Healthcare worker in Chile opens up the Chinese-developed “CoronaVac” COVID-19 vaccine.

The Chinese-developed “CoronaVac” vaccine against COVID-19 vaccine triggers a sixfold reduction in neutralizing antibody response against the P.1 variant first identified in Brazil, according to a pre-print study published last week, while the Oxford/AstraZeneca vaccine is likely effective against the variant of concern. 

These findings come as hospitals in northern Brazil are increasingly overwhelmed and overcrowded; the country is reporting record high death rates; and the P.1 variant is becoming dominant in most of the country. 

The CoronaVac vaccine, produced by the Chinese pharma firm, Sinovac Biotech, is Brazil’s principal vaccine, with 120 million doses purchased by the government. CoronaVac accounts for over 70% of COVID-19 vaccines now being administered in Brazil. 

Some 10.83 million doses of COVID-19 vaccines have been administered in Brazil, but the virus continues to rage out of control, nearing record highs in daily cases, with 80,508 new cases reported on Sunday. With 2.68 million people fully vaccinated – 1.28% of the population – it could be too soon to draw conclusions about the efficacy of the vaccines in preventing transmission and infection in Brazil.

The new COVID-19 cases reported in Brazil. The country is reaching record high daily cases, with a seven day average of 66,869 new cases in March.

The P.1 variant was discovered in Manaus City in Brazil in early January and has several mutations – E484K, K417T, and N510Y – that are also present in the B.1.325 variant, which is circulating around the United Kingdom and South Africa and has been linked to higher transmissibility. 

The small-scale study of the CoronaVac vaccine, produced by the Chinese firm Sinovac Biotech, was conducted by researchers in Brazil, the United Kingdom, and the United States, found that the plasma from eight individuals vaccinated with Sinovac’s vaccine “failed to efficiently neutralize” the P.1 SARS-CoV2 variant. 

“Our data suggests that the SARS-CoV2 lineage P.1 can escape from neutralization antibodies elicited during infection or immunisation with previous circulating viral variants,” said the authors of the study. 

The neutralizing capacity in the blood plasma was six times lower against the P.1 variant compared to earlier lineages. According to the authors, the partial immunity against new variants could suggest that reinfection of previously infected or vaccinated individuals could occur. 

AstraZeneca’s Vaccine is Effective Against P.1 Variant, Says Preliminary Data

In contrast to Sinovac’s CoronaVac vaccine, early results from a study conducted at the University of Oxford indicate that the Oxford/AstraZeneca COVID-19 vaccine is effective against the P.1 variant. The results of the AstraZeneca study, which have not yet been made public, were shared with Reuters. The data indicates that the vaccine would not need to be modified to target the variant. 

This encouraging news follows the earlier release of data from a South Africa study, suggesting that the AstraZeneca vaccine was unable to protect people against mild and moderate cases of the B.1.351 variant of the SARS-CoV2, first detected in South Africa and bearing similarities to the P.1 variant. The full study will likely be released in March.

Sinovac Vaccine To Be Rolled Out Across Several Countries in Latin America and Asia
A second batch of 6.5 million doses of the Sinovac vaccine arriving in Turkey in late January.

Along with Brazil, mass vaccination drives of CoronaVac have begun in China, Indonesia, and Turkey and the vaccine has also been approved for emergency use in Colombia and Mexico. 

The efficacy rate of the vaccine against SARS-CoV2 was only 50.3%, based on late stage clinical trial results from Brazil. However, its developers claim that the vaccine is still 83.7% effective for more serious cases requiring medical treatment, and 100% effective in preventing hospitalisation. 

Sinovac previously said that the firm is looking into developing a vaccine for the variants or offering booster shots to extend protection. Both of these options could be developed fairly quickly, the company says.

“It’s like there’s this thief whom we’ve already caught,” said Yin Weidong, Sinovac’s CEO, in an interview with the Chinese government-controlled TV channel, CGTN, last week. “Even if it’s mutating, we can totally use the current research and production capacity to effectively develop a vaccine for the new variant.”

Risk Posed By P.1 Variant Extends To Other COVID Vaccines

Meanwhile, the P.1 variant, which has spread to more than 20 countries, poses potential risks to several other COVID-19 vaccines as well as possibly being more fatal. 

According to a pre-print study conducted by researchers at the University of São Paulo, Imperial College London, and the University of Oxford, the P.1 variant is between 1.4 and 2.2 times more transmissible than previous SARS-CoV2 lineages. 

The researchers estimate that P.1 evades 25% to 61% of protective immunity provided by infection from a different strain of the virus. 

“There was also evidence of an increase in mortality risk but whether this is due to P.1 or the extensive healthcare collapse Manaus has experienced remains uncertain,” said Thomas Mellan, a research associate at Imperial College London and co-author of the study, in a press release. 

“Uncertainty in the ways SARS-CoV2 is changing and implications for vaccine design calls for much more sequencing and analysis of virus genomes globally,” said Ester Sabino, professor of infectious diseases at the University of São Paulo and co-author of the study.

Image Credits: Twitter – Chinese Embassy Manila, Pontificia Universidad Católica de Chile, New York Times, Twitter – TRT World Now.

Innovation has, until recently been a male-dominated preserve, but a group of women pioneers speaking at the Africa Health Agenda International Conference on Monday told of how the right mindset and a desire to improve lives has helped change the landscape.

Speaking during a virtual panel discussion on Women in Innovation: Providing leadership, creating solutions and driving change, panellists shared their stories of how they overcame adversity and gender disparity as women inventors and entrepreneurs to make a difference.

Dr Matshidiso Moeti, the World Health Organization’s Africa Director, who grew up in a South African township during apartheid,  encouraged participants to push for positive change even when facing challenges. She emphasised the importance of bringing men on board when dealing with gender imbalances.

“Help men to understand that it is to their benefit. Men can be powerful enablers of gender empowerment. Women are power…let’s get men to support us,” Moeti said.

The first day of the conference coincided with International Women’s Day and the discussions were aimed at demystifying the notion that women have a limited role in innovation.

“Through this event, we wish to mobilize and provoke change, and help advance women in the field of technology and science topics that we aim to further explore in a series of discussions through the year,” said the conference organisers, adding that “innovation is crucial to identifying solutions to achieve the UN sustainable development goals (SDGs)”.

For Edna Adan Ismail, Somaliland’s first midwife and renowned healthcare activist, the journey to success was all about considerable and equal participation of women in business, education and innovation. 

Driven by the urge to address the inadequate healthcare in her country and increase women participation in an almost male-dominated environment, Ismail said her focus had been to do something that would advance women. 

On Tuesday, Ismail will celebrate the 20th anniversary of a hospital she built in Somaliland, the Edna Adan Maternity Hospital, which was established primarily to provide better health care to people whose lives have been traumatized by war, and to train nurses, midwives, and other health workers. 

