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Skyline of Cape Town with a landscape painting by the French-Swiss artist Saype as part of the “Beyond Walls” project
Photo: Valentin Flauraud / EPA-EFE / Shutterstock
The news is not good: According to a recent study, the AstraZeneca vaccine may not protect against mild or moderate Covid courses caused by the new virus variant B.1.351.
This variant was first discovered in South Africa, where the study by the Universities of Oxford and Witwatersrand, Johannesburg, took place.
The University of Oxford developed the vaccine ChAdOx1 nCoV-19 together with the pharmaceutical company AstraZeneca.
The study has not yet been published and has not yet been reviewed by other researchers.
However, some key results are known after a press conference attended by several vaccine specialists in addition to South Africa's Minister of Health Zweli Mkhize.
The vaccine appears to work against the original strain, but not fully against the variant, Mkhize said on Sunday.
Therefore, the agent is not initially vaccinated in South Africa.
The government will wait for the recommendation from academia how to deal with the vaccine.
The country has received around a million doses of the AstraZeneca vaccine.
South Africa has the highest number of coronavirus cases on the African continent.
More than 1.4 million corona cases and more than 46,000 deaths related to Covid-19 are documented.
In the study, the effectiveness of ChAdOx1 nCoV-19 against the new virus variant could be tested because the investigation was running while B.1.351 spread increasingly in South Africa from October.
According to Shabir Madhi from the Witwatersrand University, this currently causes 90 percent of new infections in the country.
B.1.351 is more contagious than the conventional Sars-CoV-2.
Even before the report on the AstraZeneca vaccine, there were indications that a coronavirus infection that had passed through gave only moderate protection against infection with B.1.351.
This raised concerns that the effectiveness of the vaccines could also be reduced.
A crucial knowledge gap
1749 subjects in the study received either the vaccine or an active substance-free placebo.
The participants were between 18 and 65 years old and risk factors for a severe course of Covid-19 were very rare for them.
People who were at high risk of a severe course of Covid due to their age were not involved.
What it found: By the end of October, the effectiveness of the vaccine was good.
There were three Covid-19 cases with mild to moderate symptoms in the group that had been vaccinated and twelve in the placebo group.
The effectiveness was thus around 75 percent.
That changed with the appearance of B.1.351: Of a total of 42 Covid cases with mild to moderate symptoms, 23 were in the placebo group and 19 in the vaccine group.
In mathematical terms, the difference is not statistically significant.
This means that it cannot be deduced from this whether the vaccine protects against B.1.351.
39 of the cases were based on B.1.351.
However, the study leaves a crucial gap in knowledge: Because there were no severe courses of Covid-19 at all among the relatively young participants, it says nothing about whether the vaccine may protect against a serious illness caused by B.1.351.
So it is still conceivable that the AstraZeneca vaccine will help against B.1.351 in this regard - but so far this is not known.
A study with another vaccine, the Johnson & Johnson compound, gives some hope in this direction.
This is also a so-called vector vaccine, which is similar to AstraZeneca's.
This vaccine is also less effective than the new virus variant, but it still prevented around 89 percent severe to fatal Covid-19 courses - despite B.1.351, according to the press conference on Sunday.
South Africa is now looking to accelerate the launch of Johnson & Johnson's vaccine.
What's next?
Vaccine expert Sarah Gilbert from Oxford University describes that work is already being done to develop a new generation of vaccines that will also protect against the new coronavirus variants.
This could be given as a booster, i.e. as a later vaccination after the administration of the conventional vaccine.
Last Friday, AstraZeneca reported that its vaccine at least protects against the British variant B.1.1.7 as well as against the original Sars-CoV-2.
Other manufacturers are also preparing to adapt their vaccines if necessary.
This is comparatively easy to implement with the mRNA vaccines from Biontech / Pfizer and Moderna.
“We could just replace the genetic information for the current virus antigen with the new, mutated one.
It all happens very quickly and would take maybe six weeks, ”said Biontech founder Özlem Türeci in an interview with SPIEGEL.
The question is how the regulatory authorities dealt with it, i.e. whether large studies with tens of thousands of test subjects are necessary again.
However, there are also simplified procedures for the flu vaccine, which has to be adjusted every year due to changed virus strains.
Infectiologist and vaccine researcher Marylyn Addo from the Eppendorf University Hospital in Hamburg also emphasizes in SPIEGEL that we »have good tools to counter potentially problematic changes in the virus«.
Sars-CoV-2 changes relatively slowly compared to other viruses.
“We currently have a chance to keep up with the virus.
To do this, however, it is also important to slow down the rate of infection. "
While the majority of people around the world are still waiting for their first vaccination, the prospect of booster vaccinations due to virus mutations is not optimistic.
But the bottom line is that vaccines can still make a very important contribution to reducing this pandemic.
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