23 ms·

South Africa suspends rollout of Oxford-AstraZeneca coronavirus vaccine

294 points by samizdis 6y ago

meekrohprocess 6y ago
So does this mean that the mRNA vaccines are probably going to be like flu vaccines, where they have to predict which variant will dominate each season and adjust the doses accordingly? Can other options like the adenovirus-based or J&J ones be expected to cover a broader spectrum of mutants? (And why are so many people downvoting these questions? I'm genuinely curious, and I really tried not to offend any sensibilities, but did I say something wrong? Oh god why do people always hate me so much? Is it possible to say or do anything right anymore? Maybe it's time to quit social media...I'm out, y'all are cruel.)
- stirlo 6y ago
  The Oxford vaccine which was paused is not mRNA it is adenovirus. GSK has recently announced plans to produce a multi-valent mRNA vaccine for distribution next year so mRNA is not necessarily limited to a single variant. https://www.gsk.com/en-gb/media/press-releases/gsk-and-curevac-to-develop-next-generation-mrna-covid-19-vaccines/ https://www.gsk.com/en-gb/media/press-releases/gsk-and-curev...
  - bedobi 6y ago
    Thanks for sharing this piece of info, I had no idea, seems like great news!
  - Closi 6y ago
    It’s worth noting that the Oxford vaccine can be quickly altered too, as it’s based on a platform technology. They suspect a version with variants can be in production and being rolled out by August.
    - mxcrossb 6y ago
      I wonder though if the really good trial data of the MRNA ones mean they’ll be able to do just safety trials (nothing on effectiveness) in the future, while the Oxford collaboration will be closer scrutinized.
- deleted 6y ago
  [deleted]
- MattGaiser 6y ago
  The Oxford one is not an mRNA vaccine.
- e_y_ 6y ago
  It's not clear how much it'll continue to mutate. Since this is a brand new virus, it's had 100M+ people so far to experiment on, and clearly the early versions were not as efficient at spreading as the newer variants. Once we have herd immunity through vaccination (since natural immunity is rather hit-or-miss) I would hope the rate of mutations slows down significantly.
  - dehrmann 6y ago
    One thing that will be interesting, and rather unusual, is we have different approaches to vaccines being deployed within months of each other.
  - cortic 6y ago
    Logically i would have thought the opposite would have happened, since natural immunity is mostly to the nucleus protein (difficult to mutate), and vaccine immunity is based on the spike protein (easy to mutate). I would have thought any partial vaccine immunity would increase mutation rate. Also been worried that mass vaccinations might short-circuit the mutate to less severe variant process that happens in nature. By taking the advantage away from the current spike configuration we might give an advantage to a worse variant that would naturally have died out (out compete by its parent variant).. Disclaimer; I'm more qualified to write a science fiction novelette on this theory than a medical paper, so take all this with a big grain of salt.
    - e_y_ 6y ago
      It's probably too early to say if the vaccines have had any effect on the mutation rate, since wide-scale vaccination has only just started ramping up. You'd think it'd be easier to say whether people are getting reinfected after catching COVID the first time, but the testing data is sparse enough that there doesn't seem to be any confirmation on whether it's widespread or just isolated cases. Most notably in Manaus, Brazil, where one of the new variants has been spreading. I'm definitely not qualified to make anything other than wild guesses on this subject, but everything I've read suggests that scientists are scratching their heads as well. Conventional wisdom is that the spike is the easiest to target, so whether the human immune system picking the N protein is a mistake or brilliant move seems to be up in the air. Some reading: https://www.nature.com/articles/s41577-020-00480-0 https://www.nature.com/articles/s41577-020-00480-0 Mutating to a less severe variant: Given that SARS-CoV-2 already has delayed symptoms and a high percentage being asymptomatic cases, I'm not sure there's much pressure to make it milder. Also the overall spike design is what gives SARS-CoV-2 its higher infectiousness compared to the original SARS, so one would hope that mutations to it (to avoid existing antibodies) would tend to make things less effective, although unluckily the virus has been discovering some new configurations that are both more infectious and also less protected against by the existing vaccines (especially the 60-70% ones). Paper on infectivity of variants: https://www.cell.com/cell/pdf/S0092-8674%2820%2930877-1.pdf https://www.cell.com/cell/pdf/S0092-8674%2820%2930877-1.pdf
- jfoster 6y ago
  I think you're probably being downvoted (note: not by me) because the way your comment is written makes it sound a bit like you're assuming the Oxford-AstraZeneca vaccine is an mRNA vaccine when it's not.
  - Closi 6y ago
    The good news though is that it does have some sort of platform technology that means it can be quickly altered.
    - bencollier49 6y ago
      They said they'd have a new one by Autumn...
    - corty 6y ago
      Problem is, the platform is a vector virus that causes immunity against the vector. So while you can create a new vaccine for the variants, you either cannot reuse the vector or you can't vaccinate old-variant-vaccinated people against the new variant. The body would kill the vector too quickly, limiting exposure to the payload too much. In that respect mRNA vaccines or live vaccines have an advantage.
      - chimprich 6y ago
        I don't think that's correct (but I'm willing to be corrected by an expert). I believe the immune response is mainly triggered by the spike protein. If the spike protein of the variant is different enough to cause a degree of vaccine escape, then the spike protein of the vaccine should be different enough to not get immediately cleared from the body. This is based on what I've understood from listening to interviews with prof. Sarah Gilbert, head of the Oxford team.
        valarauko 6y ago
        The parent is referring to a valid concern that with repeated doses (like from a subsequent booster), the mild antigenicity of the vector virus itself can be a problem. The Oxford vaccine uses a Chimpanzee adenovirus, which can infect human cells but not replicate inside them. There after delivering the vaccine payload, over time the protein coat of the vector will be chopped up and presented to the immune system, as are all cellular proteins. As you are unlikely to have been previously infected with a chimp adenovirus, it should elicit not much of an immune response, but the body will see it as foreign and start raising antibodies against the adenovirus proteins (adenoviruses have their own versions of "spike" proteins, among others). Of course, we would expect most of the immune response would be against the corona spike payload, but some fraction would inevitably be for the adenovirus as well. When you get your second dose, you already have some antibodies against chimp adenovirus, which will potentially destroy some of the vector before it has a chance to be taken up by your cells. Third or fourth booster shots against coronavirus variants using the same chimp adenovirus vector would trigger worse reactions, destroying some portion of the vector before the payload can be delivered. The Russian Sputnik vaccine tries to reduce this likelihood by using different adenovirus vectors for each dose.
- peter_retief 6y ago
  I up voted you, the voting system on HN is a mystery to me.
  - peter_retief 6y ago
    I got downvoted for upvoting you, the plot thickens...
    - tempestn 6y ago
      Your comment appeared to be complaining about downvotes (as does this one). Even if not that though, it's at least commenting about voting, which the guidelines discourage. > Please don't comment about the voting on comments. It never does any good, and it makes boring reading. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html I expect a comment more likely to be well received would be something discussing and/or reinforcing the specific points the parent made. In that context it would probably be fine to say something like, "I don't think you should have been downvoted." But without context or reasoning it doesn't have much substance.
      - peter_retief 6y ago
        "I don't think you should have been downvoted." The virus is in the same family as some of the common cold virus'. Coronaviruses replicate their RNA genomes using enzymes called RNA-dependent RNA polymerases. (RNA is relevant) https://www.newscientist.com/term/coronavirus/#ixzz6lrn6xyYr https://www.newscientist.com/term/coronavirus/#ixzz6lrn6xyYr
- hedora 6y ago
  There seems to be a group of people that systematically downvote anything that suggests a vaccine might not be a panacea. They also like to downvote math + statistics regarding Covid. Comments like yours tend to bounce around zero with lots of votes in both directions. Not sure what the deal is with the big silent anti-science crowd on HN. They don’t seem to be the majority. I just upvote anything that’s gray and not violating HN’s community guidelines. shrug
- bumbada 6y ago
  I agree that people on HN downvote reasonable opinions and questions that do not go against HN guidelines. It is the reddit effect. At first Reddit was like HN populated with highly educated people. As it got more and more users it democratized: The vote of a know-it-all 16 years old is the same as the one from a PhD in the field. In fact there are thousands of non experts for each expert, so they always win in a public space. We add to that that we are using text, we do not carry intonation and other emotional information and lots of people will misunderstand whatever you say. So the more popular a place like this becomes, the most degraded it becomes. Do not take that seriously. I had great karma when I posted my real identity years ago and now lots of my comments are downvoted too, and I am the same person. I did not care then and not care now.
- powerapple 6y ago