The hospital also has diagnostic laboratory facilities and an emergency blood bank and offers diagnosis and treatment for sexually transmitted diseases.

Ismail also built a medical university 10 years ago which currently has 1500 students enrolled in various disciplines of the medical field,  70% of whom are women. 

At 84, Ismail said one is never too old to contribute to meaningful change and encouraged participants to “never give up as giving up is never an option”.

“What we do, how we collaborate, the contributions we make to save human lives is what will continue to drive us,” she said adding that women bring positive change when provided with opportunities and training.

Several panellists shared personal stories of how they used entrepreneurial skills to overcome adversity, how they were empowered and the challenges they faced.

Sheila Alumo, Managing Director, Eastern Agricultural Development Co. Ltd, was forced to care for her two younger siblings when she was just 11-years-old after her mother died. There were days when her family went without food and she had lost all hope.

Her story is one of hope, perseverance and succeeding against all odds. Alumo recalled how, at one stage, she would walk several kilometers to buy and resell sugar cane to help feed her family.

Today Alumo’s Uganda-based company employs 22 people and, through its agricultural business, pursues improved socio-economic and human development of rural smallholder farmers. The company has a network of 3,117 farmers, 40% of whom are women. Alumo said she works with rural populations to contribute to their livelihood improvement.

“I know what it is to be hungry, not to have food…no hope. As a young girl knew that I had to make a difference.”

It was Alumo’s parting words that resonated with most of the panelists and participants: “Our backgrounds define our future, but our resilience will carry us through”.

The conference runs until Wednesday, and covers a range of topics including the state of health security in Africa and the need for an African Medicines Agency.

Image Credits: Photo credit: NSTOP Team.

Less than half of Africa’s citizens (52%) – some 615 million people – have access to the healthcare they need, the continent’s quality of health services is generally poor and the family planning needs of half the continent’s women and girls are unmet.

This is according to a report on Africa’s progress toward achieving universal health coverage (UHC) released on Monday at the Africa Health Agenda International Conference (AHAIC).

Each year, approximately 97 million Africans, representing 8.2% of the continent’s population, incur “catastrophic healthcare costs” – particularly in Sierra Leone, Egypt and Morocco. Annually, 15 million people will be pushed into poverty as a result of these out-of-pocket costs, according to the report, which was compiled by a multi-national AHAIC commission.

 

Some 15-million Africans are forced into poverty every year because of massive medical bills.

World Health Organization Director General Dr Tedros Adhamon Ghebreyesus said that the COVID-19 pandemic had highlighted the importance of all people having access to adequate health services.

“Achieving UHC require investments in resilient health systems, especially in strong primary health care with an emphasis on promoting health and preventing disease,” said Tedros. 

“ An important part of that journey is ensuring a reliable supply of safe, effective and high-quality medicines across the continent. To that end, WHO is working with the African Union and the Africa Centres for Disease Control (CDC) to establish the African Medicines Agency (AMA). And I call on all AU countries to ratify the treaty so that African Medicines Agency can enter into force.”

The AMA is envisaged as a central regulatory agency expected to improve access to medicines on a continent where some countries simply don’t have the capacity to regulate medicines.

Life Expectancy Has Increased Thanks to Malaria and Reproductive Health Management

Also opening the conference was Kenya’s President Uhuru Kenyatta who pointed out that Africa’s life expectancy had increased from around 40 in the 1960s to 64 currently, mainly as a result of better management of malaria, and reproductive health services.

“If we are to achieve universal health coverage by 2030, we need to give greater priority to primary health care, water, sanitation and hygiene,” said Kenyatta. “Indeed, during this COVID period, all of us have been amazed by how simple hygiene practices such as hand washing, introduced during this response to this pandemic, have reduced diarrhea and other diseases.” 

Tedros praised Kenya and Rwanda for making the most progress on the continent in achieving UHC.

Kenyatta explained that user charges had been removed in Kenyan dispensaries and health centres, and free maternity services had been introduced. 

“Currently, we are embarking on a national programme to ensure universal access to health hospital insurance fund through mandatory enrollment, and a full government subsidy for the poor and most vulnerable,” said Kenyatta.

Both he and Kenya’s Health Secretary, Mutahi Kagwe, stressed the importance of local production of health products.

Welcoming the fact that the International Federation of Pharmaceutical Manufacturers Associations (IFPMA) was one of the conference sponsors, Kagwe said he wanted to send a message to them to improve production capacity on the continent.

“It is possible for you to have money and not to have supplies,” said Kagwe. “One of the most frustrating and panicky things for African health ministers at the start of the pandemic was when we did not have PPEs yet we were getting cases in our hospitals. We didn’t have reagents but we wanted to test. Why didn’t we have reagents? Because they are not made on the continent. Regions have closed systems and there was no way of getting reagents from anywhere,” said Kagwe. 

COVID-19 Has ‘Made Us Aware of Our Potential’

“We have learned from COVID-19 experiences. They have made us more aware of our vulnerability and made us more aware also of our potential. We are no longer importing PPEs. We are making them locally.”

Rwanda’s health minister, Dr Daniel Ngamije, said his country has introduced community-based health insurance for those who could not pay for health services. 

“The premium for their membership of this scheme is paid by the government and it allows them to be treated from the primary health care application level of care,” said Ngamije.

Rwanda had also recognised that women’s and girls’ access to family planning was hampered by religious health service providers not providing this service and by the legal requirement for girls to be 18 before they could get contraceptives.

The Rwandan government was trying to ensure it had family planning clinics in areas dominated by faith-based service providers and it was engaging with parliament to address the legal barrier of age which was driving unwanted pregnancies among teenagers.

Ethiopia’s health minister, Lia Tadesse, said that her government had initially subsidized services for the poor while the rest pay out-of-pocket. 

“But this was not sustainable for government and also caused high out-of-pocket expenses. So in the past few years, Ethiopia started a community-based insurance system and we are on our way to starting social health insurance. We still have exempted services for things like family planning, immunization, HIV, maternal and neonatal services but universal insurance is what we are trying to head towards.”

Some of the solutions proposed by the report to speed up UHC include using the “vast network of African traditional healthcare providers” to improve primary healthcare services, “especially preventive and promotive care”, strengthening governance including anti-corruption strategies and progressively increasing financing of the health sector.

 

Image Credits: Xavier Vahed/DNDi, AHAIC Commission Report on UHC in Africa.

On 1 March, Ghana started its COVID-19 vaccine campaign. Samira Bawumira, the vice-president’s wife, was one of the first to be vaccinated.

The World Health Organization (WHO) and its COVAX partners are hosting a summit next week with governments and pharmaceutical companies to address the bottlenecks in COVID-19 vaccine production and delivery.

This follows a spectacular start in the past week for COVAX, the global vaccine delivery platform, which delivered more than 20 million doses of COVID-19 vaccines to 20 countries, according to WHO Director General Dr Tedros Adhanom Ghebreyesus.

