Govt, WHO defend use of AstraZeneca vaccine in Lesotho

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Herbert Moyo

HEALTH Minister Semano Sekatle and the World Health Organisation (WHO) have defended the planned use of the AstraZeneca vaccine in Lesotho, saying it would be highly effective against more severe symptoms of the Covid-19 disease.

In an exclusive interview with the Lesotho Times this week, Mr Sekatle and WHO representative in Lesotho, Richard Banda, said Basotho should not read too much into reports that the vaccine had been found to be ineffective against the South African variant, of the deadly disease also known as B.1.351 or 501.V2. They said South Africa had only released preliminary findings based on a study of the effectiveness of the vaccine in just a tiny fraction of that country’s estimated 58, 6 million population.

Mr Sekatle and Dr Banda’s sentiments were echoed by Nthatisi Mothisi, the manager of the Expanded Programme on Immunisation (EPI) in the health ministry, and Tholoana Masupha, the senior programme manager at the Clinton Health Access Initiative in Lesotho.

Last week, Mr Sekatle announced that Lesotho had ordered Covid-19 vaccines from three different leading pharmaceutical companies.

He said the government had ordered the Pfizer, Johnson & Johnson as well as the AstraZeneca vaccines ahead of rolling out a mass vaccination programme which is likely to begin next week with the vaccination of health workers.

The three vaccines are seen as the best way of fighting Covid-19. A study of 1, 2 million people in Israel, which has vaccinated most of its population with the Pfizer vaccine over the last two months, found that it was 94 percent effective across all age groups.

Some studies have shown that the Johnson & Johnson vaccine can be 85 percent effective in treating Covid-19 and preventing infections.

It has been recommended for use in the United States of America (US)- the country with the highest number of Covid-19 infections in the world. By yesterday, the US had recorded a cumulative total of 29 143 256 infections and 523 294 deaths.

While the AstraZeneca has been used in other jurisdictions it has been found to be ineffective against the South African variant of Covid-19.

South Africa took delivery of a million doses of the AstraZeneca vaccine before halting more deliveries after a study found that the vaccine was ineffective against its variant of the virus.

South African Health Minister Zweli Mkhize subsequently said his country would sell AstraZeneca vaccines to the African Union (AU) for distribution to countries “who have already expressed interest in acquiring the stock”.

The South African findings have raised fears in several quarters that the AstraZeneca vaccine would also be ineffective in Lesotho. Given that Lesotho is completely surrounded by South Africa and many Basotho either live and work in South Africa while others regularly travel between the two countries, it is highly likely that this country has been exposed to the South African variant of Covid-19 which the AstraZeneca vaccine has reportedly proved ineffective against.

Despite these misgivings, Mr Sekatle said Lesotho was forging ahead with the use of the AstraZeneca vaccine. He sought to allay fears about its efficacy, saying it had proved to be effective in preventing deaths and treating severe symptoms of the Covid-19 disease.

His sentiments were echoed by Dr Banda who said Lesotho should use the AstraZeneca vaccine to reduce deaths and other severe symptoms of Covid-19.

Dr Banda said in any event, the South African study which had raised questions about the efficacy of AstraZeneca was a preliminary study which had several limitations. Therefore, the study could not be used as a yardstick in determining the vaccine’s effectiveness, he said.

Asked if Lesotho had actually conducted any studies to ascertain whether the country had the South African variant of Covid-19, Dr Banda said, “we have collected specimens and sent them to the National Institute for Communicable Diseases (NICD) laboratory in South Africa to see whether we have the South African variant circulating in Lesotho and if so to what extent it is circulating.

“More specimens will be sent this week. The results are not yet back. But whether there is the South African variant circulating in Lesotho or not, we still recommend the use of AstraZeneca because all that South Africa did in its study was to assess its effectiveness in preventing the mild symptoms. But other studies have shown that AstraZeneca is highly effective in reducing severe symptoms.”

When it was put to him that the South African study had concluded that AstraZeneca was only 22 percent effective, Dr Banda said, “severe symptoms are what we are worried about here in Lesotho.

“The South African study on AstraZeneca had a lot of limitations. They found out that the vaccine was 22 percent effective in protecting against mild symptoms. What was not assessed was how well the vaccine would protect against very severe symptoms.

“So, the (South African) study did not come out with findings on how well this vaccine can prevent deaths and other severe symptoms. Also, it should be noted that when you are vaccinated, there are two types of reactions that the body develops. There is an antibody reaction and then there’s cellular immunity. Now what they tested in the South African study was the antibody reaction but they did not test to ascertain whether the vaccine would generate cellular immunity in people.

“Even South Africa now wants to do further studies because what they found was just preliminary. We cannot suspend a vaccine because of preliminary findings which are yet to be confirmed by a larger study,” Dr Banda said.

Ms Mothisi and Ms Masupha concurred, saying the South African study was not conclusive as it had been conducted on just 2000 people around the same age group. They said it would therefore be difficult to extrapolate the preliminary findings and use them as a basis for concluding that the vaccine was ineffective in the general population of South Africa which is currently estimated at 58, 6 million.

South Africa has the 16th highest number of Covid-19 infections in the world. As of yesterday, it had recorded a cumulative total of 1 514 815 infections and 50 271 deaths.

Although Mr Sekatle said people would not be forced to vaccinate, he and the health experts urged the public to be vaccinated.

“My message to Basotho is that they should understand that the decisions that the leadership of this country is making right now are very important,” Dr Banda said.

“I urge them to listen to their leaders and be vaccinated. This vaccination programme can only be successful if people participate in large numbers. We ask them to accept these vaccines because these vaccines will help all of us to reduce the number of Covid-19 deaths and hospitalisations. Not only will these vaccines save lives, they will also help the economy of this country to recover because once people have been vaccinated economic activities will resume and many people will be able to get back to their productive capacities and contribute to national development.”

Ms Mothisi said they were ready to roll out the vaccination programme.

“What I can say is that from the programme side, the country is ready to roll out the vaccine. We have developed a curriculum because the vaccinators have to know exactly how to manage the vaccinations. So, we are planning to start vaccinating soon, probably next week.

“We are expecting an initial 36 000 doses of vaccines. Each person will get two doses. Phase one of the immunisation programme will target health workers.

“Phase two will target essential workers, the elderly, those with chronic illnesses and the last phase will target the rest of the population,” Ms Mothisi said.

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