Cape Town – Health worker unions and medical bodies have thrown their weight behind the government's temporary hold on the use of AstraZeneca's Covid-19 shot in its vaccination programme.
The safety of front-line staff, who were first in line to get the jab, and ensuring their immunity against the virus were the main concerns, said the organisations.
They were reacting to a new study which showed that the Oxford/AstraZeneca vaccine, of which South Africa had procured 1 million doses from the Serum Institute of India, may not have the same efficacy (or effectiveness) against the mutated Covid-19 501Y.V2 variant predominant in the country.
Despite the temporary hold on the AstraZeneca vaccine, Health Minister Dr Zweli Mkhize said vaccinations would start next week as planned with a batch of Johnson&Johnson's (J&J) Janssen vaccines.
Mkhize, speaking to the media yesterday, said that in order to ensure the vaccination continued, the government had reached out to vaccine producers to bring forward the vaccines South Africa had ordered.
The government has faced criticism over its handling of the vaccine after it also emerged that the doses from India were set to expire in April, which was only discovered after they arrived in the country last week.
The Democratic Nursing Organisation of South Africa (Denosa) yesterday said it welcomed the move to put the roll-out plan of the AstraZeneca vaccine on hold in view of the latest scientific data.
“We hope the process of accelerating the procurement and roll-out of the J&J and Pfizer vaccines and the approval of these by Sahpra (South African Health Products Regulatory Authority) will be expedited.
“It is a matter of fact now that many health-care workers are exposed to the virus in the workplace, more especially now that PPE has proven not to be effective in protecting them as research by UCT and an investigation by SIU have revealed,” Denosa said.
It said its main concern was the safety of health-care workers and their communities, and it acknowledged the scientific guidance the government was getting and acting on.
“We hope that, in future, the efficacy of the vaccine will be confirmed in the country before purchasing.”
According to a presentation by the co-chair of the South African Covid19 Ministerial Advisory Committee, Professor Salim Abdool-Karim, the AstraZeneca vaccine recorded a 22% efficacy rate in South Africa while the J&J vaccine recorded a 57% efficacy rate for the 501Y.V2 variant.
Karim said the findings did not spell “doom and gloom” and that vaccines made by Pfizer and Moderna seemed to do “reasonably well” against the 501Y.V2 variant, even with their neutralising activity diminished.
The World Health Organisation (WHO) last night noted that given the small sample size of the trial and the low-risk nature of the participants (whose median age was 31), it is now important to determine the vaccine's efficacy when it comes to preventing more severe illness.
The WHO said it was currently considering the AstraZeneca vaccine for Emergency Use Listing as well as for recommendations by the Strategic Advisory Group of Experts on Immunisation (Sage).
Karim added that the Sinopharm vaccine also showed a small reduction, of about 1-5-fold, in efficacy. However, there was hope that the J&J vaccine would show a smaller decline in efficacy against the variant, making it a plausible choice for roll-out.
The J&J vaccine has yet to be approved by Sahpra and is listed as being “under review”.
“Covid vaccines remain effective against existing variants. The next set of vaccines will be made from the 501Y.V2 variant. We are expecting two kinds of vaccines: the first are 501Y.V2 boosters, and we have already heard about the good progress they are making on these boosters,” Karim said.
“We can still proceed with our roll-out, but we need to do it wisely by taking a stepped approach,” he said.
SA Medical Association chairperson Dr Angelique Coetzee said they were pleased that the government had made public the findings of the AstraZeneca studies promptly.
“We also take note of the fact that the studies need to progress regarding severe disease and to see whether (AstraZeneca) is effective in keeping patients out of hospital.
“As health-care workers on the front line you prefer for them to get a better immunity, especially against a severe strain, to also lessen hospitalisation on that level,” she said.
“There will never be a vaccine that is 100% (effective). For now we need to make sure people don't die, and if they get the disease, they don't end up in hospital.
’’You can still get the disease, even if you use AstraZeneca, or Pfizer or J&J. Your chance with J&J of ending up in ICU is smaller.
“There was a lot of pressure on the government during December and January … so the government was pressured into buying what was available during that time.”
Professor Shabir Madhi, who led the clinical trial of the Oxford/AstraZeneca vaccine candidate locally, said that until the end of October last year, before the new variant began spreading, the vaccine showed “tremendous potential”.
He said just 14 days after taking the first of two injections, participants showed a 75% lesser likelihood of becoming infected with Covid-19.
However, the 501Y.V2 variant then emerged and spread rapidly throughout the country, and much of the antibody induced by the vaccine was not actually active against the variant circulating in South Africa.
Cape Times