U.S. pauses J&J COVID-19 vaccine over rare blood clots

By Manas Mishra and Michael Erman

(Reuters) – U.S. federal health agencies on Tuesday recommended pausing the use of Johnson & Johnson’s COVID-19 vaccine after six women under 50 developed rare blood clots after receiving the shot, dealing a fresh setback to efforts to tackle the pandemic.

The move comes a week after European regulators said they had found a possible link between AstraZeneca’s COVID-19 vaccine and a similar rare blood clotting problem that led to a small number of deaths.

Johnson & Johnson’s (J&J) single dose vaccine – most COVID-19 shots are delivered over two doses – and AstraZeneca’s low-cost vaccine are seen as vital tools in the fight against a pandemic that has claimed more than three million lives.

Most of the available J&J vaccine has been used in the United States due to production issues that have limited the company’s supply. As of April 12, more than 6.8 million doses of the J&J vaccine had been administered in the United States, compared with more than 180 million shots combined of the Moderna and Pfizer/BioNTech shots.

An advisory committee to the U.S. Centers for Disease Control and Prevention (CDC) will meet on Wednesday to review the cases, and the U.S. Food and Drug Administration (FDA) will review the analysis, the agencies said in a joint statement.

All six cases involved women between the ages of 18 and 48, and the symptoms occurred six to 13 days after vaccination.

In the cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia).

The CDC and FDA said the adverse events appeared to be extremely rare.

“I think this is a very low risk issue, even if causally linked to the vaccine: 6 cases with about 7 million doses (lower than the risk of clots with oral contraceptives) is not something to panic about,” Dr. Amesh Adalja, an infectious disease expert at the Johns Hopkins Center for Health Security in Baltimore, said in an email.

“People are asking me if they should cancel their J&J vaccine appointments and I have told them not to but I know many will and this will stall progress in controlling the pandemic.”

J&J said it was working closely with regulators and noted no clear causal relationship had been established between the cases and the COVID-19 vaccine made by its Janssen unit.

One woman died and a second in Nebraska has been hospitalized in a critical condition, the New York Times reported, citing officials.

‘ABUNDANCE OF CAUTION’

“The FDA recommendation to pause the administration of the Johnson and Johnson vaccine out of an abundance of caution makes sense in terms of the nature of the unusual and serious side effect not seen with the other vaccines,” said Dr. Robert Klugman at the UMass Memorial Medical Center in Massachusetts in an email.

“While the incidence is very low, the severity and potential for brain damage and other blood clot-related injuries is of great concern.”

J&J’s shares were down 3% before the opening bell.

The U.S. move comes less than a week after Europe’s drugs regulator said it was reviewing rare blood clots in four people in the United States who had received the J&J shot.

The J&J and AstraZeneca vaccines both use an adenovirus vector – a harmless cold virus that instructs human cells to produce a protein found on the surface of the coronavirus, thereby spurring the immune system to prepare an arsenal against the COVID-19-causing virus.

Among leading global COVID-19 vaccine developers, China’s CanSino Biological and Russia’s Gamaleya Institute with its Sputnik V vaccine are also relying on this approach. The Pfizer/BioNtech and Moderna vaccines use mRNA technology.

The rollout of J&J’s vaccine has been slowed by issues at production plants.

The company has supplied the United States with at least 20 million doses but is behind schedule on its deliveries. Problems at a Baltimore, Maryland plant run by outside contractor Emergent BioSolutions forced the companies to trash a batch of vaccine substance.

The plant – meant to be one of J&J’s main U.S. manufacturing facilities – has yet to be approved by U.S. regulators to supply vaccine doses, and J&J shipments to the states were expected to fall sharply next week.

J&J only began delivering its COVID-19 vaccine to European Union countries this week. It has committed to delivering 55 million doses to the bloc by the end of June and another 120 million in the third quarter.

J&J has been doing vaccinations in South Africa to study the effects on health workers, and had vaccinated just under 300,000 people there as of Monday, according to data from the country’s health department. J&J recently struck a deal with the African Union for up to 400 million doses.

Europe’s drugs regulator continues to recommend the use of AstraZeneca’s COVID-19 vaccine, saying the benefits outweigh the risks. Several EU countries, however, have limited its use to certain age groups.

Australia has no current plans to add J&J’s coronavirus vaccine to its immunization drive, authorities said on Tuesday, as it moves away from procuring vaccines under review for potential links to blood clots.

(Reporting by Manas Mishra in Bengaluru and Michael Erman in Maplewood, N.J., additional reporting by Julie Steenhuysen in Chicago and Ludwig Burger in Frankfurt; Editing by Sriraj Kalluvila and Mark Potter)

European countries may have to mix COVID-19 shots amid AstraZeneca crisis

By Matthias Blamont, Gwladys Fouche and Essi Lehto

PARIS (Reuters) – Several European countries are considering mixing up COVID-19 vaccines for citizens who received a first dose of AstraZeneca’s shot, an unprecedented move that highlights challenges for governments struggling to tame fresh rises in infections.