  What you are saying might turn out to be true. There was a report on how Chinese vaccine was good in some countries but not doing well in Brazil, it may be related to mutation as well. If the virus mutates fast because countries are not controlling the spread well enough, current vaccine may be less and less effective in time. I am sure the producers are updating their vaccines in meantime. It will take time and the production will take time as well. Unfortunately mRNA vaccines will not be a universal solution for all countries, it will only be applicable for a few rich countries.
  - Ulrich2 6y ago
    Good news: Curevac needs only a standard refrigerator for storage. Hopefully it works. Also, Biontech is working on a V2.0 with less cooling required.
- sjg007 6y ago
  Yes most likely we will have a yearly vaccine or cocktail of vaccines for covid. Not sure if it will be mRNA specifically but most likely it will be. The flu shot for example isn't an mRNA vaccine but rather the strain they think will be dominate. Regardless, we will be wearing masks and social distancing for a long time (years) to come.
  - koheripbal 6y ago
    The moment we discovered that numerous other species are transmitting the illness - made yearly shot inevitable.
    - sjg007 6y ago
      We've know this is true for generations...
  - ghaff 6y ago
    Boosters are probably inevitable but once people are widely vaccinated, most are going to get on with their lives in a largely pre-pandemic way.
    - ls612 6y ago
      I feel like it is optimistic to think that we will be allowed to live our lives the pre pandemic way. These new strains will be trotted out as a good excuse to keep these restrictions around much longer.
      - ghaff 6y ago
        IMO no government in the US is going to indefinitely ban large indoor gatherings, indoor dining, bars, schools/universities as usual, physical conferences, etc. And any "rules" notwithstanding I fully expect that when summer rolls around and a lot of people, especially the more vulnerable, have been vaccinated whether it's imperfectly or not are going to back to beaches, bars, concerts, etc. At some point, it's just another disease of which there are many that sometimes kills people.
senectus1 6y ago
so, because it it only protects people from dying... its not good enough? What fresh hell in standards is this? If we could turn Covid into "common cold" level illness through vaccines THEN DO IT!
- deleted 6y ago
  [deleted]
- stirlo 6y ago
  The dominant strain of Covid in South Africa is different and existing vaccines are far less effective at countering due to changes in the spike protein which these vaccines target. The effectiveness against this strain is not 60-80% as it is against the other strains but below 50% which was the standard the WHO chose as a acceptable vaccine. South Africa has limited health resources and spending them rolling out an ineffective vaccine when they have orders for the Johnson and Johnson one coming next month doesn't make sense.
  - The_rationalist 6y ago
    Saving lifes for a month doesn't make sense?
    - Infinitesimus 6y ago
      Depends on the cost. If they use resources to roll out am ineffective vaccine now to the detriment of future attempts to roll out effective options, waiting might be a better choice. Also, there is enough vaccine skepticism in the world today and I'm not sure vast distribution of something with questionable efficacy is necessarily a good idea.
    - babesh 6y ago
      Read the comment by Clewza313. The vaccine doesn’t seem to protect the people in the study (young people). Young people don’t tend to die from covid. They don’t know if it would work on older people but I would think it wouldn’t either. This doesn’t look like it actually saves lives. The study may be early to really tell but so far there is no evidence that the vaccine works at all against the variant that is widespread in South Africa.
sterlind 6y ago
In my Algorithms in Drug Design class in school, one of the research projects was using docking software to do an alpha/beta search for mutations that would alter protein structure while preserving binding affinity, with the idea of heading off vaccine escape (in this case HIV) by predicting the mutations likely to escape antibody binding. Is anything like that being done with covid? Edit: the Alpha move was to mutate the antibody and the Beta move was to mutate the viral protein iirc.
- yellowcake0 6y ago
  Yes such things are being done, see this paper for example: https://www.biorxiv.org/content/10.1101/2020.12.31.425021v1.full https://www.biorxiv.org/content/10.1101/2020.12.31.425021v1....
- p4coder 6y ago
  Not exactly, but there is this [1] that shows how the binding strength varies with single amino acid change. [1] https://jbloomlab.github.io/SARS-CoV-2-RBD_DMS/ https://jbloomlab.github.io/SARS-CoV-2-RBD_DMS/
- nahuel0x 6y ago
  Check this: https://singularityhub.com/2021/01/19/a-language-ai-is-accurately-predicting-covid-19-escape-mutations/ https://singularityhub.com/2021/01/19/a-language-ai-is-accur...
blintz 6y ago
I am part of the US study for this vaccine. Any ideas on what this could mean for the possibility of an EUA in the US?
- JamisonM 6y ago
  AZ has already said they are waiting until their new US-based trail finishes before even applying. They haven't finished recruiting, 28 days between shots, then (I think) 75 infections in the participants before they will report interim data. It is going to be quite a while.
  - blintz 6y ago
    Finishes?! I was told the study completes in 2 years...
  - justinc8687 6y ago
    I'm also in the AZ study and just spoke to the head doctor of my testing site Friday. They've finished recruitment and likely will have enough cases by the end of this month. BUT...the FDA said they won't consider an EUA until they have at least 2 months of safety data from half the participants. Given that restriction, he expects them to not be able to apply for an EUA until April.
    - tim333 6y ago
      Seems a bit unnecessary to wait for the US data when they could use the same data the UK used, plus we've now given the vaccine to several million.
      - corty 6y ago
        The AZ data is often considered to be somewhat dodgy, e.g. with dosages mixed up, patient groups selectively joined or split up for p-hacking purposes, etc. I can understand the US wanting a proper study under their own oversight.
easytiger 6y ago
Total lunacy. I had hoped SA might not descend into its usual levels of incompetence, misinformation, blame games. They have done this because the batch they received has a 2-3 month expiry life. They do not believe they can give that batch out in that timeframe. They have set up almost literally no infrastructure SAs vaccination plan is to generally beg other countries to do it for them. They already frittered away most of a R500bn IMF loan on absolutely nothing.
reddotX 6y ago
EU will probably follow suit and ban AstraZeneca. in many EU countries is restricted to under 55
- easytiger 6y ago
  Based on fake news and a campaign against it to deflect from EU commission failure around vaccine roll out. I see it is working.
  - hef19898 6y ago
    Yeah, it seems like it. The only real issue the AZ vaccine seems to have is the South African mutation. The other so called "issues", efficiency for elderly, is just fake. Intentionally leaked by the German ministry of health by the looks of it. That claim was debunked, and it still got a hold on things. The press is still pushing it to some degree. Would be interesting to see the motive behind all that. Also funny, the AZ contract is the only one that leaked. And they are by no means the only one to face production ramp up issues. Biontech is getting the opposite reporting in Germany. That is somewhat puzzling. EDIT: The South African strain seems to be a challenge, the Novavax and J&J vaccines are also less effective (source:https://www.theguardian.com/world/2021/jan/30/two-new-covid-vaccines-work-worse-against-south-african-strain https://www.theguardian.com/world/2021/jan/30/two-new-covid-...).
    - _fizz_buzz_ 6y ago
      > The other so called "issues", efficiency for elderly, is just fake. There is good reason to believe it will be efficient on older people, but efficiency for elderly hasn't been proven. > Also funny, the AZ contract is the only one that leaked. It wasn't leaked, the EU and AZ agreed to publish it. And it is also not the only one that was published. The CureVac contract was also published.
      - hef19898 6y ago
        Thr initial claim I am aware of came from a German newspaper, Bild (the Handelsblatt was quick with it as well, not sure which newspaper was first). That claim was "AZ only 8% efficient with patients over 60 (or 65, don't remember that with all the figures thrown around)". That claim was false, as the 8% related to the number of trial patients. That claim came from the German Ministry of Health, "informed circles". Only after that AZ clarified what the 8% really mean. And yes, efficiency is not yet proven. Unproven efficiency is quite a different thing from a claimed 8% efficiency so. I see a real pro Biontech and anti AZ campaign going on in the German media. One that is quite welcome, as it allows politicians to deflect blame. Brexit helps to mud the waters even further. Don't forget, we have elections in Germany this year. As far as I know, the AZ contract is the only one with additional uncensored parts that was published. AZ is in the defensive now. For no real reasons. And over this discussion, in the EU and also in SA it seems, we totally miss the importance of a smooth vaccination campaign. And the lacking preparation thereof.
nevi-me 6y ago
