Vaccine: WHO’s Dr Nabarro calls for global rollout to be ‘fair’
The UK’s vaccination programme is the envy of the world, with almost 1000 people a minute vaccinated on Saturday. Despite the colossal effort, a yet to be peer-reviewed study amplifies fears about new South Africa strain. The review findings suggest a two-dose regimen of the Oxford/AstraZeneca vaccine provides minimal protection against mild-moderate COVID-19 infection from the B.1.351 coronavirus variant first identified in South Africa.
In response, the South African government has temporarily suspended the rollout of the Oxford/AstraZeneca jab.
What does this mean for the UK rollout?
Health experts across the board have been quick to allay fears about the new finding.
Writing in the Daily Telegraph, Nadhim Zahawi, the UK government’s vaccine minister, said “we can take confidence from the current roll out and the protection it will provide all of us against this terrible disease”.
Prof Sarah Gilbert, Oxford’s lead vaccine developer, echoed this point, stating the vaccines should still protect against severe disease.
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The reassuring tone stems from the fact that there is no evidence that the vaccine is ineffectual against moderate to severe forms of the disease.
There were no cases of Severe disease/hospitalisations in either the vaccinated or the placebo group which is why Oxford are unable to conclude if this is the case.
Larger trials of another vaccine using the same Virus vector technology did show evidence that it could prevent severe disease which suggests the Oxford vaccine should yield similar results.
What did the original study find?
In an analysis, submitted as a pre-print prior to peer-review publication, a two-dose regimen of the Oxford/Astrazeneca vaccine provided minimal protection against mild-moderate COVID-19 infection from the B.1.351 coronavirus variant first identified in South Africa.
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Efficacy against severe COVID-19 infection from this variant was not assessed.
The analyses being submitted in the pre-print show the vaccine had high efficacy against the original coronavirus strain in South Africa.
Researchers from the University of Witwatersrand and others in South Africa and the University of Oxford, UK found that the effectiveness of vaccine against the B.1.351 coronavirus variant were substantially reduced when compared with the original strain of the coronavirus.
These early data, which have been submitted for scientific peer-review, appear to confirm the theoretical observation that mutations in the virus seen in South Africa will allow ongoing transmission of the virus in vaccinated populations, as has been recently reported even in those with prior infection due to earlier circulating variants.
In this study of approximately 2,000 volunteers who were on average 31 years old, mild disease was defined as at least one symptom of COVID-19.
Protection against moderate-severe disease, hospitalisation or death could not be assessed in this study as the target population were at such low risk.
Work is already underway at the University of Oxford and in conjunction with partners to produce a new version of vaccine which has been adapted to target variants of the coronavirus with mutations similar to B.1.351.
Shabir Madhi, Professor of Vaccinology and Director of the Vaccines & Infectious Diseases Analytics (VIDA) Research Unit at University of the Witwatersrand, and Chief Investigator on the trial in South Africa said:
“Recent data from a study in South Africa sponsored by Janssen which assessed moderate to severe disease, rather than mild disease, using a similar viral vector, indicated that protection against these important disease endpoints was preserved.”
“These findings recalibrate thinking about how to approach the pandemic virus and shift the focus from the goal of herd immunity against transmission to the protection of all at risk individuals in population against severe disease.”
Andrew Pollard, Professor of Paediatric Infection and Immunity, and Chief Investigator on the Oxford vaccine trial, said: “This study confirms that the pandemic coronavirus will find ways to continue to spread in vaccinated populations, as expected, but, taken with the promising results from other studies in South Africa using a similar viral vector, vaccines may continue to ease the toll on health care systems by preventing severe disease.”
Sarah Gilbert, Professor of Vaccinology at the University of Oxford added: “Efforts are underway to develop a new generation of vaccines that will allow protection to be redirected to emerging variants as booster jabs, if it turns out that it is necessary to do so.
“We are working with AstraZeneca to optimise the pipeline required for a strain change should one become necessary. This is the same issue that is faced by all of the vaccine developers, and we will continue to monitor the emergence of new variants that arise in readiness for a future strain change.”
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