THE coronavirus variant discovered in South Africa may evade the protection provided by Pfizer/BioNTech’s COVID-19 vaccine to some extent, a real-world data study in Israel found, though its prevalence in the country is very low and the research has not been peer-reviewed.

The study, released on Saturday, compared almost 400 people who had tested positive for COVID-19, 14 days or more after they received one or two doses of the vaccine, against the same number of unvaccinated patients with the disease.

It matched age and gender, among other characteristics.

The South African variant, B.1.351, was found to make up about 1% of all the COVID-19 cases across all the people studied, according to the study by Tel Aviv University and Israel’s largest healthcare provider, Clalit.

But among patients who had received two doses of the vaccine, the variant’s prevalence rate was eight times higher than those unvaccinated – 5.4% versus 0.7%.

This suggests the vaccine is less effective against the South African variant, compared with the original coronavirus and a variant first identified in Britain that has come to comprise nearly all COVID-19 cases in Israel, the researchers said.

“We found a disproportionately higher rate of the South African variant among people vaccinated with a second dose, compared to the unvaccinated group. This means that the South African variant is able, to some extent, to break through the vaccine’s protection,” said Tel Aviv University’s Adi Stern.

The researchers cautioned, though, that the study only had a small sample size of people infected with the South African variant because of its rarity in Israel.

They also said the research was not intended to deduce overall vaccine effectiveness against any variant, since it only looked at people who had already tested positive for COVID-19, not at overall infection rates.

Pfizer declined to comment on the Israeli study.

Pfizer and BioNTech said on April 1 that their vaccine was around 91% effective at preventing COVID-19, citing updated trial data that included participants inoculated for up to six months.

They have been testing the third dose of their shot as a booster, and have said they could modify the shot to specifically address new variants if needed.

In respect to the South African variant, they said that among a group of 800 study volunteers in South Africa, where B.1.351 is widespread, there were nine cases of COVID-19, all of which occurred among participants who got the placebo. Of those nine cases, six were among individuals infected with the South African variant.

Some previous studies have indicated that the Pfizer/BioNTech shot was less potent against the B.1.351 variant than against other variants of the coronavirus, but still offered a robust defense.

VARIANT IS NOT WIDESPREAD

While the results of the study may cause concern, the low prevalence of the South African strain was encouraging, according to Tel Aviv University’s Stern.

“Even if the South African variant does break through the vaccine’s protection, it has not spread widely through the population,” said Stern, adding that the British variant may be “blocking” the spread of the South African strain.

Almost 53% of Israel’s 9.3 million population has received both Pfizer doses. Israel has largely reopened its economy in recent weeks while the pandemic appears to be receding, with infection rates, severe illness, and hospitalizations dropping sharply.

About a third of Israelis are below the age of 16, which means they are still not eligible for the shot.

Source - Thomson Reuters Foundation

IN a matter of weeks COVID-status certificates, or ‘vaccine passports’, which allow people to more easily show their COVID-19 status, have moved from a fringe issue to the centre of polarised political debates. In the UK, the announcement this week of COVID-status certificate pilots has triggered outcry, from the public, parliamentarians and publicans.

In the U.S., the White House has ruled out a federal system that ‘requires Americans to carry a credential’ on the grounds they infringe on privacy and human rights. Meanwhile, Walmart and New York State, forge ahead with their own rollouts

Why are countries giving serious consideration to these divisive technological solutions?

The case for vaccine passports is they will help to restore partial freedoms, and support economic recovery and social participation before herd immunity is achieved by creating an individual approach to risk.

Coronavirus vaccine passports: What you need to know

Those against using vaccine passports for travel include the World Health Organisation who, this week, cited lingering uncertainty over whether inoculation prevents transmission of the virus.

When it comes to the potential upsides, every country will face a different score sheet, calculated on local contexts of vaccine rollout, hesitancy, access to technology and comfort with identity systems and state monitoring.

But while the opportunities are contextual, many of the risks are universal. Any country or company looking to roll out vaccine passport schemes that are effective, trusted and socially beneficial will need to overcome significant challenges while managing operational overheads and navigating the serious issues posed to society.

The first is technical. With some models bringing together identity information, biometric information (face-scanning for example) with health records, the technology must incorporate the highest-level of security to mitigate risks inherent in bringing sensitive information together. To protect against digital discrimination – wherein those without access to the internet miss out – governments will also need to create a non-digital (paper) alternative that doesn’t open the whole system to fraud.