Note: I edited this to fix formatting, and I initially suggested a different link [12], but have removed the suggestion, as the interesting point of the article is still made (the suspension of the specific vaccine). ___ There's some important details not mentioned in the article, which make this more of an emergency than a reader of just the article will notice. Allow me to paint some back story, but the summary is this: - We (our country) got 1 million doses of this vaccine last week, being ill-prepared and flustered to get our act together - These doses expire in April, we do not have a roll-out strategy because politicians played politics (I'll explain below) - We are broke, and the trust between people and gov is diminishing quickly Initial Lockdown (March 2020) Many people were initially positive when our first lockdown started. The President set up a "Solidarity Fund" [0], with initial donations of ~$70m USD (R1 billion) from a few wealthy families in the country. The government 'diverted' funds to the PPE roll out, and the President expressly said that there wouldn't be looting [1] of funds. The government put us in a quasi-martial-law with a committee called the NCCC [2] (name can be found in the link), parts of which have been taken to court, because of arbitrary laws/rules, and a very apparent power-grab by the ruling/governing party. Some of the bizzare things that came out of this NCCC: - A ban on cigarette sales, not substantiated by anything scientific at the time. They lost the court battle, but true to form, are appealing [3]. - Regulations on sales of winter clothes. Arbitrarily defining the details of clothes that can be bought or not, what aisles to be used. It was as ridiculous as talking about crop tops and tights [4]. - Instituting racist policies to only help certain businesses [5]. I feel obliged to say that I'm an African black, and I agree with the sentiment that this was unConstitutional, as we all should enjoy the same rights. The gist of this was that the President said something like "this is a chance to redistribute wealth by only supporting black businesses". The above has been met with criticism, and has eroded trust. PPE Looting/Corruption Now, one only needs to search for "PPE Corruption South Africa" to get stories about articles almost-daily. - Premiers (leaders of provinces) have been implicated or accused - President's spokesperson has been suspended, and has failed to submit her financial interests [6] - As of October 2020, at least $700M USD is under investigation for being looted for PPE [7]. Politically connected people were setting up companies, selling 100ml of sanitisers for up to $3000 USD, all sorts of horrors. Anecdotally, one of the provincial ministers (MEC) of education, has been up in arms against a white-owned/run trade union called Solidariteit, for deciding to build their own techno-university with private funds. The university was to cost ~$20M USD, and has been completed after around 2 years. I mention this, because this MEC's department spent ~$30M USD 'fumigating' schools that were closed during the lockdown. The criticism has been that the virus doesn't last long enough in sufraces to warrant this waste. He is unable to account, trying to use 'processes' to shield himself [8]. Funding The Vaccine Now, back to the vaccine. The SA government is part of the COVAX programme [9]. They 'missed' the deadline to make a deposit twice last year [10]. The Minister of Finance will disagree with this, but for the Solidarity Fund, and other NGOs to step in, is troubling. There have been discussions from our Treasury, to raise taxes to fund the vaccine [11]. This comes in the midst of irresponsible behaviour by our government, that has contributed to the closure of a lot of companies. I need not bore the reader with details, but we are broke, our unemployment is rising (even the Statistics SA are stymied from gathering stats, because they're under-funded). A pause of the vaccine rollout makes medical sense, but given that the doses that we've paid for and received 1 million doses (for a country of 58+million) [12], and have no roll-out plan [13]. So, how is a government that has looted more than enough money to pay for enough doses of the vaccine (less than the $700M USD 'under investigation') to the point of not being able to pay a mere deposit on time, going to fund alternative vaccines? EDIT: Medical aid/insurers talked about sourcing the vaccines for their members, but government and the public at large seemed to initially be against this move. I don't know what's changed, but the private medical insurers are now helping government with administration instead. It's a shame that Africa suffers, while it has the resources to alleviate poverty. If you've read this far, this has been opinions of mine, with some articles to provide context. I'm no reporter. Thanks ___ [0] https://solidarityfund.co.za/ https://solidarityfund.co.za/ [1] I can't find a reference to this anymore, there's just so much noise about the actual looting, that the initial promises are hard to find. I'll update if I find an article or tweet from Presidency. [2] https://www.news24.com/news24/southafrica/news/govts-coronavirus-command-council-not-established-in-terms-of-any-act-ramaphosas-answers-reveal-20200610 https://www.news24.com/news24/southafrica/news/govts-coronav... [3] https://businesstech.co.za/news/lifestyle/459136/governments-tobacco-case-appeal-raises-fears-of-another-cigarette-ban-in-south-africa/ https://businesstech.co.za/news/lifestyle/459136/governments... [4] https://www.sowetanlive.co.za/news/south-africa/2020-05-14-governments-restrictions-on-winter-clothing-elicit-anger/ https://www.sowetanlive.co.za/news/south-africa/2020-05-14-g... [5] https://citizen.co.za/business/2259481/confirmed-guideline-that-government-will-only-help-51-black-owned-companies-is-fake/ https://citizen.co.za/business/2259481/confirmed-guideline-t... [6] https://www.news24.com/news24/southafrica/news/khusela-diko-facing-disciplinary-hearing-after-failure-to-disclose-financial-interests-20210110 https://www.news24.com/news24/southafrica/news/khusela-diko-... [7] https://businesstech.co.za/news/government/442058/r10-5-billion-under-investigation-for-covidpreneur-looting-in-south-africa/ https://businesstech.co.za/news/government/442058/r10-5-bill... [8] https://twitter.com/SundayTimesZA/status/1355806487650689024 https://twitter.com/SundayTimesZA/status/1355806487650689024 [9] https://www.who.int/initiatives/act-accelerator/covax https://www.who.int/initiatives/act-accelerator/covax [10] https://businesstech.co.za/news/trending/457668/south-africa-misses-covax-deadline-to-secure-vaccines/ https://businesstech.co.za/news/trending/457668/south-africa... [11] https://businesstech.co.za/news/government/461548/south-africa-treasury-considers-tax-hike-to-fund-vaccines-report/ https://businesstech.co.za/news/government/461548/south-afri... [12] https://www.dailymaverick.co.za/article/2021-02-08-south-africa-switches-to-jjs-astrazeneca-vaccine-halted/ https://www.dailymaverick.co.za/article/2021-02-08-south-afr... [13] The health minister was asking health-care practitioners on Twitter last week, to register themselves. There's been overall criticism by HPCs that they're in the dark about doses coming in just a week. This is something that should have started last year already. https://www.timeslive.co.za/news/south-africa/2021-02-03-34000-sa-healthcare-workers-register-for-covid-19-vaccines-on-first-day/ https://www.timeslive.co.za/news/south-africa/2021-02-03-340...
ascorbic 6y ago
The important thing to note is that the significance of this study goes beyond the AZ vaccine. Please correct me if I've missed one, but from what I've seen there aren't any other vaccines that have completed similar trials in South Africa. The "good news" about the other vaccines' effectiveness against the variant have been based on in vitro immune response[1], not real-world trials. What would be good to know though is what response the AZ vaccine had in tests similar to the ones performed with other vaccines. [1]And we know the issues with that standard https://xkcd.com/1217/ https://xkcd.com/1217/
- birken 6y ago
  The JNJ vaccine had trials in South Africa with ~10k participants and Novavax with ~4400. In fact AZ with ~2k participants was the smallest trial. Source: https://twitter.com/EricTopol/status/1358486648359591937/photo/1 https://twitter.com/EricTopol/status/1358486648359591937/pho...
kaminar 6y ago
Campsite.bio/westonaprice
kome 6y ago
The most efficient vaccine should be put under the public domain, and its production liberalized in every country. Market and private propriety here are not efficient.
- maelito 6y ago
  Why don't we talk more about this ? How many deaths could be avoided ?
  - curiousgal 6y ago
    These last few weeks have opened my eyes to how hypocritical the world is. Last year everyone was up in arms about mask production being centralized in China and every country was calling for domestic production. Now, with the vaccine being made by 3 or 4 companies, everyone is like "oh we can't get the doses we paid for? It's okay we'll wait". Including the EU so this isn't a matter of just "masks are easier to manufacture locally than vaccines".
    - macspoofing 6y ago
      >Including the EU so this isn't a matter of just "masks are easier to manufacture locally than vaccines". But masks are easier to manufacture locally than vaccines. And context is important too. Had there been no patents, are we sure the private investments would have been made 10+ years ago to developed COVID-19 vaccines in record time this year?
  - em500 6y ago
    Maybe we don't talk more about this because nobody here has deep insights into the current vaccine production chains (and therefor into the actual bottle necks), so we have no clue how many deaths could be avoided?
  - rebuilder 6y ago
    Now or when the next pandemic hits? Suspend patents now, better be prepared to develop the next vaccines without private pharma. Then again, maybe that would work out just fine. I doubt it would be unproblematic, either.
sgt101 6y ago
Worth noting that the JJ vaccine (which is similar) showed 89% efficacy against severe disease (hospitalization) wrt the SA variant. So - it's very likely that all vaccines will prevent healthcare systems getting stressed and significant excess mortality. Additionally if the vaccines are retarding the viral loads (it seems likely) then they should reduce transmission.
- koheripbal 6y ago
  ...which means that the optimal strategy is still go ahead with the Oxford-AstraZeneca phase 3 trial DESPITE these disappointing results, because they don't have another vaccine in SA and they really need to reduce hospitalizations and transmissability. Unfortunately, the vaccine review system is not setup to allow such nuanced approvals.
  - rossdavidh 6y ago
    I wouldn't be surprised if that's what SA does; the health minister kind of signaled that it may be resumed. I'm sure they're at least considering it. Normal approval processes for vaccines are getting modified all over the place, nowadays.
tinus_hn 6y ago
Good for them! Now if they can just send their supplies our way?
- arcturus17 6y ago