“We currently face several barriers to increasing the speed and volume of production of vaccines, from export bans to shortage of raw materials, including glass, plastic, and stoppers,” Tedros told the body’s bi-weekly media briefing on Friday. 

“Next week, WHO and our COVAX partners will meet with partners from governments and the industry to identify bottlenecks in production and discuss how to solve them.”

The WHO runs COVAX together with GAVI, the global vaccine alliance and the Coalition for Epidemic Preparedness Innovations (CEPI).

COVAX Distribution Remains Small – Relative to Needs

Describing the COVAX launch as a landmark, Tedros added that “the volume of those being distributed through COVAX is still relatively small”, as they covered “between 2-3% of the population of countries receiving vaccines, even as other countries make rapid progress towards vaccinating their entire population within the next few months”.

To help all countries to end the pandemic, the WHO was looking at four approaches, said Tedros.

The first and most short-term was to link vaccine producers with companies that have excess capacity to “fill and finish”, such as the deal reached this week between Johnson & Johnson and Merck, where Merck will provide “fill and finish” services – filling vials with vaccines and packaging them – for the J&J vaccine.

“We need more partnerships like this,” stressed Tedros. “And we need them in all regions. WHO can support this process by identifying gaps and providing a matchmaking service between vaccine producers and companies with capacity.”

The second approach, said Tedros, was “bilateral technology transfer through voluntary licensing from a company that owns the patents on a vaccine to another company who can produce them”. 

“A good example of this approach is AstraZeneca, which has transferred the technology for its vaccine to SK Bio in the Republic of Korea, and the Serum Institute of India, which is producing AstraZeneca vaccines for COVAX,” said Tedros, although he decried the “the lack of transparency” in this approach.

´Coordinated’Technology Transfer

The third approach is a “coordinated technology transfer” that would see universities and manufacturers licensing their vaccines to other companies through a global mechanism, coordinated by WHO.

With this approach, there would be more transparency, global coherence and it would also “facilitate the training of staff at the recipient companies and coordinate investments in infrastructure”, said Tedros.

The final solution, said Tedros, was for countries “to start producing their own vaccines by waiving intellectual property rights as provided for in the TRIPS agreement”.

“Those provisions are there for use in emergencies. The WHO believes that this is a time to trigger that provision and waive patent rights. We thank South Africa and India for their proposal to the World Trade Organisation to waive patents on medical products, or COVID-19, until the end of this unprecedented pandemic.”

Next week’s summit will involve the International Federation of Pharmaceutical Manufacturers Associations (IFPMA), which represents most major pharma companies. However, Marie-Paul Kieny, chair of the Medicines Patent Pools Foundation and a guest at the briefing, said that many other generic manufacturers needed to be brought into the discussion.

Kieny said her foundation was in the process of “leveraging our close relationships with generic manufacturers across the globe to help identify suitable partners to ‘fit and finish’ vaccine needs, and as potential recipients of technology transfer”.

COVAX Roll-out Continues Next Week
WHO special advisor Dr Bruce Aylward

This week’s first COVAX deliveries were to Ghana, and Cote d’Ivoire. Shortly afterwards, deliveries were made to Angola, Cambodia, Colombia, the Democratic Republic of the Congo, Gambia, India, Kenya, Lesotho, Malawi, Mali, Moldova, Nigeria, the Philippines. the Republic of Korea, Rwanda, Senegal, Sudan, and Uganda.

By the end of next week, COVAX will deliver 14.4million more doses to 31 additional countries, which will mean it have reached 51 countries out of the 190 COVAX members, said WHO adviser and COVAX representative Dr Bruce Aylward.

Aylward described the process of getting the vaccines to countries as complex.

At a global level, the WHO had to examine the vaccines and grant them emergency use listing, while at country level, “some of the biggest challenges that we’ve seen is the regulatory authorisation for these products as well as the indemnification and liability provisions for the use of these products”, said Aylward.

“The national vaccine plans have to be in place. And then once all that’s in place, we’ve got to be able to link it up with the shipments, the logistics, the purchase orders etc.”

Despite the complexities, Aylward said only 24 countries had not jumped through all the hoops – but were expected to have done so within the next two weeks.

 

Image Credits: Flickr: Francis Kokoroko/UNICEF.

Women in Africa account for a slightly smaller proportion of Covid-19 infections and deaths than men although a health expert cautions that access to testing and reluctance to being treated in hospitals could mean that women’s cases are undercounted.

Unveiling findings of a preliminary analysis of COVID-19 gender-specific epidemiological data in 28 African countries, the World Health Organization (WHO) on Thursday revealed that women account for about 41% of African COVID-19 cases. However, there was a large range from 31% for cases in Niger to over 57% in South Africa.

“In most countries, women are somewhat less likely to die from COVID-19 than men,” WHO stated. 

In Côte d’Ivoire, the case fatality ratio stands at 0.4% for women compared with 0.5% in men, while in the Democratic Republic of the Congo it is 2.2% versus 2.7%. In Seychelles, it is 0.1% for women against 0.5% in men, although the country has only had 13 COVID-related deaths.

This is despite the fact that women account for a large part of the health workforce and are thus at higher risk of infection. 

“In Africa, more than 95,000 health workers have been infected with COVID-19. In Seychelles, women account for 71% of health worker infections, 64% in Eswatini, 55% in Cote d’Ivoire and 54% in Senegal,” the WHO reported.

“Other studies report that men are significantly more likely to suffer severe effects of COVID-19 and more likely to have pre-existing conditions, explaining the slightly lower fatality rate seen in women,” the report stated.

Noting the need for further analyses to determine the factors behind the gender disparity, the report suggested that biological, behavioural or social factors could be responsible. 

However, Nigerian public health expert Bayo Ajala noted that the trend could be as a result of fewer women getting tested and unable to abandon their family duties to be at isolation centres.

“Many people are getting over COVID-19 even without any intervention. For women, in many African countries, they are the pillars of families and the household cannot survive without them. Maybe they are not getting tested for their details to be captured in the official data,” he told Health Policy Watch in Ibadan, Nigeria.

Women at higher risk of gender-based violence

But while fewer women appear to have been infected than men, the WHO noted that school closures during the COVID-19 crisis led to “an increase in teenage pregnancy and unintended pregnancies in many countries”. “Additionally, staying out of school for an extended period usually led to greater likelihood of engagement in risky sexual behaviour and increased sexual violence and exploitation. Also, women and girls are increasingly becoming victims in the spike of domestic violence fuelled by economic hardship as millions of people are pushed into extreme poverty.”

According to Matshidiso Moeti, the WHO Regional Director for Africa. “the aftershocks of the COVID-19 pandemic on women and girls have been profound, leaving many grappling with heightened risks to their health and safety”. 

