More Haste, Less Speed

South Africa’s COVID-19 vaccine trial is paused, and that’s good news

By David Whitehouse

Posted on September 10, 2020 08:56

A syringe with a vaccine is seen ahead of trials by volunteers testing for the coronavirus disease (COVID-19), and taking part in the country’s human clinical trial for potential vaccines at the Wits RHI Shandukani Research Centre in Johannesburg, South Africa, August 27, 2020. Picture taken August 27, 2020. REUTERS/Siphiwe Sibeko

The interruption in the COVID-19 vaccine trial at South Africa’s University of the Witwatersrand following the suspension of the partner trial in the UK is grounds for reassurance rather than alarm.

The UK trial for the vaccine candidate developed by AstraZeneca was paused on 8 September after a patient developed an unspecified illness.

University of the Witwatersrand (Wits), which is collaborating with the University of Oxford and the Oxford Jenner Institute and vaccinated the first candidates in June, followed suit, citing standard regulatory procedure. The South African study is overseen by the same safety committee as that in the UK.

READ MORE Coronavirus: Africa leads vaccine quest with trials in Johannesburg

Pausing the trials is “application of sound clinical practice and demonstrates the rigour of the independent oversight process”, Professor Shabir Madhi – who is leading the trial at Wits – said in a statement. “Assessing the safety of the vaccine is the reason why studies such as these are essential in South Africa.”

The interruption highlights the danger of the deeply misguided race to be the first to register an approved vaccine. The worst-case scenario is undermining public confidence in vaccinations by rushing them out too quickly.

  • If people don’t trust the vaccine and refuse to use it, then more lives will be lost and the world economy will be damaged for longer. A temporary halt now avoids that.

The fact that one person has some kind of illness does not affect the prospects for any vaccine candidate. Such an occurrence is common in trials. World stock markets, experienced in evaluating the fluctuating prospects for the development of “blockbuster” drugs, disregarded the news and posted gains for the day.

COVID and Race

Madhi told The Africa Report in June that, even in a best-case scenario, he saw no prospect of an effective vaccine being widely available before the middle of 2021. That timetable can easily slip if trials are delayed.

READ MORE China: Africa to have priority access to COVID-19 vaccine

Globally, however, a much bigger concern is getting the trials to reflect the populations that they aim to protect. Lack of sufficient black representation in the testing groups could lead to vaccines being delayed until enough people come forward.

  • In the US, more than half of COVID-19 cases to date are among Blacks and Hispanics. But, according to Dr Jim Kublin of the COVID-19 Prevention Network in the US, only about one in ten volunteers for clinical trials there are drawn from those groups.
  • Lack of black engagement with clinical trials in the US is a long-standing problem. According to the US Food and Drug Administration (FDA), only 9% of the trial participants for 48 new drugs approved in 2019 were Blacks, despite their population share of 13%.

That’s reflected in a relative lack of confidence among American blacks in any future vaccine.

  • According to the Pew Research Center, only 54% of Black adults in the US say they would take an approved COVID-19 vaccine, compared with 74% of White and Hispanic adults.

Many studies have pointed to differing rates of COVID-19 infection and mortality among different races and ethnicities. No-one really knows if people from some ethnic backgrounds are more vulnerable for others, or whether the differences are explained by living conditions, access to healthcare and state of health.

There’s only one way to find out if a vaccine will work equally on different groups and that’s to carry out representative trials. Cutting corners will only undermine the global credibility of whichever candidates are finally used.

Bottom line

A vaccine that has not been tested on all sections of the world’s population won’t protect Africa, or anyone else.

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