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Infectious Diseases

Updated 17 July 2020

SA Covid-19 vaccine trial results may occur earlier than expected

The South African Ox1Cov-19 Vaccine VIDA-Trial is underway. If successful, does this mean we can expect a vaccine rollout in 2020? Professor Shabir Madhi explains.

  • SA's Covid-19 vaccine trial may produce results as early as November
  • Unfortunately, this doesn't mean vaccines will be accessible in 2020
  • For now, our focus needs to be on continuing preventative measures, says Professor Shabir Madhi 

The South African Ox1Cov-19 Vaccine VIDA-Trial, which is the first clinical trial in Africa of a Covid-19 vaccine, started just over two weeks ago. It is a collaboration between the University of Witwatersrand (Wits) and the University of Oxford and the Oxford Jenner Institute.

The plan was to enrol 2 000 participants over four to six weeks, and to have planned follow-ups for up to 12 months after vaccination. In terms of the timeline, scientists involved in the study are expecting results sooner than expected, said Professor Shabir Madhi, Professor of Vaccinology at Wits University and Director of the South Africa Medical Research Council (SAMRC) Vaccines and Infectious Diseases Analytics Research Unit (VIDA), during a WHO Africa Online Press Briefing today. Madhi is also leading the SA study.

“The reason for that is because of the really high rate of transmission that is currently occurring in South Africa,” Madhi explained, adding that the team will be able to determine whether the vaccine works once they reach about 42 cases of Covid-19 in trial participants.

“We anticipate that this would likely occur as soon as November or December this year. Previously, we projected it might only occur in June of next year,” said Madhi.

If successful, can we expect vaccine roll-out this year?

Unfortunately, it’s not as simple as that. The scientists are working on a timeline that could show results as early as the first quarter of next year. However, the development of the vaccine, named ChAdOx1-Cov19, is also currently being trialled in the UK and Brazil, which means that development is completely dependent on all clinical trial results.

A further study of the same vaccine candidate is planned to take place in the US. And on that topic, Madhi brought up a pertinent point:

“It’ll be available for public emergency use as early as next year. But we will need billions of doses of vaccines, and it’s really going to be about how companies are supported in terms of being able to scale up production, but at the same time also make it affordable.”

In the Wits briefing last month, Madhi mentioned that manufacturing plants are currently being set up in the event that the trials produce favourable results. In today’s briefing, he expanded on this point, saying that the University of Oxford has entered into an agreement with AstraZeneca – the pharmaceutical company responsible for manufacturing the vaccine.

There are also agreements with AstraZeneca and CEPI, Gavi and the Serum Institute of India (SII) to bring the vaccine to low-and-middle-income countries. According to their website: “A number of supply chains are being built across the world to support global access at no profit during the pandemic, and has so far secured manufacturing capacity for two billion doses of the potential vaccine."

Long road ahead

Although there is great excitement about vaccines, Madhi said we need to understand that even with 19 vaccines going into human trials, we’ll be highly successful if more than two are shown to be effective.

"There’s still a long path ahead. In the meantime, the focus should not be on vaccines – it should be on non-pharmaceutical interventions, such as regular handwashing and physical distancing in order to slow the transmission of this virus," he said.

Will this potential vaccine be freely available to all?

“No vaccine is going to be made available freely to all because someone needs to eventually pay for it,” said Madhi.

Madhi added that it’s challenging to develop a funding mechanism which allows for equitable access across the globe, but said that the above agreements will aid in providing vaccine access to the low-and-middle-income countries.

However, Madhi concluded that the onus is really on governments to be proactive, in that they need to engage with various initiatives to ensure that when a vaccine does become available, they can actually make it available to its citizens.

‘We are not guinea pigs’

Responding to the question of Africa being the testing ground for a Covid-19 vaccine was Professor Pontiano Kaleebu, director of the Uganda Virus Research Institute (UVRI), who said:

“This is not surprising. People always have these concerns at the start, but that’s why we need to make sure we have processes to ensure we follow the highest standards. We have scientists and institutions of high calibre, but we’re also working with international scientists that have a good track record… so we will make sure we are not just being used as guinea pigs."

Dr Matshidiso Moeti, regional director of the World Health Organization (WHO) regional office for Africa, who was also part of the panel, said:

“I think what’s very important is to establish the principles by which African countries, scientists and populations participate in vaccine trials to make sure they’re carried out according to the highest international standards.

“What we also want to be sure of is to make sure populations understand this; that the systems are in place in African countries and that those precautions are being taken. The regulatory bodies are being increasingly well-developed and these principles are being respected in Africa."

Moeti added that governments impose strict regulatory measures in countries in which the vaccines are administered, and that these are of international standards, and said that partaking in these trials would be to their advantage.

“It is extremely important that these tools be tried out in African populations so that we can understand how they interact with us and how we can benefit.”