“Our response must go beyond the clinical aspects of the pandemic and address the hidden crises that risk causing long-term effects to lives and livelihoods.”

According to WHO preliminary analysis of 22 countries, 10 reported a rise in maternal deaths between February and July 2020 compared with the same period in 2019, with the highest increases reported in Comoros, Mali, Senegal and South Africa. 

“Nine of the 22 countries reported a decline in births in health facilities and an increase in complications due to abortions,” WHO stated.

Oulimata Sarr, UN Women Regional Director for Central and West Africa, called for efforts to promote “positive masculinity”, involving men in addressing issues affecting women. 

“At UN Women, we are convinced that to be able to bring about change, people want to leapfrog into the future. We need to enroll the men, and those men, we call them our HeforShe. Those are really our champions who might be on decision-making tables where we are not and who will take full responsibility for a fair and just world that gives equal opportunity to men and boys and girls and women,” Sarr said.

As Africa joins the rest of the world to celebrate International Women’s Day on 8 March, Moeti said efforts should be geared towards closing the gender gaps by designing services in a people-centered way. 

“And taking into account inequity, and gender-driven inequity as well in the design of policies from financing health for designing our systems for health insurance for making sure that the approaches to improving access to services take into account all people,” Moeti concluded.

 

 

 

 

Minister of State for Masvingo Provincial Affairs and Devolution Ezra Chadzamira has today received his first dose of SinoPharm Covid-19 vaccine.

CAPE TOWN & KAMPALA – From Asia to the Americas, vaccines are fast becoming the new currency by which nations and geopolitical blocs wield influence and buy political favours – with more value than oil or bitcoin. 

But nowhere is this more apparent, perhaps, than in Africa, Latin America and south Asia, where both Russia and China are using bilateral SARS-CoV2 vaccine donations and deals to cement alliances with low- and middle income countries stung by the vaccine gold rush – in which high income countries have charged far ahead buying up limited supplies. 

Vast Trade in Vaccines 
The first consignment of AstraZeneca’s vaccine arrived in South Africa on 1 February

While global COVID-19 vaccine procurement and donations developments are very fluid, Health Policy Watch has tracked a vast trade in vaccines across Africa and other continents.  And it is clear that Chinese and Russian vaccines are deeply penetrating markets in many low- and middle-income countries (LMICs) – declarations of global solidarity by G-20 countries notwithstanding.

China reports that it has offered vaccine assistance to 53 developing countries, and that it has exported or is exporting vaccines to 22 nations, according to Foreign Minister Wang Yi. Meanwhile, by 25 February, Sputnik V had been registered in 37 countries.

In contrast, Western companies such as Pfizer/ BioNtech, Moderna, AstraZeneca/Oxford, and Johnson & Johnson, whose vaccine was the latest to be approved by the US Food and Drug Administration, are focused on a select group of high income countries in North America, Europe, the Middle East – peppered by only a few middle- or upper-middle income African or Latin American nations that teamed up with big pharma in clinical trials or swung heavily leveraged deals.  

Although the AstraZeneca vaccine is also being marketed to LMICs through the WHO co-sponsored COVAX global vaccine initiative, those sales are taking place through a separate license with the Serum Institute of India (SII). And there, too, SII has made a series of parallel, bilateral  deals, charging South Africa and Uganda 2-3 times the fee per dose, paid by Europe for the same vaccine.  

“As some high-income nations have already immunized more than 20% of their population with at least one dose, only a few African countries have reached even 1 in 1,000 people. It is frankly impossible to defeat the virus if these disparities persist,” says Solomon Zewdu, the Bill & Melinda Gates Foundation’s deputy director told Health Policy Watch, in explaning the desperate rush of others.

China’s Vaccine Outreach To Africa Began Months Ago

It is on the African continent where the Chinese vaccines are being marketed the most intensively – and perhaps embraced the most extensively. 

Beijing has confirmed that it is assisting 21 African countries to get vaccines, according to Foreign Ministry spokesperson Wang Wenbin. Significantly, Egypt, Africa’s fourth largest country, has signed an agreement with China’s Sinovac to produce its COVID vaccine, as well as distribute it to other African countries. 

That represents the fruits of a Chinese vaccine outreach initiative that began months ago.

 

Sinopharm hosted an in-person delegation of some 50 ambassadors and diplomats on its factory premises.

Already in October of 2020, Sinopharm hosted an in-person delegation of some 50 African ambassadors and diplomats on its factory premises – in a period when Beijing was stonewalling over WHO requests to permit entry of just 14 scientists into Wuhan to investigate the origins of the SARS-CoV2 virus.  

“Sinopharm stands ready to work with the African people to deepen cooperation in the fight against and pandemic, consolidate China-Africa friendship and make an important contribution to the joint development of the China-Africa health community,” Company chairperson Liu Jingzhen told the visiting delegation at the time.  

“President Xi Jinping pointed out that after the COVID-19 vaccine is developed and put into use, it will take the lead in benefiting African countries.” 

Using a ‘Common Interest’ Approach to Cement Superpower Status

China had become an expert in public diplomacy on the continent using a “common interest approach” in its quest to cement its superpower status,  Dr Yazini April, co-ordinator of the BRICS (Brazil, Russia, India, China and South Africa) Research Centre at the Human Sciences Research Council in Pretoria, told Health Policy Watch in an interview. 

Its “vaccine diplomacy” involved three things, according to April: the country’s desire to be viewed as a “trusted friend, business and political control”.

While much of Africa is not yet part of China’s massive global transport “Belt and Road” infrastructure plan, often referred to as the Silk Road, “each country has something they can trade with, such as water in Lesotho etcetera”, she added, referring to the country’s abundant resources that provide water to parched South Africa and hydroelectricity domestically. 

On New Year’s Eve, Gabonese President Ali Bongo Ondimba promised his people that they would be among the first on the continent to get the COVID-19 vaccine. But by mid-February, when there were no signs of COVAX deliveries, Gabon turned to China and will soon get 100,000 doses of the Sinopharm vaccine. 

Many other African countries are receiving China’s Sinopharm vaccine. Equatorial Guinea has received a donation of 100,000 doses, Zimbabwe received 200,000 doses as did Sierra Leone. Algeria is set to receive 200,000 doses and Senegal has purchased 200,000 China’s Sinopharm doses, with rollout anticipated soon. 

Uganda has also been offered a donation of 300,000 Sinopharm doses. However, the modalities of receipt of vaccine have not been concluded, said Ugandan Health Minister Jane Ruth Acheng during a press briefing in Kampala last week.

China’s Foreign Ministry spokesperson Wang Wenbin said that the vaccine aid “is a clear manifestation of the China-Africa traditional friendship”,  adding that China will continue to provide support and assistance within its capacity and in accordance with the needs of Africa.