  > Good for them! Now if they can just send their supplies our way? Seriously? Not only is the selfishness in the comment questionable, the selfish logic in itself is flawed... You can pretty much count on the SA strain reaching your country at some point, if it's not already there. The news is chilling no matter what perspective you take - altruistic, selfish, or anywhere in between.
  - tinus_hn 6y ago
    Oh, you’d suggest that they just let them expire instead?
    - arcturus17 6y ago
      No, I edited my comment. I suggested that the callousness of exclaiming "good for them" is pretty bad.
      - tinus_hn 6y ago
        As you can read in other comments, this is a political game using a deadly epidemic as a wedge. On the one hand there’s people complaining the rich countries don’t provide vaccines to the poor African countries. On the other hand South Africa doesn’t want to use the vaccine for political reasons. Note also that even if the results of their studies are right, using the vaccine is still much better than not using it. If they choose not to use it, which according to the article they do, I have about as much sympathy for them as I have for antivaxers. Suit yourself, as long as you don’t require me to quarantine because of your decision I don’t care.
taipan100 6y ago
All based on the results of a study with 95% CI between -50% and 60% efficacy.
- LandR 6y ago
  What does an efficacy of -50% mean?
  - ArgyleSound 6y ago
    You’re 50% more likely to develop symptoms from the virus after vaccination
  - willj 6y ago
    I would assume the very wide CI mentioned above means that, since it includes 0, we can’t say there is a statistically significant effectiveness (it is not significantly different from 0% effectiveness).
    - Closi 6y ago
      > we can’t say there is a statistically significant effectiveness Agreed, although to clarify and be more precise, it also doesn't prove it's not effective. It effectively says that the sample was too small to tell anything. > (it is not significantly different from 0% effectiveness). This statement isn't true - it means that they are 95% sure the range of possible values is between -50 and +60, but it does not mean that the average of those two values is correct. 0% effectiveness is possible, but was not shown in this study.
      - willj 6y ago
        You’re right, semantics are everything. I left implicit the “in this study” part. As always, failing to reject the null doesn’t mean the null is true :)
    - taipan100 6y ago
      This is not really correct. CI means we are 95% sure that the true result falls somewhere within the range of -50 to 60. What this really means is that the study lacks statistical power to say anything interesting at all about vaccine effectiveness.
sradman 6y ago
The 501.V2 variant is widespread in South Africa and is troubling due to its potential for vaccine evasion [1]: > On 6 February 2021, The Financial Times reported that provisional trial data from a study undertaken by South Africa's University of the Witwatersrand in conjunction with Oxford University demonstrated reduced efficacy of the Oxford–AstraZeneca COVID-19 vaccine against the 501.V2 variant. [68] The study found that in a sample size of 2,000 the AZD1222 vaccine afforded only "minimal protection" in all but the most severe cases of COVID-19. [69] On 7 February 2021, the Minister for Health for South Africa suspended the planned deployment of around 1 million doses of the vaccine whilst they examine the data and await advice on how to proceed. [70] [1] https://en.wikipedia.org/wiki/501.V2_variant#Vaccine_evasion https://en.wikipedia.org/wiki/501.V2_variant#Vaccine_evasion [68] https://www.reuters.com/article/us-health-coronavirus-astrazeneca-varian/oxford-astrazeneca-covid-shot-less-effective-against-south-african-variant-study-idUSKBN2A60SH https://www.reuters.com/article/us-health-coronavirus-astraz... [69] https://www.bbc.co.uk/news/world-africa-55975052 https://www.bbc.co.uk/news/world-africa-55975052 [70] https://www.washingtonpost.com/world/europe/astrazeneca-oxford-vaccine-south-african-variant/2021/02/07/e82127f8-6948-11eb-a66e-e27046e9e898_story.html https://www.washingtonpost.com/world/europe/astrazeneca-oxfo...
- sradman 6y ago
  Yesterday’s TWiV 717 podcast [1] is a great resource explaining antibody escape. Takeaways: 1. Reinfection is most likely driving the selection pressure that results in antibody escaping variants. 2. SARS-CoV-2 Antigens are present in the gut of many individuals for months after the initial infection. [1] https://www.microbe.tv/twiv/twiv-717/ https://www.microbe.tv/twiv/twiv-717/
Tepix 6y ago
Looking at the bigger picture I think the world will suffer from those countries that handle Covid the worst because the virus will not disppear in those countries and it has time to mutate there until it reaches a state that can evade the vaccines and then re-infect the other countries.
- luch 6y ago
  Several epidemiologist are trying to warn the developed nations that the current battle for covid vaccines provisioning is doing the world a disservice since it allows the virus to mutate in parts of the world that can't compete economically for vaccine shots (Manaus, South Africa, etc.) But Nash equilibrium is still more powerful than everything else ...
  - rossdavidh 6y ago
    Since we don't have enough doses or dosing capacity yet to make anywhere reach herd immunity, not even tiny Israel (although hopefully they are getting close), it's not like shipping everything to South Africa would change anything. Also, given the refrigeration requirements of the early vaccines, shipping it to lower income countries would probably just increase the chance of some of the doses spoiling. Really, it's in virtually every country, so there's not a place on Earth where it's not mutating.
  - bluGill 6y ago
    That doesn't matter. Any person that isn't vaccinated is a potential source of a mutation. It doesn't matter where that person is. Once a country reaches herd immunity, then by all means get vaccines to other countries, but until then non-vaccinated people are fungible.
    - koheripbal 6y ago
      You are forgetting animal hosts. Numerous other species also transmit.
      - 6y ago
vinay427 6y ago
If anyone else was curious about the vaccines purchased by major countries/blocs, I found this graphic which provides a good visualization of it: https://www.theguardian.com/world/2021/jan/29/canada-and-uk-among-countries-with-most-vaccine-doses-ordered-per-person https://www.theguardian.com/world/2021/jan/29/canada-and-uk-... (Scroll down past the first few paragraphs)
- mleonhard 6y ago
  FT.com has interactive graphs showing how many people each country has vaccinated: https://ig.ft.com/coronavirus-vaccine-tracker/ https://ig.ft.com/coronavirus-vaccine-tracker/
Mvandenbergh 6y ago
What's particularly worrying is that all vaccines use the same spike protein (although AZ doesn't have the pre-fusion conformation stabilising mutation which a number of other vaccines do). So if this substantially lowers efficacy of one vaccine it will have directionally the same effect on all of them. Of course the response of efficacy to antibody titre and other correlates of protection is non-linear so it could be that AZ was just low enough for the mutation to kick them into the "doesn't work" zone. I expect that come late summer we'll all be getting another booster of some sort against whatever mix of variants is around. The trick will be prediction although we are helped by the fact that both mRNA and vectored vaccines can be changed and produced quite quickly. I also think that the emergence of this variant may save lives in the end because it forces to the front of everyone's mind the necessity of vaccinating the entire world and may make it politically easier to ship vaccine to the poor countries of the world before the rich countries have finished their vaccination programmes.
- rossdavidh 6y ago
  I may be a cynic, but I believe you are massively overestimating the rationality of decision-making during this pandemic.
  - dk1138 6y ago
    I think there's enough evidence from 2020 that your views aren't cynical, but instead realistic. The feasibility of world-wide coordination should no longer be expected regardless how high the stakes.
- Triv888 6y ago
  > I expect that come late summer we'll all be getting another booster of some sort against whatever mix of variants is around. A booster? I don't think I will be able to get my first dose by then...
  - rcpt 6y ago
    These two comments are giving me two more reasons to try radvac
mchusma 6y ago
This is a horrible decision. All the data we have suggests AZ is probably 100% effective at preventing death from the South African strain. (Mostly) everyone agrees we want to have a vaccine that is: -safer than not vaccinating -effective against death -actually available to use AZ is all 3 of these in South Africa (and everywhere). It also provides some additional benefits, like: -cheap -no cold storage -easier to administer By banning AZ you aren't trading it for Pfizer, you are trading it for no vaccine.
- hobbes78 6y ago
  a) Let's say you vaccinate all south-africans with AZ+Moderna+JJ+PB, then 1/4 of the population will be barely protected. b) Let's say you vaccinate all south-africans with Moderna+JJ+PB, then all the population will be protected. If you pay the same in both scenarios, why on earth would you choose a)?
  - bluGill 6y ago
    Because vaccines are in short supply. The choice isn't AZ+Moderna+JJ+PB vs Moderna+JJ+PB. the real choice today is AZ+Moderna+JJ+PB+NOTHING vs Moderna+JJ+PB+NOTHING, with the size of nothing being larger in the second case. So really it is c: you vaccinate everyone with whatever you can get your hands on. Once everyone has had some vaccine you look at data of what is working and give everyone with a less effective vaccine an additional dose of whatever works - which will probably be a new vaccine that doesn't exist yet! Don't forget that mutations are continuous. We might be looking at another mutation in 3 months as supply catches up that evades vaccines in a completely new way.
    - zeku 6y ago
      To be fair the article claims they will have other vaccines available in a couple of weeks.
      - mannykannot 6y ago
        That works both ways: the sooner the alternatives are available in adequate quantities, the less the harm (if there is anything to be concerned about) of continuing to use the AZ vaccine at least until then.

