In a setback for South Africa’s Covid-19 vaccine rollout, the use of the AstraZeneca-Oxford vaccine was recently halted. The decision to withdraw the vaccine from its rollout to the country’s healthcare workers followed the release of data from a locally conducted trial. Data showed a 22% efficacy rate against a unique strain of Covid-19 responsible for 90% of cases in the country. Given that the study was relatively small (just 2,000 participants) and the median age was 31 years, some experts warned that it is too soon to give up on the AstraZeneca vaccine. Professor of Vaccinology at the University of the Witwatersrand, Shabir Madhi has said that the shot has a high likelihood of protecting vulnerable people against severe illness and death. Meanwhile,  South Africa’s Ministerial Advisory Committee Co-chair Professor Salim Abdool Karim said a staggered rollout is being considered. ‘We don’t want to end up with a situation where we vaccinate a million people or two million people with a vaccine that may or may not be effective in preventing hospitalisation or severe disease,’ said the professor. South Africa’s government has announced that it will roll out the Johnson& Johnson vaccine instead and Minister of Health Zweli Mkhize has said that this could happen as early as next week. He added that the AstraZeneca vaccines – which were purchased through the Covax initiative – will not go to waste, as other countries have expressed interest in buying them. The World Health Organisation has said that the vaccine is still a viable option, with further studies needed. It has now recommended that the vaccine be used in all population groups over the age of 18 years, including the elderly. – Melani Nathan

Oxford-AstraZeneca vaccine recommended for all adults by WHO panelBy Corinne Gretler

(Bloomberg) – A World Health Organization panel recommended AstraZeneca’s Covid-19 vaccine for all adults over 18, paving the way to speed up inoculations in developing countries.

The recommendation may encourage more countries to use the vaccine broadly, after some European Union members advised against giving it to the elderly because of insufficient trial data. The shot’s effect in older people is expected to be the same as for younger recipients, according to Alejandro Cravioto, chairman of the WHO’s Strategic Advisory Group of Experts on Immunisation.

The move is good news for developing countries, many of which are waiting to administer their first shots as wealthier countries have already inoculated millions of residents. AstraZeneca, which developed the vaccine with the University of Oxford, has pledged significant supplies to Covax, a facility that aims to distribute vaccines equitably around the world.

The WHO’s recommendation on the Astra shot follows the organization’s decision to clear a vaccine from Pfizer and BioNTech in December. The UK drugmaker’s shot is easier to deploy than other vaccines like Pfizer’s that need to be stored at ultra-cold temperatures, and costs less.

Astra’s inoculation is more effective when the second dose is administered later, the panel found, recommending 8 to 12 weeks between the doses. The UK has adopted a similar dosing interval, which is wider than the recommended gap for some other two-shot vaccines.

As mutated virus strains spread across the globe, concern has grown that they’ll impact vaccine efficacy. South Africa, where one of the variants was first identified late last year, said it would pause a rollout of AstraZeneca’s vaccine after a trial showed it had limited efficacy against mild infections with the strain. AstraZeneca Chief Executive Officer Pascal Soriot said the shot should still protect against severe disease, and WHO officials underlined the benefits of continuing to use the vaccine even in variant-hit areas.

Covax plans“We made the recommendation that even if there is a reduction in possibility of this vaccine having a full impact in its protection capacity, there’s no reason not to recommend its use, even in countries that have the circulation of variants,” Cravioto said in a briefing.

Covax said last month that it’s on track to deliver at least two billion doses – about two-thirds of which will go to lower-income economies – and to vaccinate at least a fifth of each participating country’s population by year’s end.

The WHO is in the last stages of evaluating AstraZeneca’s vaccines managed by the company and the Serum Institute of India for emergency use approval and will make a decision mid-February, officials said.

The WHO’s authorisation is needed for Covax to send the vaccines to participating countries, in order to ensure a product’s safety and efficacy for those that might not have the resources to make the assessments themselves. Individual nations can still make their own decisions on the use of shots.

AstraZeneca shares traded 0.9% lower in London.

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