SA adviser proposes Astra shot test for severe Covid

A top adviser to South Africa’s government has proposed that the country administer AstraZeneca Plc’s coronavirus vaccine to 100 000 people as a way to determine whether it’s effective in curbing hospitalisation rates.

Early data of a small phase trial, released shortly after the first vaccines arrived in the country earlier this month, showed that AstraZeneca’s shot has limited efficacy against mild disease caused by the B.1.351 variant now dominant in South Africa. That prompted the government to suspend plans to give it to health workers, some of whom have since received Johnson & Johnson’s vaccine.

The study didn’t determine whether the AstraZeneca inoculation protects against severe Covid-19 cases and deaths because most participants were young healthy adults. South Africa ordered 1.5 million doses of the shot developed by AstraZeneca and the University of Oxford and produced by the Serum Institute of India Ltd.

“If it prevents hospitalisation and severe disease, then we’ll use it. The trouble is now we don’t know,” said Salim Abdool Karim, who co-chairs the health minister’s ministerial advisory committee on Covid-19. “Ideally, I’d like AstraZeneca to give us the data, but I don’t think we should expect that.”

By giving it to some of the country’s estimated 1.3 million frontline health workers and to others — such as essential workers, the elderly and those with co-morbidities or living in congregate settings that fall into South Africa’s second vaccination phase — efficacy could then be measured in the local setting, he said.

“I propose what is called a stepped roll-out strategy,” Karim said. “We give it to 100 000 people and we monitor what their hospitalisation rate is. If it’s below the threshold, then yes, it’s fine, go ahead and give all one-and-a-half million doses.”

Such a test would have to be voluntary and most likely be limited to people between 45 and 65 years old, he said. It could be rolled out in one or two provinces alongside J&J’s shot. Still, with AstraZeneca recommending a 120-day gap between its two doses, results from this home-grown study would take time.

Karim’s suggestion comes after a lead researcher of the initial South African AstraZeneca trial urged authorities to continue using the shot. Namibia, which neighbors South Africa, plans to go ahead with its AstraZeneca roll-out.