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In a Crucial South African Vaccine Trial, a Cautionary Tale


Once afterthoughts in the vaccine race, those global trials have saved the world from sleepwalking into year two of the coronavirus, oblivious to the way the pathogen could blunt the body’s immune response, scientists said. They also hold lessons about how vaccine makers can fight new variants this year and redress longstanding health inequities.

The deck is often stacked against medicine trials in poorer countries: Drug and vaccine makers gravitate to their biggest commercial markets, often avoiding the expense and the uncertainty of testing products in the global south. Less than 3 percent of clinical trials are held in Africa.

Yet the emergence of new variants in South Africa and Brazil has shown that vaccine makers cannot afford to wait years, as they often used to, before testing whether shots made for rich countries work in poorer ones, too.

“If you don’t identify and react to what’s happening in some supposedly far-flung continent, it significantly impacts global health,” said Clare Cutland, a vaccine scientist at the University of the Witwatersrand in Johannesburg, who coordinated the Oxford trial. “These results highlighted to the world that we’re not dealing with a single pathogen that sits there and does nothing — it’s constantly mutating.”

Despite offering minimal protection against mild or moderate cases caused by the variant in South Africa, the Oxford vaccine is likely to keep those patients from becoming severely ill, averting a surge of hospitalizations and deaths. Lab studies have generated a mix of hopeful and more worrisome results about how much the variant interferes with Pfizer and Moderna’s shots.



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