Russia – Also Present in Africa

While less active, Russia is also present too. South Africa’s regulatory authority confirmed to Health Policy Watch that it had received an application for licensing from Sputnik V’s manufacturer on 24 February and was in the process of considering the “safety, quality and efficacy of the vaccine”. The South African government has also confirmed that it is in talks with Sinopharm but has a non-disclosure agreement with the company.

In late December, Guinea, one of the world’s poorest countries – but also a Russian source of the mineral bauxite – started to vaccinate people “on an experimental basis” with Sputnik V. Most vaccinations so far have been of government officials. 

On 1 March, Ghana started its COVID-19 vaccine campaign with vaccines received from the WHO co-sponsored COVAX initiative – but still more are needed.

Ghana’s government also has said that it is considering securing some doses of Sputnik V under bilateral arrangements. Franklin Asiedu-Bekoe, Ghana’s Director of Public Health, confirmed that the country has “opened our doors outside the COVAX facility to ensure that more than 20 million Ghanaians are vaccinated. We have registered the Russian Sputnik V vaccine which will provide a backup of doses”.

Africa Centres for Diseases Control and Prevention (CDC) also is in contact with the producers of Chinese and Russia vaccines – which have no special requirements for transportation and can be stored at normal refrigeration temperatures.  John Nkengasong, the director of Africa CDC, said Russia has already submitted its dossier for the Sputnik V vaccine directly to Africa CDC – and an expert committee was reviewing their data and would come up with guidance. 

Whether or not Africa CDC will act on its own or wait for WHO remains to be seen. WHO officials have urged countries to procure only those vaccines that have received an “Emergency Use Listing” from WHO, or are approved by another strict national regulatory agency, usually understood to mean the US, UK or European Medicines Agency. In the case of both Sputnik as well as the Sinopharm and Sinovac vaccines, those WHO reviews are still pending, said Matshidiso Moeti, WHO’s  Regional Director for Africa. 

The WHO also has repeatedly urged both pharma manufacturers and countries to refrain from bilateral deals and procure their COVID-19 vaccines through the COVAX facility – although those pleas have largely been to no avail. 

“To maximimize the chance of getting fair price for COVID-19 vaccines, we are advising countries to use as much as they can the pooled procurement platforms that are in existence for the moment: COVAX or AVATT,” said Dr. Richard Muhigo the head of immunisation and vaccine development at the WHO Africa office. 

“If the countries decide to go for bilateral deals with vaccine manufacturing, our recommendation is to procure as much as they can vaccines that have been listed by WHO for emergency use,” said Muhigo. 

China and Asia
Thailand’s first shipment of vaccines arrives from China.

Between October and January, Chinese Foreign Minister Wang Yi visited every country in Southeast Asia except Vietnam, according to the Center for Strategic and International Studies. 

“At each of his stops, Wang coupled promises of Chinese vaccine access with other foreign policy priorities, including advancing major projects under China’s Belt and Road Initiative (BRI), which have been stalled amid the pandemic,” according to the CSIS.

In the Philippines, Wang promised half a million doses of Covid-19 vaccines along with $1.3 billion in loans and $77 million in grants for infrastructure projects. In Indonesia, the delivery of 3 million Sinovac vaccines has come with China’s commitment to “help Indonesia become a manufacturing hub for Chinese vaccines” and speed up a high-speed railway link, according to the center. 

In Myanmar, a promise of 300,000 vaccine doses was accompanied by talks to develop a  China-Myanmar Economic Corridor, which would also ensure that China’s Yunnan Province just over the border would gain better access to the Indian Ocean.

All in all, China says that it is providing vaccines to 14  Asian countries including Pakistan, Brunei, Nepal, the Philippines, Myanmar, Cambodia, Laos, Sri Lanka, Mongolia and the Palestinian Authority: “China has decided to donate COVID-19 vaccines to Palestine,” China’s UN Ambassador Geng Shuang told the Security Council in late February, during its monthly meeting on the Israeli-Palestinian conflict.  

The Palestinian Authority (PA), however, has so far spoken publicly only about its procurement of Russia’s Sputnik vaccine – after a high-level PA official visited Moscow last month and signed a contract. The PA is also receiving a dispatch of vaccines from the Global COVAX facility. On 22 February, Hamas-controlled Gaza, received a shipment of some 20,000 Sputnik vaccines, donated by the United Arab Emirates.  Israel, criticized for failing to share more of its supply of Pfizer vaccines, has given the PA a few thousand doses directly, and is now beginning to vaccinate some 140,000 Palestinian workers – along with Arab residents of East Jerusalem which both Israel and the PA claim.  

China has also been active elsewhere in the Middle East region, supplying the UAE, Iran, Bahrain, Jordan, Iran, Egypt and Morocco. However, the UAE, Bahrain, Kuwait, Oman, Qatar and Saudi Arabia have also bought the Pfizer vaccine.

Russia Makes Inroads in Europe & Latin America 

Meanwhile, Russia has mostly sewn up vaccine markets in Euroasia and is also making inroads in the European Union, according to official news agency Tass. 

“Hungary became the first EU country to receive samples of the Sputnik V vaccine for research. Austria, Germany, Greece, Italy, Slovenia, the Czech Republic and Finland have already expressed interest in the possible use of the Russian preparation or its local production in case of its approval,” reported Tass on 19 February.

Sputnik Favoured in Latin America

At least 10 Latin American countries have received Sputnik V, beginning with starting with Argentina on 30 December. Since then Belize, Brazil, Bolivia, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay and Venezuala have all received doses – some as small donations and others as paid orders. 

In Bolivia, vaccine talks were accompanied by discussions of Russian assistance to develop gas reserves, restart a nuclear plant project and co-operate on lithium mining, according to Reuters.

Russia has also licensed manufacturing companies to produce its vaccine in India, Brazil, China, South Korea, and Argentina.

Argentina, Brazil, Bolivia and Mexico are getting both the Sputnik and Sinopharm vaccines, while Colombia, the Dominican Republic, Ecuador, Peru, Chile and Uruguay have only secured the Sinopharm vaccine so far.

Political Power or Donations to the Global Public Good ? 
China’s Xi Jinping in 18 May 2020 address before the World Health Assembly

Although China has been accused of donating its Coronavirus vaccines for political power, Chinese President Xi Jinping has stressed at recent meetings of the World Health Assembly that it viewed its COVID vaccines as a global “public good’. 

China has also joined the global vaccine access platform, COVAX, and promised it 10 million doses.  However neither of the two leading vaccine candidates, by Sinpharm and Sinovac, have been approved by an external regulatory agency – and discussions are still continuing, according to WHO officials.

Nor have the Chinese vaccine developers published peer-reviewed studies on their vaccines. Company reports show Sinopharm’s multi-country trials yielding efficacy results  of 79%, while Sinovac trials from four different countries showed results ranging from 91.3% in a Turkish trial to 50.3% in an independently managed  Brazilian trial among health care workers. 