Vaccination programs have been upset after a small number of reports that recipients of the AstraZeneca inoculation have suffered extremely rare blood clots, leading some countries worldwide to suspend its use out of caution.

A senior official for the European Medicines Agency (EMA) said in an interview published on Tuesday there was a link between the vaccine and rare blood clots in the brain but the possible causes were still unknown.

The EMA later said in a statement that its review of the vaccine was ongoing. It will give an update on its investigation on Wednesday afternoon.

AstraZeneca has said previously its studies have found no higher risk of clots because of the vaccine, millions of doses of which have been administered worldwide.

While many countries have resumed using the shot, some have imposed age restrictions.

In many instances, this has left officials scratching their heads over what to do for people who received a first dose of AstraZeneca but are no longer eligible under the new rules.

While the numbers are small compared with the tens of millions being inoculated across the region, the decision is significant because it has not been tested in late-stage human trials.

Any divergence to the EMA’s marketing authorization would also be considered as “off label use”, meaning it would not be approved by the regulator and leave individual countries responsible for any possible side-effects.

The EMA had no immediate comment when asked about mixing and matching vaccines and referred to the briefing later on Wednesday.

Some experts say that, because all of the vaccines target the same outer “spike” protein of the virus, they could work together to train the body to fight off the virus. There is no evidence it will be as effective.

Germany was the first European country to recommend on April 1 that people under 60 who have had a first AstraZeneca shot should receive a different product for their second dose.

Norway will decide whether to resume using AstraZeneca’s vaccine or rely on alternatives by April 15.

“The outcome is either you get one vaccine, the AstraZeneca vaccine … or you get a booster vaccine with other types of vaccines,” Sara Viksmoen Watle, a senior physician at the Norwegian Institute of Public Health, told Reuters.

Norwegian authorities are also waiting for the results of a British trial launched in February to explore mixing doses of Pfizer and AstraZeneca vaccines. The timing of the data is not known.

Britain said late last year it would allow people to be given shots of different COVID-19 vaccines on rare occasions, but it has not yet had to do so.

Finland, which resumed using the AstraZeneca vaccine from March 29, but will only give it to people aged 65 and over, said it would wait for the EMA’s conclusions before making a recommendation. It will have to start giving second doses by mid-April.

In France, where the vaccine can now only be used for those aged 55 or older, the issue affects hundreds of thousands of people.

A top health advisory body in charge of defining the use of vaccines, the Haute Autorité de la Santé (HAS), is also contemplating deploying a messenger RNA (mRNA) vaccine produced by Pfizer-BioNTech or Moderna as a second dose, according to two sources aware of the organization’s plans.

A formal decision has not been yet taken, however, as experts await more data, notably from Britain, one of the sources added. France has until early May, which marks 12 weeks after the first doses were administered.

The HAS had no comment.

Back in February, it said there was no data to assess interchangeability of AstraZeneca’s vaccine and therefore advised that those who had already received a first dose should not get a different shot when vaccinated for the second time.

“We are left guessing and that makes me and other colleagues feel very uncomfortable,” said Charlotte Senechal, a 52-year-old hospital nurse working in Strasbourg, eastern France.

India AstraZeneca shot delay could be ‘catastrophic’ for Africa: health official

ADDIS ABABA (Reuters) – India’s temporary hold on major exports of AstraZeneca’s COVID-19 shot will undermine Africa’s vaccination plans, and could have a “catastrophic” impact if extended, the head of the continent’s disease control body said on Thursday.

India decided to delay big exports of the shots made in its territory by the Serum Institute of India (SII) to make sure it could meet local demand, two sources told Reuters last week.

The hold “will definitely impact our ability to continuously vaccinate people,” the director of the Africa Centers for Disease Control and Prevention, John Nkengasong, told a news conference in Addis Ababa.

The African Union had planned to vaccinate 30-35% of the continent’s population by the end of the year he said. “If the vaccines are delayed we are unlikely to meet our target,” he added.

That AU target primarily relies on supplies from the global COVAX vaccine-sharing facility, through which 64 poorer countries including many in Africa are supposed to get doses from the SII. COVAX aims to provide enough shots for African countries to inoculate at least 20% of their populations.

“If the delay continues, I hope it’s a delay and not a ban, that would be catastrophic for meeting our vaccinations schedule,” Nkengasong said.

African countries have reported 4.25 million coronavirus infections and 112,000 related deaths, though experts have said the actual numbers could be higher.

The AU has also been negotiating with manufacturers to help member states secure the additional doses they will need to achieve 60% coverage.