294 points by samizdis 6y ago

So does this mean that the mRNA vaccines are probably going to be like flu vaccines, where they have to predict which variant will dominate each season and adjust the doses accordingly? Can other options like the adenovirus-based or J&J ones be expected to cover a broader spectrum of mutants? (And why are so many people downvoting these questions? I'm genuinely curious, and I really tried not to offend any sensibilities, but did I say something wrong? Oh god why do people always hate me so much? Is it possible to say or do anything right anymore? Maybe it's time to quit social media...I'm out, y'all are cruel.)

stirlo 6y ago
The Oxford vaccine which was paused is not mRNA it is adenovirus. GSK has recently announced plans to produce a multi-valent mRNA vaccine for distribution next year so mRNA is not necessarily limited to a single variant. https://www.gsk.com/en-gb/media/press-releases/gsk-and-curevac-to-develop-next-generation-mrna-covid-19-vaccines/ https://www.gsk.com/en-gb/media/press-releases/gsk-and-curev...
- bedobi 6y ago
  Thanks for sharing this piece of info, I had no idea, seems like great news!
- Closi 6y ago
  It’s worth noting that the Oxford vaccine can be quickly altered too, as it’s based on a platform technology. They suspect a version with variants can be in production and being rolled out by August.
  - mxcrossb 6y ago
    I wonder though if the really good trial data of the MRNA ones mean they’ll be able to do just safety trials (nothing on effectiveness) in the future, while the Oxford collaboration will be closer scrutinized.
deleted 6y ago
[deleted]
MattGaiser 6y ago
The Oxford one is not an mRNA vaccine.
e_y_ 6y ago
It's not clear how much it'll continue to mutate. Since this is a brand new virus, it's had 100M+ people so far to experiment on, and clearly the early versions were not as efficient at spreading as the newer variants. Once we have herd immunity through vaccination (since natural immunity is rather hit-or-miss) I would hope the rate of mutations slows down significantly.
- dehrmann 6y ago
  One thing that will be interesting, and rather unusual, is we have different approaches to vaccines being deployed within months of each other.
- cortic 6y ago
  Logically i would have thought the opposite would have happened, since natural immunity is mostly to the nucleus protein (difficult to mutate), and vaccine immunity is based on the spike protein (easy to mutate). I would have thought any partial vaccine immunity would increase mutation rate. Also been worried that mass vaccinations might short-circuit the mutate to less severe variant process that happens in nature. By taking the advantage away from the current spike configuration we might give an advantage to a worse variant that would naturally have died out (out compete by its parent variant).. Disclaimer; I'm more qualified to write a science fiction novelette on this theory than a medical paper, so take all this with a big grain of salt.
  - e_y_ 6y ago
    It's probably too early to say if the vaccines have had any effect on the mutation rate, since wide-scale vaccination has only just started ramping up. You'd think it'd be easier to say whether people are getting reinfected after catching COVID the first time, but the testing data is sparse enough that there doesn't seem to be any confirmation on whether it's widespread or just isolated cases. Most notably in Manaus, Brazil, where one of the new variants has been spreading. I'm definitely not qualified to make anything other than wild guesses on this subject, but everything I've read suggests that scientists are scratching their heads as well. Conventional wisdom is that the spike is the easiest to target, so whether the human immune system picking the N protein is a mistake or brilliant move seems to be up in the air. Some reading: https://www.nature.com/articles/s41577-020-00480-0 https://www.nature.com/articles/s41577-020-00480-0 Mutating to a less severe variant: Given that SARS-CoV-2 already has delayed symptoms and a high percentage being asymptomatic cases, I'm not sure there's much pressure to make it milder. Also the overall spike design is what gives SARS-CoV-2 its higher infectiousness compared to the original SARS, so one would hope that mutations to it (to avoid existing antibodies) would tend to make things less effective, although unluckily the virus has been discovering some new configurations that are both more infectious and also less protected against by the existing vaccines (especially the 60-70% ones). Paper on infectivity of variants: https://www.cell.com/cell/pdf/S0092-8674%2820%2930877-1.pdf https://www.cell.com/cell/pdf/S0092-8674%2820%2930877-1.pdf
jfoster 6y ago
I think you're probably being downvoted (note: not by me) because the way your comment is written makes it sound a bit like you're assuming the Oxford-AstraZeneca vaccine is an mRNA vaccine when it's not.
- Closi 6y ago
  The good news though is that it does have some sort of platform technology that means it can be quickly altered.
  - bencollier49 6y ago
    They said they'd have a new one by Autumn...
  - corty 6y ago
    Problem is, the platform is a vector virus that causes immunity against the vector. So while you can create a new vaccine for the variants, you either cannot reuse the vector or you can't vaccinate old-variant-vaccinated people against the new variant. The body would kill the vector too quickly, limiting exposure to the payload too much. In that respect mRNA vaccines or live vaccines have an advantage.
    - chimprich 6y ago
      I don't think that's correct (but I'm willing to be corrected by an expert). I believe the immune response is mainly triggered by the spike protein. If the spike protein of the variant is different enough to cause a degree of vaccine escape, then the spike protein of the vaccine should be different enough to not get immediately cleared from the body. This is based on what I've understood from listening to interviews with prof. Sarah Gilbert, head of the Oxford team.
      - valarauko 6y ago
        The parent is referring to a valid concern that with repeated doses (like from a subsequent booster), the mild antigenicity of the vector virus itself can be a problem. The Oxford vaccine uses a Chimpanzee adenovirus, which can infect human cells but not replicate inside them. There after delivering the vaccine payload, over time the protein coat of the vector will be chopped up and presented to the immune system, as are all cellular proteins. As you are unlikely to have been previously infected with a chimp adenovirus, it should elicit not much of an immune response, but the body will see it as foreign and start raising antibodies against the adenovirus proteins (adenoviruses have their own versions of "spike" proteins, among others). Of course, we would expect most of the immune response would be against the corona spike payload, but some fraction would inevitably be for the adenovirus as well. When you get your second dose, you already have some antibodies against chimp adenovirus, which will potentially destroy some of the vector before it has a chance to be taken up by your cells. Third or fourth booster shots against coronavirus variants using the same chimp adenovirus vector would trigger worse reactions, destroying some portion of the vector before the payload can be delivered. The Russian Sputnik vaccine tries to reduce this likelihood by using different adenovirus vectors for each dose.
peter_retief 6y ago
I up voted you, the voting system on HN is a mystery to me.
- peter_retief 6y ago
  I got downvoted for upvoting you, the plot thickens...
  - tempestn 6y ago
    Your comment appeared to be complaining about downvotes (as does this one). Even if not that though, it's at least commenting about voting, which the guidelines discourage. > Please don't comment about the voting on comments. It never does any good, and it makes boring reading. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html I expect a comment more likely to be well received would be something discussing and/or reinforcing the specific points the parent made. In that context it would probably be fine to say something like, "I don't think you should have been downvoted." But without context or reasoning it doesn't have much substance.
    - peter_retief 6y ago
      "I don't think you should have been downvoted." The virus is in the same family as some of the common cold virus'. Coronaviruses replicate their RNA genomes using enzymes called RNA-dependent RNA polymerases. (RNA is relevant) https://www.newscientist.com/term/coronavirus/#ixzz6lrn6xyYr https://www.newscientist.com/term/coronavirus/#ixzz6lrn6xyYr
hedora 6y ago
There seems to be a group of people that systematically downvote anything that suggests a vaccine might not be a panacea. They also like to downvote math + statistics regarding Covid. Comments like yours tend to bounce around zero with lots of votes in both directions. Not sure what the deal is with the big silent anti-science crowd on HN. They don’t seem to be the majority. I just upvote anything that’s gray and not violating HN’s community guidelines. shrug
bumbada 6y ago
I agree that people on HN downvote reasonable opinions and questions that do not go against HN guidelines. It is the reddit effect. At first Reddit was like HN populated with highly educated people. As it got more and more users it democratized: The vote of a know-it-all 16 years old is the same as the one from a PhD in the field. In fact there are thousands of non experts for each expert, so they always win in a public space. We add to that that we are using text, we do not carry intonation and other emotional information and lots of people will misunderstand whatever you say. So the more popular a place like this becomes, the most degraded it becomes. Do not take that seriously. I had great karma when I posted my real identity years ago and now lots of my comments are downvoted too, and I am the same person. I did not care then and not care now.
powerapple 6y ago
What you are saying might turn out to be true. There was a report on how Chinese vaccine was good in some countries but not doing well in Brazil, it may be related to mutation as well. If the virus mutates fast because countries are not controlling the spread well enough, current vaccine may be less and less effective in time. I am sure the producers are updating their vaccines in meantime. It will take time and the production will take time as well. Unfortunately mRNA vaccines will not be a universal solution for all countries, it will only be applicable for a few rich countries.
- Ulrich2 6y ago
  Good news: Curevac needs only a standard refrigerator for storage. Hopefully it works. Also, Biontech is working on a V2.0 with less cooling required.
sjg007 6y ago
Yes most likely we will have a yearly vaccine or cocktail of vaccines for covid. Not sure if it will be mRNA specifically but most likely it will be. The flu shot for example isn't an mRNA vaccine but rather the strain they think will be dominate. Regardless, we will be wearing masks and social distancing for a long time (years) to come.
- koheripbal 6y ago
  The moment we discovered that numerous other species are transmitting the illness - made yearly shot inevitable.
  - sjg007 6y ago
    We've know this is true for generations...
- ghaff 6y ago
  Boosters are probably inevitable but once people are widely vaccinated, most are going to get on with their lives in a largely pre-pandemic way.
  - ls612 6y ago
    I feel like it is optimistic to think that we will be allowed to live our lives the pre pandemic way. These new strains will be trotted out as a good excuse to keep these restrictions around much longer.
    - ghaff 6y ago
      IMO no government in the US is going to indefinitely ban large indoor gatherings, indoor dining, bars, schools/universities as usual, physical conferences, etc. And any "rules" notwithstanding I fully expect that when summer rolls around and a lot of people, especially the more vulnerable, have been vaccinated whether it's imperfectly or not are going to back to beaches, bars, concerts, etc. At some point, it's just another disease of which there are many that sometimes kills people.