In the case of Russia’s Sputnik V vaccine, the Gamaleya Institute developers together with the Russian Direct Investment Fund (RDIF) say they have submitted the vaccine portfolio to the  European Medicines Agency for review.  And a Lancet report on Phase 3 trial results, found the vaccine to be 90% efficacious against the SARS-CoV2 virus.  But the CEO of the  RDIF has also stated that it prefers to deal directly with countries rather than via the global COVAX facility.

Meanwhile, in the absence of other approvals, individual countries ranging from upper middle income Chile to impoverished Zimbabwe have taken matters into their own hands – registering Chinese or Russian vaccines for emergency use – regardless of the capacity of their regulatory authorities. 

And regardless of regulatory status, China and Russia have taken advantage of the three-month interval between the start of vaccine drives in wealthy countries and the launch of the COVAX facility’s global vaccine distribution effort in lower and middle-income countries, beginning just this past week in Ghana, Cote D’Ivoire and Nigeria.

COVAX Enters The Picture 

Now that COVAX has finally started the first allocations, with the aim to deliver some 2 bllion vaccines in 2021, it may soon eclipse the individual bilateral efforts of China and Russia. Or will it? 

In fact,  COVAX is only likely to reach about 20% of the populations of countries that have joined the facility by the end of the year.  So given the global vaccine thirst, Russian and Chinese vaccines will likely continue to find willing markets, at least in the near-term.

If the Russian Sputnik is finally approved by the EMA – the doors to much wider distribution in Europe and elsewhere will open much wider – particularly in light of the vaccine’s affordable US$ 10 price tag per dose. 

However, China appears unlikely to submit its Sinopharm and Sinovac vaccines to the EMA – or to any other strict western regulatory agency for review and approval.  

So what remains to be seen, against the landscape of unmet demands as well as enormous political pressures, is how WHO will handle the delicate balance of science and politics that could surround the review of the Chinese vaccines’ efficacy for a WHO Emergency Use Listing.

Image Credits: TellZimbabwe/Twitter, GovernmentZA/Flickr, CGTN, Flickr: Francis Kokoroko/UNICEF, the foreign photographer/Flickr.

Police in South Africa seized hundreds of fake COVID-19 vaccines and make several arrests in November, 2020, following a global alert by INTERPOL – leading to the recent arrest in China of the global trafficking ring.

LYON, France – Chinese police have successfully identified a network selling counterfeit COVID-19 vaccines as far away as Africa, raiding the manufacturing premises, arresting some 80 suspects, and seizing more than 3,000 fake vaccines on the scene, according to  the global INTERPOL agency [International Criminal Police Organization]. The investigation was supported and facilitated by INTERPOL’s Illicit Goods and Global Health (IGGH) Programme.

The China-South Africa trafficking ring, the first confirmed instance of fake vaccine smuggling across continents, was first identified in a February 2021 Health Policy Watch report of the exclusive investigation by the South African journal, Bhekisisa, “Little Vials, Big Crime, Criminals Primed For Onslaught on Africa’s Vaccines.

The story warned of the risks of organized crime flooding Africa and other markets with fake COVID-19 vaccines – and cited the case of 2,400 fake vaccine doses imported from China, and discovered in a warehouse outside of Johannesburg’s OR Tambo airport, by South African authorities in November 2020.

As Interpol told Bhekisisa, the “vaccines” had been advertised for sale on a Chinese social media app, WeChat, and had been imported from Singapore as “cosmetic injections”.  South African authorities arrested three Chinese and a Zambian national in connection with the counterfeit goods seizure.

Fake vaccine vials seized by South African police in November 2020, as a result of INTERPOL warnings, leading to the recent arrests in China of the trafficking ring.

“This is only the tip of the iceberg when it comes to COVID-19 vaccine related crime,” Jürgen Stock, the agency’s secretary general, noted in the agency’s most recent statement on Wednesday, March 3, on the arrests in China of the traffickers.

In addition to the arrests in South Africa and China, INTERPOL is also receiving additional reports of fake vaccine distribution and scam attempts targeting health bodies, such as nursing homes, the agency said in its statement.

Read the Interpol statement on the arrests and follow-up investigation here:

Image Credits: Interpol , INTERPOL.

The Brazilian state of Acre declared a state of emergency, facing rising COVID cases, a dengue epidemic, and flooding.

NEW YORK CITY – Although North America is experiencing an overall decline in new COVID-19 cases and deaths, Brazil and other localized hotspots in South America are experiencing a dramatic spike in infection and hospitalization rates, said WHO officials in the region’s Washington DC-based Americas office. 

In a Wednesday briefing, Pan American Health Organization (PAHO) director Dr. Carissa F. Etienne expressed particular concern regarding countries and areas in the Amazon Basin. “The Brazilian state of Acre has just declared a state of emergency due to a deadly combination of COVID-19 infections, a dengue epidemic, and flooding in several cities,” she said. 

“Nearly 94% of [Acre’s] ICU is occupied and the health system is collapsing as more and more patients require hospitalization.” 

Her comments followed an outspoken interview in the Guardian by Duke University neuroscientist Miguel Nicolelis, who called Brazil a “breeding ground for this virus” due to its lack of effective control of the pandemic. 

“If you allow the virus to proliferate at the levels it is currently proliferating here, you open the door to the occurrence of new mutations and the appearance of even more lethal variants,” said Nicolelis, complaining of the government’s lack of direction in controlling cases. 

As of 3 March, Brazil reports 10, 587, 001 confirmed cases of COVID-19 with 255,720 deaths. 

With Second Wave of Pandemic in Brazil, People Cannot Remain Complacent

Nicolelis, who has been self-confined to an apartment in São Paulo for most of the pandemic, called Brazil’s response a “domestic tragedy”. The failures of the far-right  president Jair Bolsonaro to implement effective prevention measures, such as masking and social distancing,  and more recently, a vaccination campaign, will impact the country until late 2020, Nicolelis said. 


Speaking at the PAHO briefing, incident manager Sylvain Aldighieri said:  “Brazil at this point in time is confronting a second wave of the pandemic, which is nationwide. This is impacting their health services, including ICU use – the rate of occupancy of beds in ICUs,” said 

Algieri also stressed the impact the virus has on the health supply chain, given the oxygen and access to special medicines needed to those who are in the ICU. 

The ongoing situation in Brazil only serves to remind us that remaining complacent during the COVID-19 pandemic can result in immeasurable loss of life. 

Etienne called on several lessons to guide the world moving forward in coming months. “As we prepare for the next crisis, first, our COVID-19 response has been strongest when it has been guided by data and science. When we use policies in data and science, we save lives.” 

“Second, public health is a global concern. COVID-19 showed us that a deadly virus that emerges halfway around the world can be a threat to anyone, anywhere. Third, access to quality health care should be universal. Where we live or how much money you have should not determine whether you live or die from COVID-19, or any disease. ”

Image Credits: IMF/ Raphael Alves.

