To sell or swap? South Africa weighs options for AstraZeneca shots ahead of J&J rollout

JOHANNESBURG (Reuters) – South Africa’s health minister said on Wednesday the government may sell or swap doses of AstraZeneca’s COVID-19 vaccine it may not need, as it scrambles to start inoculating its citizens with an alternative U.S. shot next week.

Vials labelled “COVID-19 Coronavirus Vaccine” and sryinge are seen in front of displayed Johnson&Johnson logo in this illustration taken, February 9, 2021. REUTERS/Dado Ruvic/Illustration

The unusual move comes just days after South Africa paused the rollout of the vaccine developed by AstraZeneca and Oxford University following a small clinical trial that showed it did not protect against mild to moderate illness from the 501Y.V2 variant dominant in the country.

One million doses of the AstraZeneca vaccine, produced by the Serum Institute of India, landed in the country last week, and another 500,000 are due to arrive in coming weeks. That’s enough to inoculate 750,000 people.

South Africa was also expecting to receive AstraZeneca shots via the COVAX global vaccine distribution scheme co-led by the World Health Organization (WHO) and an African Union (AU) arrangement.

Health Minister Zweli Mkhize told a news conference the country would start vaccinating health workers with Johnson & Johnson’s vaccine in the form of an “implementation study” with researchers some time next week.

He said he would wait for advice from scientists before proceeding with the possible sale or switch of the British shot.

“Why not sell the AstraZeneca to other countries, well it’s an option, … we will consider it. First our scientists will tell us what we do with it, can we use it within the time that’s available … before it expires,” Mkhize said.

“If not, can we swap it with anyone else, because we’ve discussed it with COVAX and with AVATT (the AU’s vaccine task team), so we will see what we will do.”

It’s not clear how an onward sale or swap would work given the varying prices for vaccines around the world or if the British drugmaker would have to agree to such a move. Serum and AstraZeneca declined to comment.

Still, in a briefing to lawmakers later in the day, Mkhize said the government wanted to see whether it could swap AstraZeneca shots it had ordered privately for a different vaccine available under the COVAX scheme run by the WHO and international vaccines alliance Gavi. The WHO and Gavi did not immediately respond to requests for comment.

Mkhize said he would discuss a proposal to swap 500,000 doses from Serum that have not yet been delivered with COVAX, which has secured big supplies of the shot for distribution to poor nations.

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The move is the latest twist in a saga that has engulfed the South African government this week as it scrambles to tame the fast-spreading variant. The country’s death toll is nearing 47,000 and infections have surpassed 1.47 million.

Turning to the U.S. drugmaker for alternative supplies is also another blow to the British drugmaker, whose vaccine is considered critical for poor nations because it’s cheap and easy to store.

ALTERNATIVES

The government’s Ministerial Advisory Committee should be able to give a considered view on how to deal with the AstraZeneca vaccines in the next week or two, Mkhize said, adding that the government had also secured vaccine doses from Pfizer for health workers.

Negotiations with Moderna, China’s Sinopharm and over Russia’s Sputnik V vaccine are ongoing.

Mkhize referred to the first batch of J&J doses as “bridging stock”, with the first shots expected to land next week.

“It’s possible that the first batch would actually be not paid for, because it would be covered more as the research stock. So if we are able to achieve that, it’s fine, but if we have got to pay for it, we have got no problem,” he said.

Officials previously said the country had secured 9 million J&J single-dose shots, and Mkhize said a deal could be finalised soon.

Eventually, most of the J&J supplies could come from local pharmaceutical company Aspen, which is due to bring production on stream around April, Mkhize said.

The J&J vaccine was 89% effective at preventing severe disease and 57% effective against moderate to severe disease in the South African leg of a global trial. Ninety-five percent of infections observed in the local study were due to the 501Y.V2 variant first identified late last year.

The 501Y.V2 variant has alarmed health experts who have raised concerns about its ability to potentially evade the immune response generated by prior exposure to the coronavirus or vaccines.

South Africa’s neighbour eSwatini said on Tuesday that it also would not be using the AstraZeneca vaccine.

South Africa hopes to vaccinate 40 million people, or two-thirds of its population, to achieve some level of herd immunity.

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