senectus1 6y ago

so, because it it only protects people from dying... its not good enough? What fresh hell in standards is this? If we could turn Covid into "common cold" level illness through vaccines THEN DO IT!

deleted 6y ago
[deleted]
stirlo 6y ago
The dominant strain of Covid in South Africa is different and existing vaccines are far less effective at countering due to changes in the spike protein which these vaccines target. The effectiveness against this strain is not 60-80% as it is against the other strains but below 50% which was the standard the WHO chose as a acceptable vaccine. South Africa has limited health resources and spending them rolling out an ineffective vaccine when they have orders for the Johnson and Johnson one coming next month doesn't make sense.
- The_rationalist 6y ago
  Saving lifes for a month doesn't make sense?
  - Infinitesimus 6y ago
    Depends on the cost. If they use resources to roll out am ineffective vaccine now to the detriment of future attempts to roll out effective options, waiting might be a better choice. Also, there is enough vaccine skepticism in the world today and I'm not sure vast distribution of something with questionable efficacy is necessarily a good idea.
  - babesh 6y ago
    Read the comment by Clewza313. The vaccine doesn’t seem to protect the people in the study (young people). Young people don’t tend to die from covid. They don’t know if it would work on older people but I would think it wouldn’t either. This doesn’t look like it actually saves lives. The study may be early to really tell but so far there is no evidence that the vaccine works at all against the variant that is widespread in South Africa.

sterlind 6y ago

In my Algorithms in Drug Design class in school, one of the research projects was using docking software to do an alpha/beta search for mutations that would alter protein structure while preserving binding affinity, with the idea of heading off vaccine escape (in this case HIV) by predicting the mutations likely to escape antibody binding. Is anything like that being done with covid? Edit: the Alpha move was to mutate the antibody and the Beta move was to mutate the viral protein iirc.

yellowcake0 6y ago
Yes such things are being done, see this paper for example: https://www.biorxiv.org/content/10.1101/2020.12.31.425021v1.full https://www.biorxiv.org/content/10.1101/2020.12.31.425021v1....
p4coder 6y ago
Not exactly, but there is this [1] that shows how the binding strength varies with single amino acid change. [1] https://jbloomlab.github.io/SARS-CoV-2-RBD_DMS/ https://jbloomlab.github.io/SARS-CoV-2-RBD_DMS/
nahuel0x 6y ago
Check this: https://singularityhub.com/2021/01/19/a-language-ai-is-accurately-predicting-covid-19-escape-mutations/ https://singularityhub.com/2021/01/19/a-language-ai-is-accur...

blintz 6y ago

I am part of the US study for this vaccine. Any ideas on what this could mean for the possibility of an EUA in the US?

JamisonM 6y ago
AZ has already said they are waiting until their new US-based trail finishes before even applying. They haven't finished recruiting, 28 days between shots, then (I think) 75 infections in the participants before they will report interim data. It is going to be quite a while.
- blintz 6y ago
  Finishes?! I was told the study completes in 2 years...
- justinc8687 6y ago
  I'm also in the AZ study and just spoke to the head doctor of my testing site Friday. They've finished recruitment and likely will have enough cases by the end of this month. BUT...the FDA said they won't consider an EUA until they have at least 2 months of safety data from half the participants. Given that restriction, he expects them to not be able to apply for an EUA until April.
  - tim333 6y ago
    Seems a bit unnecessary to wait for the US data when they could use the same data the UK used, plus we've now given the vaccine to several million.
    - corty 6y ago
      The AZ data is often considered to be somewhat dodgy, e.g. with dosages mixed up, patient groups selectively joined or split up for p-hacking purposes, etc. I can understand the US wanting a proper study under their own oversight.

easytiger 6y ago

Total lunacy. I had hoped SA might not descend into its usual levels of incompetence, misinformation, blame games. They have done this because the batch they received has a 2-3 month expiry life. They do not believe they can give that batch out in that timeframe. They have set up almost literally no infrastructure SAs vaccination plan is to generally beg other countries to do it for them. They already frittered away most of a R500bn IMF loan on absolutely nothing.

reddotX 6y ago

EU will probably follow suit and ban AstraZeneca. in many EU countries is restricted to under 55

easytiger 6y ago
Based on fake news and a campaign against it to deflect from EU commission failure around vaccine roll out. I see it is working.
- hef19898 6y ago
  Yeah, it seems like it. The only real issue the AZ vaccine seems to have is the South African mutation. The other so called "issues", efficiency for elderly, is just fake. Intentionally leaked by the German ministry of health by the looks of it. That claim was debunked, and it still got a hold on things. The press is still pushing it to some degree. Would be interesting to see the motive behind all that. Also funny, the AZ contract is the only one that leaked. And they are by no means the only one to face production ramp up issues. Biontech is getting the opposite reporting in Germany. That is somewhat puzzling. EDIT: The South African strain seems to be a challenge, the Novavax and J&J vaccines are also less effective (source:https://www.theguardian.com/world/2021/jan/30/two-new-covid-vaccines-work-worse-against-south-african-strain https://www.theguardian.com/world/2021/jan/30/two-new-covid-...).
  - _fizz_buzz_ 6y ago
    > The other so called "issues", efficiency for elderly, is just fake. There is good reason to believe it will be efficient on older people, but efficiency for elderly hasn't been proven. > Also funny, the AZ contract is the only one that leaked. It wasn't leaked, the EU and AZ agreed to publish it. And it is also not the only one that was published. The CureVac contract was also published.
    - hef19898 6y ago
      Thr initial claim I am aware of came from a German newspaper, Bild (the Handelsblatt was quick with it as well, not sure which newspaper was first). That claim was "AZ only 8% efficient with patients over 60 (or 65, don't remember that with all the figures thrown around)". That claim was false, as the 8% related to the number of trial patients. That claim came from the German Ministry of Health, "informed circles". Only after that AZ clarified what the 8% really mean. And yes, efficiency is not yet proven. Unproven efficiency is quite a different thing from a claimed 8% efficiency so. I see a real pro Biontech and anti AZ campaign going on in the German media. One that is quite welcome, as it allows politicians to deflect blame. Brexit helps to mud the waters even further. Don't forget, we have elections in Germany this year. As far as I know, the AZ contract is the only one with additional uncensored parts that was published. AZ is in the defensive now. For no real reasons. And over this discussion, in the EU and also in SA it seems, we totally miss the importance of a smooth vaccination campaign. And the lacking preparation thereof.

