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* 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 WHO panel, Gavi, Gray comments)
By Alexander Winning and Wendell Roelf
JOHANNESBURG, Feb 10 (Reuters) - South Africa's health
minister said on Wednesday the government may sell doses of
AstraZeneca's COVID-19 vaccine it may not need or swap
for a different vaccine, 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
offered minimal protection 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 sometime 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 is not clear how a sale or swap would work given the
varying prices for vaccines around the world, or whether the
British drugmaker would have to agree to such a move. The Serum
Institute 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 from the Serum Institute for
doses of a different vaccine available under the COVAX scheme
run by the WHO and international vaccines alliance Gavi.
The move is the latest twist in a saga that has engulfed
South Africa this week as it tries to tame the fast-spreading
variant. The country's death toll is nearing 47,000 and
infections have surpassed 1.47 million.
A WHO panel said on Wednesday that the AstraZeneca vaccine
was safe and effective and should be deployed widely, including
in countries where the 501Y.V2 variant could reduce its
efficacy. Gavi said COVAX was exploring ways for countries
participating in the facility to exchange vaccine doses with
each other to optimise for their needs.
ALTERNATIVES
Turning to J&J for alternative supplies is another blow to
AstraZeneca, whose vaccine is considered critical for poor
nations because it is cheap and easy to store.
South Africa's Ministerial Advisory Committee should be able
to give a considered view on how to deal with the AstraZeneca
vaccine in the next week or two, Mkhize said, adding the
government had also secured 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" and said they could arrive next week.
Officials previously said the country had secured 9 million
J&J single-dose shots, and Mkhize said a deal could be finalised
soon.
Glenda Gray, Medical Research Council (MRC) president, said
the government and the MRC aimed to immunise up to 500,000
health workers in the J&J study, with batches of around 80,000
doses arriving every seven to 14 days once the study is
approved.
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 large global trial. About 95% of
infections in the local study were due to the 501Y.V2 variant.
The 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 it would
not use the AstraZeneca vaccine.
(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, Nick Macfie and Lisa
Shumaker)
