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26 Nov, 2020 18:32

I’m an epidemiology professor and I have some genuine concerns about the AstraZeneca Covid vaccine. Here’s why…

I’m an epidemiology professor and I have some genuine concerns about the AstraZeneca Covid vaccine. Here’s why…

As the world awaits the roll-out of a vaccine to combat coronavirus, the announcement of AstraZeneca’s trial results this week was greeted with enthusiasm by some and scepticism by others. I believe there will be better options.

With over one-and-a-half million Covid-19 deaths and six million recorded cases worldwide, everyone is aware that the need for a vaccine to stop the spread of the virus is urgent. It has to be developed swiftly and safely, and target all age groups, particularly those at higher risk.

The race is hotting up, and among those working on one is the Swedish/British company AstraZeneca, which announced earlier this week that it had developed a vaccine that was ‘on average’70 percent effective. This claim came five days after US pharmaceutical company Pfizer had announced that its coronavirus vaccine was 95 percent effective and had “no serious side effects”.

Perhaps AstraZeneca was confident enough that its product would be strongly competitive in the market due to two key advantages it offers over rival products – a lower price and the relatively uncomplicated way of storing it.

But the AstraZeneca announcement did not impress Wall Street – the company registered a drop of two percent in the stock market. It’s worth bearing in mind that the primary goal of western pharmaceutical corporations is not to serve public health, but maximising the profits of the company. And that was primarily the reason, in my opinion, why AstraZeneca updated the interpretation of the results of its clinical trials. By 24 November, the media headlines were reporting that AstraZeneca’s vaccine was 90 percent effective. The previously mentioned ‘70 percent’ – and ‘62 per cent’ in some circumstances – had been dropped.

A closer view of the AstraZeneca reports showed that the ‘70 percent’ was obtained as the ‘average’ of two different doses regimes – one with 62 percent effectiveness, from samples in Brazil; one with 90 percent from the UK sample. Neither data details on the trials, nor peer reviewed reports, are available. In addition, it has now became established that the 90 percent efficacy UK sample was obtained with only younger subjects.

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In a statement released by the company, Professor Andrew Pollard, chief investigator of the Oxford Vaccine Trial, declared: “Excitingly, we’ve found that one of our dosing regimens may be around 90 percent effective and if this dosing regime is used, more people could be vaccinated…”

Aside from the aggravating fact that the ‘90 percent’ result was arrived at via a mistake in dosage caused by a manufacturing error by AstraZeneca, the question is, who is then going to buy the ‘62 percent’ dosing regimen vaccine? Or, as Anthony Fauci, the Director of US National Institute of Allergy and Infectious Diseases, put it: “What are you going to do with the 70 percent when you’ve got two [vaccines] that are 95 percent?” 

Fauci was referring to the Pfizer vaccine and one from Moderna, but an equally effective product, with demonstrated 95 percent effectiveness, is the pioneer Sputnik V one developed by the Gamaleya Center for Epidemiology and Microbiology in Moscow.

According to The Telegraph, the World Health Organisation (WHO) is in talks with the Russian research institution that worked on Sputnik V “concerning its potential application for Emergency Use Listing”. It is already being trialled in Hungary.

The Sputnik V has a vaccine efficacy of over 95 percent, 42 days after the first dose. On day 28 after the first dose it achieves 91.4 percent efficacy. Clinical trial protocols indicate that over 18,000 volunteers had received the first and second doses of the vaccine.

Comparing the Swedish/British AstraZeneca vaccine with the Russian Sputnik V, substantial differences can be observed in their composition and in their targeting, which may explain the different degrees of effectiveness they have in humans. 

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The AstraZeneca program works out an adenovirus, chimpanzee-originated, whose DNA genetic payload has been detached, then replaced with a DNA to produce the SARS-CoV-2 virus protein. There have been suggestions in the scientific community that the first shot may hamper the immunity capability.

Instead, Sputnik V uses two different human adenovirus vectors. It is a two-stage dose, using firstly an Ad26-spike vaccine, and 21 days later a booster with an Ad5 spike. The two different adenovirus are to prevent hampering the second shot, which would happen if the same vector is used in the schema.

As Dr Fauci explained, in the AstraZeneca schema “the smaller initial dose [the priming] may “tickle” the immune system enough to generate T cells, but not trigger development of antibodies that might work to suppress the response to the booster shot.”

AstraZeneca’s international marketing of its vaccine suggested that its price would be much lower than its competitors. To me, it sounds like a neo-colonialist challenge directed to countries with poorer economies: trade effectiveness for affordability. Richer countries will opt for quality, regardless of price.

There is another decisive factor why the Sputnik V vaccine should actually be considered by poorer countries. This is the fact that the Russian vaccine can be transported and stored in a standard cold chain, without the need for ultra-low temperatures (such as around minus 80° C as in the case of Pfizer). This would avoid the investment in large and expensive ‘cold farms’, that these poorer countries would have difficulty in implementing. As Charlotte Houldcroft, a University of Cambridge virologist, stated: “Sputnik V…needs a standard cold chain to be rolled out rather than an ultracold chain like the RNA vaccines, and that’s a big plus.”

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Furthermore, my scientific epidemiological confidence in Sputnik V is demonstrated by the fact that I am trying, from Italy, to acquire – with my own private funds –740 dosing units to donate to the elderly population of one commune in Bergamo, San Giovanni Bianco, that has been one epicentre of the pandemic. Yes, the administration of the vaccine would first have to be approved by the Italian health authorities. But assuming it is, perhaps other local initiatives would, or should, do the same to protect their elderly population at risk.

One other element worth mentioning regarding the AstraZeneca vaccine is the problematic topic of safety, which I discussed when interviewed recently on RT television.

During the clinical trials, there were issues which – to the best of my knowledge – have not been fully clarified. For example, in the preclinical phase, where rhesus macaque monkeys were used, it was not shown that sufficient protection against infections was provided. In the combined 2 and 3 trials, blood monitoring was recorded in one out of ten of participants: in 46 percent of these a transient decrease of the white blood cells (neutrophils) was observed. And most concerning was a case, possibly two, of transverse myelitis, inflammation of the spinal cord.

In conclusion, it’s also worth saying that considering the ever-growing number of Covid-19 deaths and new infections – and the scarcity of health care resources in many parts of the world – it's unforgivable that Western pharmaceutical corporates have not coordinated research efforts to provide the world with a safe, affordable vaccine in the spirit of human rights for all.

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The statements, views and opinions expressed in this column are solely those of the author and do not necessarily represent those of RT.