On Monday, Johnson & Johnson announced it would supply the AU with up to 400 million doses of its COVID-19 vaccine. Delivery of those doses is due to begin in the third quarter of this year and will continue through 2022.

Those doses are separate from the GAVI/WHO-backed global COVAX facility.

Nkengasong said on Thursday the AU has “pivoted” towards the J&J shot in part as a result of the delay in the delivery of AstraZeneca shots, and also because it is a single-dose shot.

The J&J doses will begin to arrive in June or July, which will ease any shortage caused by the delay in the AstraZeneca doses, Nkengasong said. The gap until the arrival of the J&J doses is a concern, he added.

(Reporting by Addis Ababa newsroom; Writing by Maggie Fick; Editing by Andrew Heavens)

Immune response may be linked to AstraZeneca vaccine clot issue; death risk rising among young adults in Brazil

By Nancy Lapid

(Reuters) -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.

Immune response may explain rare clots after AstraZeneca vaccine

Researchers may have found an explanation for the rare but serious blood clots reported among some people who received AstraZeneca’s COVID-19 vaccine. They believe the phenomenon is similar to one that rarely occurs with a blood thinning drug called heparin, called heparin-induced thrombocytopenia (HIT). In HIT, the drug triggers the immune system to produce antibodies that activate platelets, which cause blood to clot. Drugs other than heparin can cause clotting disorders that strongly resemble HIT, and researchers suspect that in rare cases, the AstraZeneca vaccine may be another such trigger. Four previously healthy individuals who got the AstraZeneca shot and developed life-threatening clots had the same kind of antibodies that activate platelets and initiate clotting in HIT, the researchers reported on Monday in a paper posted on Research Square ahead of peer review. Twenty individuals who received the vaccine but did not develop clots did not have these antibodies. An editorial comment posted with the study noted that drug-induced thrombocytopenia is treatable if identified promptly. Millions of people have received the vaccine without issues and European regulators and the World Health Organization say the benefits of the AstraZeneca shot outweigh its risks.

COVID-19 death risk rising for young adults in Brazil

Southern Brazil is seeing a sudden rise in COVID-19 deaths among young and middle-aged adults after the identification there of a concerning virus variant known as P.1, researchers said. They analyzed data from Parana – the largest state in southern Brazil – on 553,518 cases diagnosed from September 2020 through March 17, 2021. In all age groups, the proportion of patients who died either held steady or declined between September and January. Starting in February, however, fatality rates rose for almost all groups over age 20, according to a report posted on Friday on medRxiv ahead of peer review. From January to February, these rates tripled among patients aged 20 to 29, from 0.04% to 0.13%, and doubled among those aged 30 to 39, 40 to 49, and 50 to 59. “Individuals between 20 and 29 years of age whose diagnosis was made in February 2021 had an over 3-fold higher risk of death compared to those diagnosed in January 2021,” the researchers said. “Taken together, these preliminary findings suggest significant increases in case fatality rates in young and middle-aged adults after identification of a novel SARS-CoV-2 strain circulating in Brazil, and this should raise public health alarms.”

Pfizer, Moderna vaccines limit asymptomatic infections

Vaccines from Pfizer Inc and partner BioNTech SE and from Moderna Inc dramatically reduced the risk of infection by the new coronavirus within weeks after the first of two shots, according to data from a study of nearly 4,000 U.S. healthcare personnel and first responders in six states. Previous trials by the companies evaluated the vaccines’ efficacy in preventing illness from COVID-19, but would have missed infections that did not cause symptoms. In the new study, conducted from mid-December to mid-March, nearly 75% of participants had received at least one dose of vaccine, and everyone had weekly coronavirus testing for 13 consecutive weeks in order to pick up asymptomatic infections. According to a report published on Monday by the U.S. Centers for Disease Control and Prevention (CDC), the risk of infection fell by 80% two weeks or more after the first of two shots and by 90% by two weeks after the second shot. “The authorized mRNA COVID-19 vaccines provided early, substantial real-world protection against infection for our nation’s healthcare personnel, first responders, and other frontline essential workers,” CDC Director Rochelle Walensky said in a statement.

Pandemic has cut parents’ access to hospitalized children

Pediatricians have long endorsed the idea that babies and children in hospitals should not be separated from their families – a practice that in many facilities was restricted or discontinued to limit COVID-19 infections, according to new research. From mid-May through early July, researchers collected survey responses from 96 pediatric care units in 22 countries in Europe, Asia, and North America. The results – mostly from intensive care units for newborns – showed that before the pandemic, 87% of units welcomed families and 92% encouraged skin-to-skin care, according to a report published in Journal of Perinatology. After the onset of the pandemic, more than 83% of the hospital units restricted family presence, with additional restrictions placed on parental participation in their infant’s care, said study coauthor Ita Litmanovitz of Meir Medical Center in Kfar Saba, Israel. Hospitals’ decisions to limit family access did not depend on their previous rules, the availability of single-family rooms, or the virus infection rate in the hospital’s geographical area. “Restrictions during the pandemic increased separation between the infant and family,” the researchers found. These restrictions, Litmanovitz added, “go against psychological and neuroscientific evidence in support of unrestricted parental presence and ability to care for their hospitalized infants.”

