advantage over older versions of the virus – these are called N501Y and E484K.
Both are on the spike protein of the virus, which is a part of its outer shell that it uses to stick to cells inside the body, and which the immune system uses as a target.
They appear to make the virus spread faster and may give it the ability to slip past immune cells that have been made in response to a previous infection or a vaccine.
What does N501Y do?
N501Y changes the spike in a way which makes it better at binding to cells inside the body.
This means the viruses have a higher success rate when trying to enter cells when they get inside the body, meaning that it is more infectious and faster to spread.
This corresponds to a rise in the R rate of the virus, meaning each infected person passes it on to more others.
N501Y is also found in the Kent variant found in England, and the two Brazilian variants of concern – P.1. and P.2.
What does E484K do?
The E484K mutation found on the South African variant is more concerning because it tampers with the way immune cells latch onto the virus and destroy it.
Antibodies – substances made by the immune system – appear to be less able to recognise and attack viruses with the E484K mutation if they were made in response to a version of the virus that didn’t have the mutation.
Antibodies are extremely specific and can be outwitted by a virus that changes radically, even if it is essentially the same virus.
South African academics found that 48 per cent of blood samples from people who had been infected in the past did not show an immune response to the new variant. One researcher said it was ‘clear that we have a problem’.
Vaccine makers, however, have tried to reassure the public that their vaccines will still work well and will only be made slightly less effective by the variant.
How many people in the UK have been infected with the variant?
At least 170 Brits have been infected with this variant, according to Public Health England’s random sampling.
The number is likely to be far higher, however, because PHE has only picked up these cases by randomly scanning the genetics of around 15% of all positive Covid tests in the UK.
Where else has it been found?
According to the PANGO Lineages website, the variant has been officially recorded in 31 other countries worldwide.
The UK has had the second highest number of cases after South Africa itself.
Will vaccines still work against the variant?
So far, Pfizer and Moderna’s jabs appear only slightly less effective against the South African variant.
Studies into how well Oxford University/AstraZeneca‘s jab will work against the South African strain are still ongoing.
Johnson & Johnson actually trialled its jab in South Africa while the variant was circulating and confirmed that it blocked 57 per cent of coronavirus infections in South Africa, which meets the World Health Organization’s 50 per cent efficacy threshold.
Oxford and AstraZeneca’s vaccine is vital to poorer and developing countries because it is significantly cheaper than others, at around £2 per dose compared to more than £20 for Pfizer’s, and it can be kept in basic fridges rather than high-tech freezers.
South Africa had bought 1.5million from the Serum Institute of India and intended to give them to front-line health workers.
But ministers have been spooked by the study showing it might not work against the country’s dominant variant of the virus.
The South African variant has developed a mutation that allows it to slip past the immune systems of some people who have developed protection based on an older version of the virus, either by catching it or by getting vaccinated.
The research, first reported by the Financial Times at the weekend and not yet published by the scientists who did it, looked at whether the vaccine could prevent mild and moderate Covid-19 in young, healthy people.
It found that the vaccine didn’t really work in this way, with efficacy dropping to around 10-20 per cent.
However, the jab was not designed for this and is instead intended to prevent severe illness and death, particularly in at-risk older groups.
This couldn’t be measured in that study, which included fewer than 2,000 people, because their natural risk of death was so low they were extremely unlikely to die of Covid even without a vaccine.
The study heightened concerns in Britain about the South Africa variant and others that appear to be developing similar mutations.
But Professor Jonathan Van-Tam this again tried to calm the concerns, explaining that the variant was not likely to become dominant because it doesn’t seem to spread faster than the Kent variant already causing most cases.
Using an analogy in his now-beloved style, he said: ‘If you are running a bath and you have got the hot water tap on and you add in a very small amount of cold water, so the cold tap is running as well but at really a very low volume, your bath water is basically going to remain hot.
‘It’s only if that cold tap was gushing much more than the hot tap, the cold water would take over.
‘That’s probably the best analogy I can give you at the moment.
‘There are no signs that South African variant is running at that speed at the moment and therefore I don’t frame it as something that is going to be a dominant issue in the next few months.’
Professor Andrew Pollard, an Oxford University expert running the trials of the British vaccine, leapt to its defence yesterday.
He told MPs in the All-Party Parliamentary Group on coronavirus: ‘All of the vaccines in the trials are in those regions that we’re talking about, where new variants are emerging, and we are not seeing a sudden shift so that lots of people who were vaccinated are ending up in hospital.
‘They’re still being protected from hospitalisation.
‘We need more data to be absolutely secure on this and we will be gathering that in all these different countries.
‘But if that’s the case: we might need boosters, we might need tweaks every year but, actually, we might not. We might be generating enough immunity from the current generation of vaccines to stop severe disease…’
He added: ‘The most likely thing is that new versions of this virus will continue to be made to allow it to better transmit in the population. The question is does that matter?
