Last checked at 
* S.Africa has paused AstraZeneca vaccinations
* Vaccine less effective vs local variant -trial
* To start immunisations with J&J doses instead
* Small amounts of J&J to arrive initially
* Rollout will be in study form with researchers
(Adds details)
By Alexander Winning and Wendell Roelf
JOHANNESBURG, Feb 10 (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.
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.
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.
(Reporting by Alexander Winning and Wendell Roelf; additional
reporting by Ludwig Burger in Frankfurt, Krishna Das in New
Delhi, Stephanie Nebehay in Geneva and Kate Kelland in London;
Writing by Raju Gopalakrishnan and Josephine Mason; Editing by
Olivia Kumwenda-Mtambo, Richard Pullin and Nick Macfie)