nevi-me 6y ago

Note: I edited this to fix formatting, and I initially suggested a different link [12], but have removed the suggestion, as the interesting point of the article is still made (the suspension of the specific vaccine). ___ There's some important details not mentioned in the article, which make this more of an emergency than a reader of just the article will notice. Allow me to paint some back story, but the summary is this: - We (our country) got 1 million doses of this vaccine last week, being ill-prepared and flustered to get our act together - These doses expire in April, we do not have a roll-out strategy because politicians played politics (I'll explain below) - We are broke, and the trust between people and gov is diminishing quickly Initial Lockdown (March 2020) Many people were initially positive when our first lockdown started. The President set up a "Solidarity Fund" [0], with initial donations of ~$70m USD (R1 billion) from a few wealthy families in the country. The government 'diverted' funds to the PPE roll out, and the President expressly said that there wouldn't be looting [1] of funds. The government put us in a quasi-martial-law with a committee called the NCCC [2] (name can be found in the link), parts of which have been taken to court, because of arbitrary laws/rules, and a very apparent power-grab by the ruling/governing party. Some of the bizzare things that came out of this NCCC: - A ban on cigarette sales, not substantiated by anything scientific at the time. They lost the court battle, but true to form, are appealing [3]. - Regulations on sales of winter clothes. Arbitrarily defining the details of clothes that can be bought or not, what aisles to be used. It was as ridiculous as talking about crop tops and tights [4]. - Instituting racist policies to only help certain businesses [5]. I feel obliged to say that I'm an African black, and I agree with the sentiment that this was unConstitutional, as we all should enjoy the same rights. The gist of this was that the President said something like "this is a chance to redistribute wealth by only supporting black businesses". The above has been met with criticism, and has eroded trust. PPE Looting/Corruption Now, one only needs to search for "PPE Corruption South Africa" to get stories about articles almost-daily. - Premiers (leaders of provinces) have been implicated or accused - President's spokesperson has been suspended, and has failed to submit her financial interests [6] - As of October 2020, at least $700M USD is under investigation for being looted for PPE [7]. Politically connected people were setting up companies, selling 100ml of sanitisers for up to $3000 USD, all sorts of horrors. Anecdotally, one of the provincial ministers (MEC) of education, has been up in arms against a white-owned/run trade union called Solidariteit, for deciding to build their own techno-university with private funds. The university was to cost ~$20M USD, and has been completed after around 2 years. I mention this, because this MEC's department spent ~$30M USD 'fumigating' schools that were closed during the lockdown. The criticism has been that the virus doesn't last long enough in sufraces to warrant this waste. He is unable to account, trying to use 'processes' to shield himself [8]. Funding The Vaccine Now, back to the vaccine. The SA government is part of the COVAX programme [9]. They 'missed' the deadline to make a deposit twice last year [10]. The Minister of Finance will disagree with this, but for the Solidarity Fund, and other NGOs to step in, is troubling. There have been discussions from our Treasury, to raise taxes to fund the vaccine [11]. This comes in the midst of irresponsible behaviour by our government, that has contributed to the closure of a lot of companies. I need not bore the reader with details, but we are broke, our unemployment is rising (even the Statistics SA are stymied from gathering stats, because they're under-funded). A pause of the vaccine rollout makes medical sense, but given that the doses that we've paid for and received 1 million doses (for a country of 58+million) [12], and have no roll-out plan [13]. So, how is a government that has looted more than enough money to pay for enough doses of the vaccine (less than the $700M USD 'under investigation') to the point of not being able to pay a mere deposit on time, going to fund alternative vaccines? EDIT: Medical aid/insurers talked about sourcing the vaccines for their members, but government and the public at large seemed to initially be against this move. I don't know what's changed, but the private medical insurers are now helping government with administration instead. It's a shame that Africa suffers, while it has the resources to alleviate poverty. If you've read this far, this has been opinions of mine, with some articles to provide context. I'm no reporter. Thanks ___ [0] https://solidarityfund.co.za/ https://solidarityfund.co.za/ [1] I can't find a reference to this anymore, there's just so much noise about the actual looting, that the initial promises are hard to find. I'll update if I find an article or tweet from Presidency. [2] https://www.news24.com/news24/southafrica/news/govts-coronavirus-command-council-not-established-in-terms-of-any-act-ramaphosas-answers-reveal-20200610 https://www.news24.com/news24/southafrica/news/govts-coronav... [3] https://businesstech.co.za/news/lifestyle/459136/governments-tobacco-case-appeal-raises-fears-of-another-cigarette-ban-in-south-africa/ https://businesstech.co.za/news/lifestyle/459136/governments... [4] https://www.sowetanlive.co.za/news/south-africa/2020-05-14-governments-restrictions-on-winter-clothing-elicit-anger/ https://www.sowetanlive.co.za/news/south-africa/2020-05-14-g... [5] https://citizen.co.za/business/2259481/confirmed-guideline-that-government-will-only-help-51-black-owned-companies-is-fake/ https://citizen.co.za/business/2259481/confirmed-guideline-t... [6] https://www.news24.com/news24/southafrica/news/khusela-diko-facing-disciplinary-hearing-after-failure-to-disclose-financial-interests-20210110 https://www.news24.com/news24/southafrica/news/khusela-diko-... [7] https://businesstech.co.za/news/government/442058/r10-5-billion-under-investigation-for-covidpreneur-looting-in-south-africa/ https://businesstech.co.za/news/government/442058/r10-5-bill... [8] https://twitter.com/SundayTimesZA/status/1355806487650689024 https://twitter.com/SundayTimesZA/status/1355806487650689024 [9] https://www.who.int/initiatives/act-accelerator/covax https://www.who.int/initiatives/act-accelerator/covax [10] https://businesstech.co.za/news/trending/457668/south-africa-misses-covax-deadline-to-secure-vaccines/ https://businesstech.co.za/news/trending/457668/south-africa... [11] https://businesstech.co.za/news/government/461548/south-africa-treasury-considers-tax-hike-to-fund-vaccines-report/ https://businesstech.co.za/news/government/461548/south-afri... [12] https://www.dailymaverick.co.za/article/2021-02-08-south-africa-switches-to-jjs-astrazeneca-vaccine-halted/ https://www.dailymaverick.co.za/article/2021-02-08-south-afr... [13] The health minister was asking health-care practitioners on Twitter last week, to register themselves. There's been overall criticism by HPCs that they're in the dark about doses coming in just a week. This is something that should have started last year already. https://www.timeslive.co.za/news/south-africa/2021-02-03-34000-sa-healthcare-workers-register-for-covid-19-vaccines-on-first-day/ https://www.timeslive.co.za/news/south-africa/2021-02-03-340...

ascorbic 6y ago

The important thing to note is that the significance of this study goes beyond the AZ vaccine. Please correct me if I've missed one, but from what I've seen there aren't any other vaccines that have completed similar trials in South Africa. The "good news" about the other vaccines' effectiveness against the variant have been based on in vitro immune response[1], not real-world trials. What would be good to know though is what response the AZ vaccine had in tests similar to the ones performed with other vaccines. [1]And we know the issues with that standard https://xkcd.com/1217/ https://xkcd.com/1217/

birken 6y ago
The JNJ vaccine had trials in South Africa with ~10k participants and Novavax with ~4400. In fact AZ with ~2k participants was the smallest trial. Source: https://twitter.com/EricTopol/status/1358486648359591937/photo/1 https://twitter.com/EricTopol/status/1358486648359591937/pho...

kaminar 6y ago

Campsite.bio/westonaprice

kome 6y ago

The most efficient vaccine should be put under the public domain, and its production liberalized in every country. Market and private propriety here are not efficient.

maelito 6y ago
Why don't we talk more about this ? How many deaths could be avoided ?
- curiousgal 6y ago
  These last few weeks have opened my eyes to how hypocritical the world is. Last year everyone was up in arms about mask production being centralized in China and every country was calling for domestic production. Now, with the vaccine being made by 3 or 4 companies, everyone is like "oh we can't get the doses we paid for? It's okay we'll wait". Including the EU so this isn't a matter of just "masks are easier to manufacture locally than vaccines".
  - macspoofing 6y ago
    >Including the EU so this isn't a matter of just "masks are easier to manufacture locally than vaccines". But masks are easier to manufacture locally than vaccines. And context is important too. Had there been no patents, are we sure the private investments would have been made 10+ years ago to developed COVID-19 vaccines in record time this year?
- em500 6y ago
  Maybe we don't talk more about this because nobody here has deep insights into the current vaccine production chains (and therefor into the actual bottle necks), so we have no clue how many deaths could be avoided?
- rebuilder 6y ago
  Now or when the next pandemic hits? Suspend patents now, better be prepared to develop the next vaccines without private pharma. Then again, maybe that would work out just fine. I doubt it would be unproblematic, either.

sgt101 6y ago

Worth noting that the JJ vaccine (which is similar) showed 89% efficacy against severe disease (hospitalization) wrt the SA variant. So - it's very likely that all vaccines will prevent healthcare systems getting stressed and significant excess mortality. Additionally if the vaccines are retarding the viral loads (it seems likely) then they should reduce transmission.

koheripbal 6y ago
...which means that the optimal strategy is still go ahead with the Oxford-AstraZeneca phase 3 trial DESPITE these disappointing results, because they don't have another vaccine in SA and they really need to reduce hospitalizations and transmissability. Unfortunately, the vaccine review system is not setup to allow such nuanced approvals.
- rossdavidh 6y ago
  I wouldn't be surprised if that's what SA does; the health minister kind of signaled that it may be resumed. I'm sure they're at least considering it. Normal approval processes for vaccines are getting modified all over the place, nowadays.

tinus_hn 6y ago

Good for them! Now if they can just send their supplies our way?

arcturus17 6y ago
> Good for them! Now if they can just send their supplies our way? Seriously? Not only is the selfishness in the comment questionable, the selfish logic in itself is flawed... You can pretty much count on the SA strain reaching your country at some point, if it's not already there. The news is chilling no matter what perspective you take - altruistic, selfish, or anywhere in between.
- tinus_hn 6y ago
  Oh, you’d suggest that they just let them expire instead?
  - arcturus17 6y ago
    No, I edited my comment. I suggested that the callousness of exclaiming "good for them" is pretty bad.
    - tinus_hn 6y ago
      As you can read in other comments, this is a political game using a deadly epidemic as a wedge. On the one hand there’s people complaining the rich countries don’t provide vaccines to the poor African countries. On the other hand South Africa doesn’t want to use the vaccine for political reasons. Note also that even if the results of their studies are right, using the vaccine is still much better than not using it. If they choose not to use it, which according to the article they do, I have about as much sympathy for them as I have for antivaxers. Suit yourself, as long as you don’t require me to quarantine because of your decision I don’t care.

taipan100 6y ago

All based on the results of a study with 95% CI between -50% and 60% efficacy.

