S Africa puts on hold AstraZeneca vaccination rollout after concern over efficacy

The planned vaccination rollout program of the one million AstraZeneca vaccines provided to South Africa by India’s Serum Institute has been put on hold after global concerns about its efficacy, Health Minister Zweli Mkhize has said.

Some of the country’s leading vaccinologists joined Mkhize in sharing results from several COVID-19 vaccine trials that South Africa has been part of, but all we're concerned about the issues that have arisen after AstraZeneca confirmed on Sunday that its current vaccine has limited efficacy against the new variant of the virus B.1.351 that was first identified in South Africa.

In a nationwide broadcast on Sunday evening, Health Minister Mkhize said that the roll-out will be put on hold until a committee of scientists have decided the way forward.

He said that full results of AstraZeneca, Johnson & Johnson and Pfizer vaccines would be available within the next month, which was why the AstraZeneca vaccine rollout was on hold for now.

The first of three phases in the vaccine rollout would have started next week, targeting health workers using the AstraZeneca vaccines manufactured in India.

Professor Shabir Madhi, Director of the Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit at the University of the Witwatersrand, who is also the Chief Investigator of the Oxford/AstraZeneca trials in South Africa, said that results from the trials showed that the AstraZeneca vaccine was less effective against mild and moderate forms of the B.1.351 coronavirus variant that were first identified in the country.

Describing this as “disappointing” and “a reality check”, Madhi suggested though that continuing the vaccine programme could be useful despite the concerns.

“Even though there are question marks in terms of the effectiveness of the AstraZeneca vaccine against severe disease, do we want to take the risk of not vaccinating high-risk groups now knowing that we are not going to cause harm but they might be protected against severe diseases?” Madhi asked.

It would be somewhat reckless of us to decide just to discard the AstraZeneca vaccine that is available, with the biological probability that those vaccines might still be useful in terms of protecting against severe disease.

We might want to reframe our target group for vaccination in the next few weeks or months, but it really needs to be focused and centred around prevention of severe disease and death from what is likely to be a resurgence sometime soon,Madhi added.

Reacting to queries after it emerged that the million doses of the vaccine which were delivered from India last Monday will expire in April, Health Ministry Director-General Dr Anban Pillay said discussions were under way with the Serum Institute about this.

“The expiry dates on vaccines are ordinarily six months. Unfortunately, these vaccines came through with an expiry date of April, which we only identified upon arrival, so we have engaged the Serum Institute of India for an extension of the date, if that is possible, or an exchange of the stock so that we can have vaccines with a longer expiry date. We are just waiting for their response around that,” Pillay added.

According to South African authorities, the country has so far reported over 1.4 million COVID-19 cases, including 44,399 deaths. The new variant of the contagion, which is now dominant in the country, has resulted in an increase in the number of cases, hospitalisations and fatalities. South Africa on February 1 received 1 million doses of the AstraZeneca vaccine produced by the Serum Institute of India with President Cyril Ramaphosa greeting the crates of COVID-19 vaccine that landed at Johannesburg's O R Tambo International Airport.

Experts had believed that the vaccine, which was to be used to inoculate the country’s frontline health workers, will be effective in preventing severe disease and death from the new variant that has become dominant in the country.