Government officials in Nigeria receive 3.92 million doses of the Oxford/AstraZeneca vaccine at the international airport in Abuja on Tuesday

IBADAN – Nigeria has received the largest single shipment of COVID-19 vaccines from the WHO global COVAX initiative to date – with initial delivery of some 3.92 million doses of the Oxford/AstraZeneca vaccines out of a total of 16 million doses that have been allocated to the country through the platform for the first phase of distribution. 

But the fact that Nigeria, a country of 201 million people – will only receive some 16 million vaccine doses through the global platform – enough to vaccinate roughly 4% of the population in the first stages – highlights the huge discrepancy between the aims of the global initiative and reality.

Even so, the delivery of the first packages on Tuesday allowed Nigerian government officials to breathe a sigh of relief – after mounting pressure from media and the Nigerian public – to produce a timeline for the vaccine rollout.

In January, the country experienced its biggest surge to date of COVID-19 cases to date, peaking at the end of the month. Cases have dropped sharply since then, however, with a total of 1,923 deaths to date, and eight new deaths on Tuesday.

Dr Walter Kazadi Mulombo, WHO Representative in Nigeria, witnessed the arrival of the vaccines.

Said Dr Walter Kazadi Mulombo, WHO Representative in Nigeria: “Vaccines are a critical new tool in the battle against COVID-19; therefore, this is a step in the right direction. These vaccines have undergone rigorous regulatory processes at global and country level and have been deemed safe and effective.” 

According to data released by COVAX, only India and Pakistan are receiving more COVID-19 vaccine doses from COVAX than Nigeria – and it was not surprising that Nigeria received the largest doses from the platform shipped yet. 

About 15 minutes before noon, an Emirates Air Boeing 777-300ER, landed at  the Nnamdi Azikiwe International Airport, in Nigeria’s capital city of Abuja with doses of the vaccine produced by the Serum Institute in India. The first consignment package was officially received by the Chair of the Presidential Taskforce on COVID-19, Boss Mustapha. Mustapha then handed over the package to the country’s Health minister, Dr. Osagie Ehanire, who presented it to the National Agency for Food and Drug Administration and Control (NAFDAC). 

On Friday, a vaccination event will be held at the National Hospital Abuja’s COVID-19 treatment centre—the first site for the commencement of vaccination of frontline health workers and support staff.

Nigeria Relying on African Union Platform For More Vaccines
A banner at the airport welcomed guests to the reception ceremony.

While the COVAX deliveries to Nigeria remain woefully short of needs, the country is relying on the African Union’s African Vaccination Acquisition Task Team (AVATT) platform to secure more doses for the country. The AU has pre-ordered over 700 million doses of vaccine for the continent’s member states in collaboration with Africa Centres for Disease Control.

Earlier in February 2021, Ehanire projected that Nigeria will be able to secure vaccine doses for about 45% of its citizens in 2021 – through acquisition of some 42 million more doses of the AstraZeneca COVID-19 vaccine through the AVATT platform.  

“Nigeria subscribes to this whole-of-Africa approach, that strives to ensure that we are safe and our neighbours are safe,” Ehanire told a press briefing. “We shall be offered over 42 million doses by AVATT. If all the projected vaccines are supplied, we estimate we should have covered over 45 per cent of the population.” 

In addition to COVAX and AVATT, however, the health minister also revealed Nigeria is holding bilateral negotiations aimed at securing doses of Sputnik V vaccine produced by Russia’s Gamaleya, as well as doses of COVAXIN, India’s first indigenous COVID-19 vaccine, which has just released interim Phase 3 results.

In a statement, the World Health Organization (WHO) described the arrival of doses of vaccine in Nigeria as “a historic step towards the goal to ensure equitable distribution of COVID-19 vaccines globally, in what will be the largest vaccine procurement and supply operation in history”.

Through the COVAX Facility, about 90 million doses of COVID-19 vaccines are expected to be delivered to Sub-Saharan Africa in the first quarter of 2021. The facility is expected to provide up to 600 million doses to the region by the end of 2021 thus vaccination of 20% of its population. The COVAX Facility, a joint initiative of the WHO, Gavi the Vaccine Alliance, and other global health groups, aims to deliver at least 2 billion doses of COVID-19 vaccines globally by the end of 2021.

Confusion on Eligibility for Vaccine 

At the same time that the first doses were being received, however, there was confusion on who really qualifies to get the vaccine first of all. 

On Monday evening, Tolu Ogunlesi, Special Assistant to President Buhari on Digital and New Media, affirmed in a  Tweet that the phases for vaccine rollout in Nigeria are: frontline health workers and strategic leadership, older people, with priority for those with comorbidities; individuals aged 18 to 49 with comorbidities and the rest of eligible population (i.e. 18-49 without comorbidities).

But just a few hours before the arrival of the vaccines in Abuja, the National Primary Health Care Development Agency (NPHCDA), which is responsible for vaccine campaigns, released a link to a COVID-19 vaccination e-registration website which suggested that any Nigerian can register and book COVID-19 vaccination appointments right away – irrespective of their age or medical background.  

The launch of the platform has resulted in confusion including a rebuke from the Nigerian Medical Association (NMA) the umbrella body of medical doctors in Nigeria.

NMA President, Professor Innocent Uja, said the move would amount to a violation of the agreement the government previously made to vaccinate frontline workers before others.

“It means it will violate the issue of frontliners first,” he said adding, “maybe they want to see the depth of acceptability of the vaccine.” 

Later, Dr. Faisal Shuaib, CEO of the NPHCDA, expressed confidence in the ability of his agency to deliver the vaccines to targeted groups first – as well as ensure cold chain storage of the vaccines. 

“We have a robust cold chain system that can store all types of COVID-19 vaccine in accordance with the required temperature. We are therefore confident that we will have a very effective roll-out of the vaccine, starting with our critical healthcare workers, who are in the frontline in providing the care we all need,” Shuaib said.

Ray of Hope

In spite of the confusion regarding registration for vaccination, Peter Hawkins, UNICEF Nigeria Country Representative, said that with the arrival of vaccines, the path to recovery for Nigerians can finally begin. 

“The only way out of this crisis is to ensure that vaccinations are available to all,” Hawkins said.

Thabani Maphosa, Managing Director for Country Programmes at Gavi, the Vaccine Alliance, said the focus now should be on ensuring the vaccines are made available to the people most at risk, as soon as possible, and to ensuring that routine immunization services for other life-threatening infections are also delivered to avoid other disease outbreaks.

Even though experts are pessimistic about Nigeria being able to reach the 70% levels of vaccine coverage that experts say would be required to reach herd immunity, Mustapha was optimistic.  He said the country could achieve herd immunity within a little more than a year:

“I therefore urge all Nigerians to continue to comply with the non-pharmaceutical measures, even as we roll out the vaccines administration plan, which is expected to reach 70 percent of our population between 2021 and 2022.” 