That’s a tall order, but the real challenge will come in managing use. Governments will need to offer clarity within an array of legal frameworks about the circumstances where it is permitted to request or require an individual to prove their health status.

Even areas that seem less controversial – discretionary and higher-risk settings like football matches, clubs or visiting care homes – will need to be scrutinised against equalities and human rights frameworks, data protection regulation and employment legislation: spaces like bars aren’t ‘discretionary’ if you work there.

The use of passports could disadvantage certain individuals by blocking routes to employment or through raising insurance premiums and pose risks to society by marginalising groups unable or unwilling to be vaccinated.

The justification for building an infrastructure for ‘gatekeeping’ members of the public (employers, publicans, box office staff) to determine other people’s rights and liberties based on their health status, would have been unimaginable pre-pandemic.

One of the biggest risks this poses to all societies is how the infrastructure might be developed or repurposed in the future to sort or stigmatise individuals based on status.

Extraordinary conditions might require extraordinary measures, but introducing them as a tool to secure partial freedoms from pandemic containment will need clear sunset clauses and timelines to dismantle the infrastructure post-crisis.

The last challenge countries face will be winning the public’s trust to ensure vaccine passports’ use is seen as legitimate. There are some people in all societies who may have legitimate concerns about harms arising from this technology – those who face over surveillance by police, with insecure citizenship or employment status, or those unable to have the vaccine.

As some apps under consideration conflate two publicly contentious systems – COVID-status certificates and facial recognition technology – this may compound public concerns about discrimination, and have implications for civil liberties.  

Against these challenges, governments must question whether vaccine passports will deliver what advocates hope for. They will need to evaluate how taking an individualistic approach to managing risk interacts with collective health measures – domestically and globally – from mass vaccination to wearing facemasks. Finally, they must calculate whether the societal risks and operational overheads are justified, or whether it will prove a technological distraction from the only effective goal to reopen society safely and equitably: global vaccination.

Source - Thomson Reuters Foundation

KENYA will let private hospitals charge for COVID-19 vaccinations and will not set a price limit on their cost – a measure charities warned would “price out the poor” and create greater inequalities in access.

The East African nation of more than 50 million people has so far received one million vaccine doses through the World Health Organization’s COVAX facility, and plans to procure another 11 million for the public sector in the coming months.

Patrick Amoth, acting director-general at the Health Ministry, said on Thursday private hospitals would be permitted to import coronavirus vaccines, subject to the necessary approvals, and offer their own inoculation service.

“The private sector plays a critical role in health services and they cannot be excluded from the provision of vaccination services, which is part of the routine services that they do provide,” Amoth told the Thomson Reuters Foundation.

“They have been excluded so far because of the limited supply of vaccines, but as more vaccines come onto the platform, definitely they will have a role,” he said, adding that the private sector provided almost 48% of health services in Kenya.

Amoth said the government would not put a price cap on vaccines and would allow “market forces” to determine the cost. Those who cannot afford the vaccine will be able to get it free-of-charge from public hospitals, he added.

“We believe that if we allow many players in the market, the rules of supply and demand dictate that the prices will be reasonable,” he said.

Two vaccines – the AstraZeneca vaccine and Russia’s Sputnik V – have so far been granted emergency use by Kenya’s Pharmacy and Poisons Board.

Health ministry officials said on Wednesday private players would need to be granted registration by the board and that any vaccines entering the country will have met approval requirements.

‘FREE FOR ALL’

Charities campaigning for equitable access of the vaccine criticized the decision, saying that placing procurement in the hands of the private sector would result in only the well-off being vaccinated.

“The move will be pricing out the poor,” said Joab Okanda, Pan Africa Just Economies and Inequality lead for Oxfam International.

“The public sector is not in a position to procure enough vaccines itself, so we will be leaving the vaccines to only those with money. Vaccines should be supplied by the government and be made free for all.”

Opening up the market to private players also raised safety concerns, said Okanda, as it would encourage unauthorised suppliers to sell unapproved vaccines on the black market.

Kenya recently extended a nationwide overnight curfew for a further 60 days as the country battles a third wave of infections.

East Africa’s biggest economy has so far recorded more than 120,000 coronavirus cases and 2,000 deaths, and positive test rates have risen to 16.5% in March compared with January’s 2%.

