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Explainer: SA’s vaccine rollout goes ahead despite AstraZeneca hiccup

UPDATE: On Tuesday, The Economic Times in India reported that South Africa’s Department of Health has asked the SII to take back the 1 million doses of the Oxford-AstraZeneca vaccine it had sent in early February. This comes after SA halted jabs following a study which showed the vaccine has minimal protection against the variant. More below.

South African healthcare workers are likely to receive their first jab of the Covid-19 vaccine this week, the Sunday Times reported. And it’s not the Oxford-AstraZeneca vaccine that SA received from the Serum Institute of India at the end of the month. Those have been put aside for now, after a study showed they weren’t that effective against mild to moderate forms of the Covid-19 variant present in SA. (We don’t know how effective they are against serious or severe illness, because that hasn’t been studied yet.) 

Instead, healthcare workers will now receive the Johnson & Johnson vaccine. 

We all thought these vaccines would only be arriving later, right? But the pharmaceutical company decided to step in sooner and help out a country in need. According to the Sunday Times, Johnson & Johnson had some 80 000 vaccines in reserve. The report says: “The quick footwork by officials and scientists in SA, and approval on Friday by the SA Health Products Regulatory Authority (SAHPRA), will bring the drugs here.”

SA did the right thing

Since research showed that the AstraZeneca vaccine provided “minimal protection” against the new variant, known as 501Y.V2, in young people, South Africa’s government had to change its plans. Even though some experts, including the World Health Organisation (WHO), said the results were inconclusive, News24 reported that some experts said the government made the right decision to change its plans. Africa Health Research Institute director and vaccinology expert, Professor Willem Hanekom reportedly said he was, “very proud of the approach the South African government took when finding out about the SA study results of the AstraZeneca vaccine,” News24 reported. 

Hanekom said the WHO was right to say the SA study of the AstraZeneca vaccine’s effectiveness on the variant was small and inconclusive, plus there’s the issue of the vaccine’s expiry date (more below). However, the results of that study cannot be ignored, Hanekom said, and if other vaccines show effectiveness against severe illness caused by the variant, we should go that route, News24 reported. The J&J vaccine is shown to be effective against the new variant. 

What about the vaccines we’ve already got?

But now, there’s the question of what SA is going to do with the 1.5 million vaccines from the SII. SA has already received 1 million of them. Health Minister Zweli Mkhize said SA might sell or swap them for a different vaccine that is more effective against 501Y.V2, News24 reported. 

But that doesn’t mean it’s the end of that saga. Because the AstraZeneca vaccine will expire in April – three months earlier than the normal expiry date of at least six months – South Africa asked the SII to replace this specific consignment, adding that the additional 500 000 that is expected “can stay in India”, City Press reported. The short shelf-life puts pressure on the government to administer the vaccines before the expiry date. 

But before we panic, the April expiry date for AstraZeneca vaccines is not set in stone, and, as more data becomes available, the manufacturing company can extend the expiration date, Bhekisasa reported. 

How awkward…

This makes things pretty awkward between SA and India. Dr Anban Pillay, deputy director-general of health reportedly said we would not pay the R75 per dose previously quoted for the 500 000 doses coming our way… 

But the ones we have might not be totally useless. City Press reported that both Professor Francois Venter, who is an expert in infectious diseases, as well as Professor Shabir Madhi, who led the South African study on the Oxford AstraZeneca vaccine, said the vaccine might be given to high-risk groups such as those with serious underlying health issues. 

What now?

South Africa is still expected to receive 9 million vaccines it had previously ordered from Johnson & Johnson. EWN has however reported that the 80 000 is part of this consignment. Then there’s the 20 million vaccines from Pfizer, and 12 million from the Covax facility, that will also arrive. In other words, the AstraZeneca saga is far from the end of the road for SA’s vaccination program.

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