Image Credits: Twitter , WHO AFRO.

older
AstraZeneca vaccine found effective in reducing COVID-19 in older adults

The AstraZeneca/Oxford vaccine can reduce severe COVID-19 in older adults by up to 70%, says a new Public Health England (PHE) study – which offers the first real-world evidence of the effectiveness of the vaccine in preventing serious disease among older adults, following its approval by UK and European regulatory agencies. 

Findings about the efficacy of the AstraZeneca/Oxford vaccine in among older people are critically important for countries not only in Europe but also in Asia and Africa – where the vaccine’s efficacy has been a matter of debate – even as it starts to be rolled out massively through the WHO co-sponsored COVAX global vaccine initiative.  

Meanwhile, an indigenous Indian COVID vaccine showed an “efficacy trend of 81%”  in a Phase 3 trial involving some 25,800 people, according to a statement Wednesday by the Indian Council of Medical Research.  The “interim analysis” involved some 6,000 participants, including mostly older people and people who had chronic diseases.

Among the 46 participants who contracted COVID, 36 had been given a placebo, said Bharat Biotech, the company that co-developed the vaccine.  

“The interim efficacy trend of 81%, analyzed as per the protocol approved by the DCGI, puts it at par with other global front-runner vaccines,” stated the ICMR press release.  It quoted ICMR’s director general as saying: “The bench-to-bedside journey of [a] completely indigenous COVID-19 vaccine in less than 8 months’ time … is a testament to India’s emergence as a global vaccine superpower.” 

UK Findings Relevant For Europe, Asia and Africa – Where AstraZeneca’s Efficacy had been Questioned 
AstraZeneca’s COVID vaccine will be the bulk of the COVAX products shipped to Africa

With regards to the AstraZeneca vaccine, preliminary findings from the Public Health England study, pre-released Monday in draft form, should provide welcome reassurance to other national health authorities rolling out the vaccine. 

“The effect of a single dose of the ChAdOx1 [AstraZeneca/Oxford] vaccine against symptomatic disease was approximately 60-75% and there was again an additional protective effect against hospitalisation, though it is too early to assess the effect and mortality,” state the study’s authors. 

Among older people aged 70 and above, who received the first dose of the AstraZeneca/Oxford vaccine, effectiveness against symptomatic disease was approximately 60-75% – although the paper did not assess the effectiveness of the full two-dose vaccine regimen. 

The study also looked at impacts from the Pfizer vaccine, finding that one vaccine dose prevented up to 70% of symptomatic disease. For two Pfizer doses, effectiveness was up to 90% among older adults. 

PHE Study Should Build AstraZeneca Vaccine Confidence – In Europe as well as Asia & Africa 
COVID-19 vaccination of elderly in India

While the Pfizer vaccine has already demonstrated its effectiveness in reducing serious illness and mortality among older adults in a number of large Israeli studies, the UK data represents the first real-world findings on the efficacy of the AstraZeneca/Oxford vaccine since the vaccine was approved by regulators in the UK as well as the European Medicines Agency. 

A number of European governments had last month recommended against using the AstraZeneca/Oxford vaccine among older age people – due to what authorities then described as a lack of evidence following approval by the European Medicines Agency. 

French President Emmanuel Macron even went so far to describe the vaccine as “quasi-ineffective for people over 65”. The Swiss regulatory agency, Swissmedic refused to approve the vaccine altogether, saying that the data so far was “not yet sufficient to permit authorization.’’ 

On 10 February, however, the World Health Organization recommended the vaccine’s use across all age groups. The WHO expert group expressed  “high confidence” efficacy among the +65 age group. The experts noted that even though the numbers of older people involved in AstraZeneca’s Phase 3 studies had been small – their immune response had been almost as good as that of younger people. 

In Africa, the Oxford/Astra Zeneca vaccine is set to be a cornerstone of the first phase rollout of COVID vaccine deliveries by the WHO co-sponsored COVAX vaccine facility initiative. The first shipments of AstraZeneca vaccines  reached Ghana and the Ivory Coast on Monday, followed by Nigeria later this week.   

In India, the AstraZeneca vaccine is a cornerstone of the national campaign – along with the Covaxin indigenous vaccine.

Study Shows Vaccines Are Effective Against so-Called British SARS-CoV2 Variants 

The PHE results also are reassuring insofar as they reflect the efficacy of both Pfizer and AstraZeneca/Oxford vaccines against the so-called British (B.117) variant that has now become dominant in the country – also spreading widely across Europe and beyond.  

The study results do not, however, provide evidence about the vaccine’s efficacy against another variant that has become a major concern due to its apparently greater ability to elude the body’s immune response – and that is the B.1351 variant first identified in South Africa. 

Earlier findings from a small South African study found that the AstraZeneca/Oxford vaccine was ineffective in preventing mild and moderate disease among younger age groups – prompting the country to rapidly shift its vaccine campaign from AstraZeneca/Oxford to Johnson & Johnson – which just received US FDA regulatory approval. 

The UK was the first country to implement a COVID-19 vaccination campaign following the approval of the Pfizer-BioNtech messenger RNA (mRNA) vaccine, BNT162b2. The UK was also the first high-income country to approve and begin rolling out the AstraZeneca adenovirus-vector vaccine, ChAdOx1 nCOV-19.  

“This adds to growing evidence showing that the vaccines are working to reduce infections and save lives. “While there remains much more data to follow, this is encouraging and we are increasingly confident that vaccines are making a real difference,” said Mary Ramsay, PHE Head of Immunisation, in a comment on the study. 

Pfizer Vaccine Also Offers High Levels of Protection Against Asymptomatic COVID  
Vaccination of the UK’s healthcare workers and elderly began in December 2020

In another UK study among healthcare workers, the Pfizer vaccine was shown to provide high levels of protection against any form of infection – preventing up to 85% of those immunized  from developing asymptomatic forms of COVID-19  as well.  

The study is important because it shows that the vaccines can also help stop the wider cycle of COVID transmission, as well as preventing symptomatic and serious disease. 

Healthcare workers in the study are regularly tested for coronavirus every 2 weeks, whether or not they have symptoms. Early data from the PHE SIREN study showed a single dose of the Pfizer vaccine had efficacy of up to 70% in preventing asymptomatic disease, rising up to 85% following the second dose. 

Even so, Ramsay cautioned: “It is important to remember that protection is not complete and we don’t yet know how much these vaccines will reduce the risk of you passing COVID-19 onto others. Even if you have been vaccinated, it is really important that you continue to act like you have the virus, practise good hand hygiene and stay at home.”

Image Credits: Gilbert Mercier/Flickr, Tim Reckman/Flickr, BNarayanpatna/Twitter, Eric Fiegl-Ding/Twitter.