‘Are vaccines still going to be good enough to stop people going into hospital or dying? Because actually, if people have just got the sniffles I think our job is done.’
Instead, South Africa will give the as-yet unapproved Johnson & Johnson vaccine to its front-line health workers beginning next week.
A study to see what protection it provides from Covid-19, and particularly against the dominant SA variant, is ongoing, the health minister said.
Zweli Mkhize said South Africa has scrapped plans to use the Oxford-AstraZeneca vaccine because it ‘does not prevent mild to moderate disease’ of the variant.
The one-shot J&J vaccine is still being tested internationally and has not been approved in any country.
But Mr Mkhize declared to the public that the vaccine is safe based on the clinical trials, including one done in South Africa.
Professor Jonathan Van-Tam, England’s deputy chief medical officer, has tried to put concerns about the South Africa variant to bed by saying he does not expect it to spread widely
The country will use this jab to first immunise its 1.25million health workers.
Then a further 40million people are expected to be vaccinated by the end of year with the addition of Pfizer’s vaccine and others from the US, China and Russia. The country has a population of around 59million people.
South Africa by far has the largest number of COVID-19 cases on the African continent with nearly 1.5million confirmed, including almost 47,000 deaths. That represents 41 per cent of the total for all 54 nations in Africa.
After a resurgence that spiked in early January, cases and deaths are now declining, but medical experts are already warning that South Africa should prepare for another upsurge in May or June, the start of the Southern Hemisphere’s winter.
WILL THE CURRENT VACCINES WORK AGAINST SOUTH AFRICAN COVID VARIANT?
The South African variant of coronavirus, known as B.1.351, has mutations on its outer spike proteins that change the shape of the virus in a way that makes it look different to the body than older versions of the virus.
Because the immune system’s antibodies are so specific, any change in the part of the virus that they attach to – in this case the spikes – can affect how well they can do so.
Current vaccines have been developed using versions of the virus from a year ago, which didn’t have the mutations the South African variant does, so scientists are worried the immunity they create won’t be good enough to stop it.
Here’s what we know about the vaccines and the variant so far:
Oxford/AstraZeneca (Approved; Being used in the UK)
Research published in February claimed that the Oxford/AstraZeneca vaccine appears to have a ‘minimal effect’ against the South African variant.
A study of 2,000 people by the University of Witwatersrand in Johannesburg found that two doses of the jab may only offer 10-20 per cent protection against mild or moderate Covid-19.
The study was controversial, however – nobody in the test group developed severe Covid-19 but the researchers said this ‘could not be assessed in this study as the target population were at such low risk’. Participants’ average age was 31 and they were otherwise healthy.
Scientists working on the vaccine said they still believe it will be protective.
Oxford and AstraZeneca said they are already working on a booster jab targeted at the South African variant and that it will be ready by autumn.
Pfizer/BioNTech (Approved; Being used in the UK)
Two studies suggest that Pfizer and BioNTech’s vaccine will protect against the South African variant, although its ability to neutralise the virus is lower.
One by Pfizer itself and the University of Texas found that the mutations had ‘small effects’ on its efficacy. In a lab study on the blood of 20 vaccine recipients they found a reduction in the numbers of working antibodies to tackle the variant, but it was still enough to destroy the virus, they said.
Another study by New York University has made the same finding on 10 blood samples from people who had the jab. That team said there was a ‘partial resistance’ from the variant and that a booster should be made, but that it would still be more effective than past infection with another variant.
Pfizer is developing an updated version of its jab to tackle the variant.
Moderna (Approved; Delivery expected in March)
Moderna said its vaccine ‘retains neutralizing activity’ in the face of the South African variant.
In a release in January the company said it had tested the jab on the blood of eight people who had received it and found that antibody levels were significantly lower when it was exposed to the South Africa variant, but it still worked.
It said: ‘A six-fold reduction in neutralizing [antibodies] was observed with the B.1.351 variant relative to prior variants. Despite this reduction, neutralizing levels with B.1.351 remain above levels that are expected to be protective.’
Moderna is working on a booster jab to tackle the South African variant.
Janssen/Johnson & Johnson (Awaiting approval; 30m doses)
Janssen, a subsidiary of Johnson & Johnson, has trialled its vaccine in South Africa and found it prevented 57 per cent of Covid cases.
This was the lowest efficacy the company saw in its global trials – in Latin America it was 66 per cent and in the US 72 per cent. These differences are likely in part due to the variants in circulation.
The vaccine was 85 per cent effective at stopping severe disease and 100 per cent effective at stopping death from Covid-19, even in South Africa where the variant is dominant, Janssen said.
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