Shabir Madhi. Picture: SUPPLIED/WITS
Shabir Madhi. Picture: SUPPLIED/WITS

SA will spearhead the first trial in Africa to test a vaccine against Covid-19. The trial, which will begin on Wednesday, will be led by Wits professor Shabir Madhi, who is a global leader in vaccine development.

Madhi said a vaccine is needed as the coronavirus is likely to rebound multiple times in SA, adding, “We can expect subsequent waves of outbreaks for at least the next 12-24 months unless a vaccine comes sooner.”

The vaccine was developed by the Jenner Institute at the University of Oxford, where it has already been tested on more than 7,000 people to see if it is safe and effective. It is one of six Covid-19 vaccines in trials worldwide.

There are 268 vaccines in development against the coronavirus.

This vaccine is expected to be tested on 10,000 people in Britain, while about 5,000 people in Brazil and 10,000 in the US will receive it in different studies.

Locally, the vaccine or a placebo will be tested on 50 people, for safety, starting on Wednesday, then on 1,900 South Africans who are healthy, under the age of 65 and do not have HIV/Aids, to see if it works to protect against the virus.

Then it may be tested on 50 HIV-positive patients to see if it is safe for them too.

A placebo of salt water is given to half the vaccine participants so scientists can later compare whether people who got the real vaccine were less likely to become infected with Covid-19, and compare side effects between groups. The participants will be followed for a year.

Madhi estimated that there are almost 35,000 new infections a week in SA. This estimate is based on modelling as most mild and asymptomatic cases are not tested. 

Madhi said another reason a vaccine is needed is because it is not clear if people who have mild or asymptomatic Covid-19 develop a strong enough and durable immune response to protect them from getting the virus again. 

When he put out a call for interest in participating in the study at a trial site in Soweto, more than 1,000 people arrived at the clinic in three days. Potential participants undergo an intensive process to ensure they understand what consenting to being involved means and must pass a test that assesses their understanding. 

Madhi’s work on vaccines has led to the global use of both the pneumococcal and rotavirus vaccines in worldwide childhood immunisation. These vaccines protect against pneumonia and some causes of diarrhoea in young children, which are big killers of children under five years old. His work has also shown that it is safe for pregnant women to get the influenza vaccine to protect their foetuses from flu in the first few months of life.

Madhi said he does not expect more than five Covid-19 vaccines in total to be successful as there is high attrition in the field of vaccine development.

‘Vaccine nationalisation’

There are expected to be two more vaccines against Covid-19 tested in 2020 in SA, said Prof Glenda Gray, head of the SA Medical Research Council (SAMRC), which is a funder of the study.

The more involved SA is in vaccine development, the closer the country will be to the “front of queue” for access when a vaccine is developed, said Gray. 

Prof Helen Rees, chair of the SA Health Products Regulatory Authority, said Africa needs to be part of vaccine testing. “We cannot only have a vaccine developed in the northern hemisphere. We need to know if it is safe and effective in all populations.”

She said that if a vaccine is developed, the world will need billions of doses of it, which will not be possible at first,  meaning it will be rationed. 

She added that there is growing “vaccine nationalisation” with countries wanting to manufacture vaccines for their own citizens first. “It is important that African countries have access to Covid-19 vaccines if the trials are successful, and being part of scientific trials help ensure this.”

Update: June 23 2020 
This article has been updated with comment and information throughout.

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