LandR 6y ago
What does an efficacy of -50% mean?
- ArgyleSound 6y ago
  You’re 50% more likely to develop symptoms from the virus after vaccination
- willj 6y ago
  I would assume the very wide CI mentioned above means that, since it includes 0, we can’t say there is a statistically significant effectiveness (it is not significantly different from 0% effectiveness).
  - Closi 6y ago
    > we can’t say there is a statistically significant effectiveness Agreed, although to clarify and be more precise, it also doesn't prove it's not effective. It effectively says that the sample was too small to tell anything. > (it is not significantly different from 0% effectiveness). This statement isn't true - it means that they are 95% sure the range of possible values is between -50 and +60, but it does not mean that the average of those two values is correct. 0% effectiveness is possible, but was not shown in this study.
    - willj 6y ago
      You’re right, semantics are everything. I left implicit the “in this study” part. As always, failing to reject the null doesn’t mean the null is true :)
  - taipan100 6y ago
    This is not really correct. CI means we are 95% sure that the true result falls somewhere within the range of -50 to 60. What this really means is that the study lacks statistical power to say anything interesting at all about vaccine effectiveness.

sradman 6y ago

The 501.V2 variant is widespread in South Africa and is troubling due to its potential for vaccine evasion [1]: > On 6 February 2021, The Financial Times reported that provisional trial data from a study undertaken by South Africa's University of the Witwatersrand in conjunction with Oxford University demonstrated reduced efficacy of the Oxford–AstraZeneca COVID-19 vaccine against the 501.V2 variant. [68] The study found that in a sample size of 2,000 the AZD1222 vaccine afforded only "minimal protection" in all but the most severe cases of COVID-19. [69] On 7 February 2021, the Minister for Health for South Africa suspended the planned deployment of around 1 million doses of the vaccine whilst they examine the data and await advice on how to proceed. [70] [1] https://en.wikipedia.org/wiki/501.V2_variant#Vaccine_evasion https://en.wikipedia.org/wiki/501.V2_variant#Vaccine_evasion [68] https://www.reuters.com/article/us-health-coronavirus-astrazeneca-varian/oxford-astrazeneca-covid-shot-less-effective-against-south-african-variant-study-idUSKBN2A60SH https://www.reuters.com/article/us-health-coronavirus-astraz... [69] https://www.bbc.co.uk/news/world-africa-55975052 https://www.bbc.co.uk/news/world-africa-55975052 [70] https://www.washingtonpost.com/world/europe/astrazeneca-oxford-vaccine-south-african-variant/2021/02/07/e82127f8-6948-11eb-a66e-e27046e9e898_story.html https://www.washingtonpost.com/world/europe/astrazeneca-oxfo...

sradman 6y ago
Yesterday’s TWiV 717 podcast [1] is a great resource explaining antibody escape. Takeaways: 1. Reinfection is most likely driving the selection pressure that results in antibody escaping variants. 2. SARS-CoV-2 Antigens are present in the gut of many individuals for months after the initial infection. [1] https://www.microbe.tv/twiv/twiv-717/ https://www.microbe.tv/twiv/twiv-717/

Tepix 6y ago

Looking at the bigger picture I think the world will suffer from those countries that handle Covid the worst because the virus will not disppear in those countries and it has time to mutate there until it reaches a state that can evade the vaccines and then re-infect the other countries.

luch 6y ago
Several epidemiologist are trying to warn the developed nations that the current battle for covid vaccines provisioning is doing the world a disservice since it allows the virus to mutate in parts of the world that can't compete economically for vaccine shots (Manaus, South Africa, etc.) But Nash equilibrium is still more powerful than everything else ...
- rossdavidh 6y ago
  Since we don't have enough doses or dosing capacity yet to make anywhere reach herd immunity, not even tiny Israel (although hopefully they are getting close), it's not like shipping everything to South Africa would change anything. Also, given the refrigeration requirements of the early vaccines, shipping it to lower income countries would probably just increase the chance of some of the doses spoiling. Really, it's in virtually every country, so there's not a place on Earth where it's not mutating.
- bluGill 6y ago
  That doesn't matter. Any person that isn't vaccinated is a potential source of a mutation. It doesn't matter where that person is. Once a country reaches herd immunity, then by all means get vaccines to other countries, but until then non-vaccinated people are fungible.
  - koheripbal 6y ago
    You are forgetting animal hosts. Numerous other species also transmit.
    - 6y ago

vinay427 6y ago

If anyone else was curious about the vaccines purchased by major countries/blocs, I found this graphic which provides a good visualization of it: https://www.theguardian.com/world/2021/jan/29/canada-and-uk-among-countries-with-most-vaccine-doses-ordered-per-person https://www.theguardian.com/world/2021/jan/29/canada-and-uk-... (Scroll down past the first few paragraphs)

mleonhard 6y ago
FT.com has interactive graphs showing how many people each country has vaccinated: https://ig.ft.com/coronavirus-vaccine-tracker/ https://ig.ft.com/coronavirus-vaccine-tracker/

Mvandenbergh 6y ago

What's particularly worrying is that all vaccines use the same spike protein (although AZ doesn't have the pre-fusion conformation stabilising mutation which a number of other vaccines do). So if this substantially lowers efficacy of one vaccine it will have directionally the same effect on all of them. Of course the response of efficacy to antibody titre and other correlates of protection is non-linear so it could be that AZ was just low enough for the mutation to kick them into the "doesn't work" zone. I expect that come late summer we'll all be getting another booster of some sort against whatever mix of variants is around. The trick will be prediction although we are helped by the fact that both mRNA and vectored vaccines can be changed and produced quite quickly. I also think that the emergence of this variant may save lives in the end because it forces to the front of everyone's mind the necessity of vaccinating the entire world and may make it politically easier to ship vaccine to the poor countries of the world before the rich countries have finished their vaccination programmes.

rossdavidh 6y ago
I may be a cynic, but I believe you are massively overestimating the rationality of decision-making during this pandemic.
- dk1138 6y ago
  I think there's enough evidence from 2020 that your views aren't cynical, but instead realistic. The feasibility of world-wide coordination should no longer be expected regardless how high the stakes.
Triv888 6y ago
> I expect that come late summer we'll all be getting another booster of some sort against whatever mix of variants is around. A booster? I don't think I will be able to get my first dose by then...
- rcpt 6y ago
  These two comments are giving me two more reasons to try radvac

mchusma 6y ago

This is a horrible decision. All the data we have suggests AZ is probably 100% effective at preventing death from the South African strain. (Mostly) everyone agrees we want to have a vaccine that is: -safer than not vaccinating -effective against death -actually available to use AZ is all 3 of these in South Africa (and everywhere). It also provides some additional benefits, like: -cheap -no cold storage -easier to administer By banning AZ you aren't trading it for Pfizer, you are trading it for no vaccine.

hobbes78 6y ago
a) Let's say you vaccinate all south-africans with AZ+Moderna+JJ+PB, then 1/4 of the population will be barely protected. b) Let's say you vaccinate all south-africans with Moderna+JJ+PB, then all the population will be protected. If you pay the same in both scenarios, why on earth would you choose a)?
- bluGill 6y ago
  Because vaccines are in short supply. The choice isn't AZ+Moderna+JJ+PB vs Moderna+JJ+PB. the real choice today is AZ+Moderna+JJ+PB+NOTHING vs Moderna+JJ+PB+NOTHING, with the size of nothing being larger in the second case. So really it is c: you vaccinate everyone with whatever you can get your hands on. Once everyone has had some vaccine you look at data of what is working and give everyone with a less effective vaccine an additional dose of whatever works - which will probably be a new vaccine that doesn't exist yet! Don't forget that mutations are continuous. We might be looking at another mutation in 3 months as supply catches up that evades vaccines in a completely new way.
  - zeku 6y ago
    To be fair the article claims they will have other vaccines available in a couple of weeks.
    - mannykannot 6y ago
      That works both ways: the sooner the alternatives are available in adequate quantities, the less the harm (if there is anything to be concerned about) of continuing to use the AZ vaccine at least until then.