Njoki Njehu, Africa coordinator for the Fight Inequality Alliance, described Kenya’s vaccine move as “the worst decision the government has ever made” and dismissed claims that the cost of the vaccine would be reasonable.

“It’s ridiculous to believe the vaccines will be affordable. Private companies exist to profit and so the costs will naturally be high,” said Njehu.

“Kenyans have already suffered enough during this pandemic due to the lockdowns. It is the most marginalised who have lost the most. Bringing in the private sector will only exacerbate inequalities in our society.”

The Association of Private Hospitals in Kenya did not immediately respond to a request for comment.

Due to the limited supply of vaccines, most countries have restricted their private sector from procurement of vaccines.

Pakistan, one of the first countries in the world to allow private imports of COVID-19 vaccines, said it will receive shipments of China’s CanSino Biologics Inc’s vaccine this week.

Kenya plans to vaccinate 1.25 million people – including frontline heath workers, the elderly and teachers – by June and another 9.6 million in the next phase.

The Health Ministry said earlier this month the country plans to vaccinate about 15 million people nationwide by the end of June 2023.

Thomson Reuters Foundation

THE following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

No variants escape all types of antibodies, so far

The human immune system makes many antibodies in response to COVID-19 infection or vaccination, and no single variant of the new coronavirus can yet escape all of them, according to a study posted on Thursday on bioRxiv ahead of peer review. Researchers looked at how mutations in coronavirus variants affect antibodies’ ability to target a key region on the virus spike called the receptor-binding domain (RBD), which has been mutating rapidly. In particular, the researchers studied three sets of antibodies that were classified by the structural features that affect their binding to the virus. Despite the diversity of antibodies, just one class dominates the antibody response that targets the RBD, they found. They also looked to see how many different classes of antibodies can be evaded by new coronavirus variants. “Several lineages have mutations that reduce binding by two of the antibody classes, but so far no lineages have mutations that escape all three classes,” said coauthor Jesse Bloom of the Fred Hutchinson Cancer Research Center in Seattle. “We suggest this is an important thing to keep an eye on as the virus continues to evolve.”

Coronavirus variants can infect mice

Some of the new coronavirus variants can cause COVID-19 in mice, researchers have found. The implications, such as whether mice could then transmit the virus to humans, will require further study, they said. The original virus strain identified in Wuhan, China, could not produce illness in mice because the spikes on its surface could not bind well to the ACE2 receptor protein on the animals’ cells. Some of the new concerning variants – particularly the ones first identified in South Africa and Brazil – have mutations that overcome this challenge, giving them the ability to infect and sicken the mice, researchers reported on Thursday on bioRxiv ahead of peer review. “This is indeed great news for animal studies to better understand the infection and disease as mice are widely available … to study many pathologies, and easier to work with than larger animals such as hamster or ferret,” said coauthor Etienne Simon-Loriere of Institut Pasteur in Paris. Whether mice can transmit the virus to each other or to humans remains to be determined. “We do not have expertise to evaluate the health risk posed by this newly acquired capacity of SARS-CoV-2, but this is definitely something that will need to be done,” Simon-Loriere said. “No one wants the virus to move to a new reservoir from where it could come back to humans, as was feared with mink farms, and hopefully it will not happen.”

Homeless patients in Boston benefit from recuperation unit

Homeless people needed to be hospitalized for COVID-19 less often after Boston Medical Center created a recuperation unit for them, according to a new report. Boston experienced a surge in cases during the spring of 2020, which disproportionately affected people experiencing homelessness and threatened to overwhelm hospital capacity. As a response, the COVID-19 Recuperation Unit was set up near Boston Medical Center to provide isolation and quarantine space for homeless people who didn’t need hospitalization and were medically stable, saving hospital beds for patients with severe COVID-19. By the time the unit had been open for two months, the hospital saw a 28% reduction in admissions of COVID-19 patients experiencing homelessness, researchers reported in JAMA Network Open. COVID-19 social distancing and quarantining restrictions “were developed from the perspective of the ‘haves’ and not from the ‘have-nots,'” said coauthor Dr. Joshua Barocas of Boston University School of Medicine. “By re-centering the conversation on people experiencing homelessness, we can actually see that resources are needed in order to keep them and all of us safer.”

Open in an external browser for a Reuters graphic on vaccines in development.