SA may still swap - or sell - its one million AstraZeneca vaccines, Mkhize says

Business Insider SA
South Africa AstraZeneca vaccine
(Photo by Karwai Tang/Getty Images)
  • South Africa has paid around R120 million for 1.5 million doses of the AstraZeneca vaccine, which is not sufficiently effective against the 501Y.V2 variant.
  • With the variant accounting for 90% of South Africa’s caseload and the vaccine’s expiry date looming, the department of health is weighing up what to do with the AstraZeneca doses.
  • Government says countries have already asked if they can buy South Africa’s AstraZeneca batch.
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South Africa is considering selling or swapping its stash of AstraZeneca vaccines to mitigate wasteful expenditure.

The vaccine, developed in partnership with Oxford University and produced by the Serum Institute of India (SII), has been shown to be less effective in preventing mild and moderate symptoms associated with the 501Y.V2 variant.

Recent clinical trials of the AstraZeneca jab’s ability to combat symptoms associated with this particular variant, which was first detected in South African samples gathered in August 2020, have revealed a greatly diminished efficacy.

The study, overseen by Professor Shabir Madhi of the University of the Witwatersrand (Wits), showed that while the vaccine had suitable efficacy in combatting the original coronavirus, against the mutated 501Y.V2 variant, efficacy had been reduced to as little as 10%.

It’s estimated that 90% of active infections in South Africa are of the 501Y.V2 variant.

The first phase of South Africa’s vaccine rollout, which focused extensively on acquiring and administering 1.5 million doses of the AstraZeneca vaccine – one million of which has already been delivered – has been put on temporary hold.

While the results of the trial come as a disappointment to South Africans, Health Minister Zweli Mkhize has assured that the government’s phased rollout would continue as planned, just with other vaccines.

The first batch of Johnson & Johnson’s vaccines, which have shown an 85% efficacy against serious disease associated with 501Y.V2, is expected to arrive in South Africa next week and will be administered to frontline healthcare workers as a priority.

In the meantime, South Africa is stuck with a million AstraZeneca doses which are quickly reaching their expiry date. Due to limited data studies, these vaccines are only rated for six months, and the expiry date of South Africa’s doses is just over two months away in April. While further studies can allow manufacturers to extend the current expiry date, Mkhize says government is figuring out ways in which to use the AstraZeneca doses before April so that the money spent on buying the vaccines is not considered “wasteful” or “fruitless” expenditure.

“Our scientist will continue with further deliberations on the AstraZeneca vaccine use in South Africa and, depending on that advice, the vaccine will be swapped before the expiry date,” explained Mkhize in detailing ongoing acquisition negotiations with other vaccine developers like Moderna and Pfizer.

“By exchanging unused vaccines before their expiry date, the department of health will ensure that the acquired AstraZeneca vaccines do not become wasteful and fruitless expenditure.”

It’s estimated that South Africa spent R120 million – or $5.25 (R77) per jab – on procuring the first 1.5 million AstraZeneca doses via the SII.

With the AstraZeneca rollout effectively on-hold in South Africa and the vaccine’s expiry date drawing ever nearer, Mkhize noted that the country was left with three options.

AstraZeneca doses can be put to use in broader clinical trials in South Africa to gain a clearer view of the vaccine’s efficacy and could, in theory, be used in conjunction with other vaccines to offer better protection.

“We may need to look at combinations of the [AstraZeneca] vaccine with other vaccines, which may in fact synergistically give a very good response,” explained Barry Schoub, Chair of the Ministerial Advisory Committee on Covid-19 vaccines.

If, however, further trials only serve to reiterate the vaccine’s diminished efficacy, even through the pairing strategy proposed by Schoub, South Africa could be stuck with millions of expired vaccines.

To prevent this, Mkhize has been in contact with countries who are looking to acquire more AstraZeneca vaccines. These are countries which are not dominated by the 501Y.V2 variant.

In turn, these countries may have an oversupply of other vaccines which have a greater efficacy against the 501Y.V2 variant and, in that case, may be willing trade or swap doses for South Africa’s AstraZeneca stash. Discussions with the SII also propose swapping out an expired batch for new vaccines, if AstraZeneca doses are determined to form part of South Africa's vaccine rollout. 

“First, our scientists must tell us what we must do with it [the AstraZeneca vaccine] and can we use it in the time that’s available before it expires and, if not, can we swap it with anyone else,” said Mkhize.

“And we can swap it… we have discussed with Covax, we have discussed with Avat [the African Vaccine Acquisition Task Team], so we’ll see what’s happening. Everyone’s looking at what can be done, because in the rest of the world this is a very well-used vaccine.”

Another option which Mkhize is mulling over is the outright sale of the AstraZeneca doses. Mkhize says countries have already asked if they can buy South Africa’s AstraZeneca batch.

“Yesterday [9 February] I was discussing with the secretary of health in the UK [Matt Hancock] and there are already some countries that are saying we must sell it to them,” said Mkhize.

“All I can say to the public is that we will not waste the money. We’re waiting for the experts to give us advice and there will not be any money wasted… that I can assure you.”

The department was approached for comment regarding the costs associated with the resale – and if South Africa would need to suffer a loss or could break even – but no reply was offered.

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