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

German COVID-19 cases are growing exponentially again: RKI

BERLIN (Reuters) – Coronavirus infections are rising exponentially in Germany, an expert at the Robert Koch Institute for infectious diseases said on Tuesday, putting at risk plans to lift the lockdown and revive the economy.

The number of cases per 100,000 reported on Tuesday was 83.7, up from 68 a week ago, and the RKI has said that metric could reach 200 by the middle of next month.

Germany is definitely in a third wave of the pandemic, driven by the fact it has loosened restrictions in recent weeks just as a more transmissible variant has spread, Dirk Brockmann, an epidemiologist at the RKI, told Germany’s ARD television.

“It has been totally irrational to loosen up here. It is just fueling this exponential growth,” he said.

Chancellor Angela Merkel and state leaders agreed a phased easing of curbs earlier this month along with an “emergency brake” to let authorities reimpose restrictions if case numbers rise above 100 per 100,000 on three consecutive days.

They are due to meet again on March 22 to discuss whether to allow any further relaxation of the rules.

The state government in the city of Berlin decided on Tuesday to put on hold any more easing, such as allowing restaurants or cinemas to open, the Tagesspiegel newspaper reported.

VACCINATION WOES

Germany’s decision on Monday to suspend AstraZeneca’s vaccine could delay progress in reaching herd immunity and postpone an economic recovery in the second quarter, analysts said.

The decision follows seven cases of thrombosis in Germany, including three deaths, and delivers a major setback to the country’s drive to speed up its sluggish vaccination campaign.

A planned meeting between Merkel and state leaders on Wednesday to discuss using family doctors to administer COVID-19 vaccines has been postponed until after the European Medicines Agency completes its review into the AstraZeneca shot.

AstraZeneca has said an analysis of its safety data covering reported cases from over 17 million vaccine doses given had shown no evidence of an increased risk of pulmonary embolism, deep vein thrombosis or low levels of platelets.

The RKI’s Brockmann noted that 1,000 people in a million had died of COVID-19, compared to possibly 1 in a million from complications associated with the vaccine.

“In the risk groups, the risk of dying of COVID is much, much higher. That means it is probably 100,000 times more likely to die of COVID than because of an AstraZeneca vaccine,” he said.

(Reporting by Emma Thomasson and Caroline Copley, Editing by Timothy Heritage and Gareth Jones)

Germany, Italy, France to halt AstraZeneca shots, further hitting EU vaccination campaign

By Thomas Escritt and Stephanie Nebehay

BERLIN/GENEVA (Reuters) – Germany, France and Italy said on Monday they would stop administering the AstraZeneca COVID-19 vaccine after several countries reported possible serious side-effects, throwing Europe’s already struggling vaccination campaign into disarray.

Denmark and Norway stopped giving the shot last week after reporting isolated cases of bleeding, blood clots and a low platelet count. Iceland and Bulgaria followed suit and Ireland and the Netherlands announced suspensions on Sunday.

The moves by some of Europe’s largest and most populous countries will deepen concerns about the slow rollout of vaccines in the region, which has been plagued by shortages due to problems producing vaccines, including AstraZeneca’s.

Germany warned last week it was facing a third wave of infections, Italy is intensifying lockdowns and hospitals in the Paris region are close to being overloaded.

German Health Minister Jens Spahn said that although the risk of blood clots was low, it could not be ruled out.

“This is a professional decision, not a political one,” Spahn said adding he was following a recommendation of the Paul Ehrlich Institute, Germany’s vaccine regulator.

France said it was suspending the vaccine’s use pending an assessment by the EU medicine regulator due on Tuesday. Italy said its halt was a “precautionary and temporary measure” pending the regulator’s ruling.

Austria and Spain have stopped using particular batches and prosecutors in the northern Italian region of Piedmont earlier seized 393,600 doses following the death of a man hours after he was vaccinated. It was the second region to do so after Sicily, where two people had died shortly after having their shots.

The World Health Organization appealed to countries not to suspend vaccinations against a disease that has caused more than 2.7 million deaths worldwide.

“As of today, there is no evidence that the incidents are caused by the vaccine and it is important that vaccination campaigns continue so that we can save lives and stem severe disease from the virus,” WHO spokesman Christian Lindmeier said.

The United Kingdom said it had no concerns, while Poland said it thought the benefits outweighed any risks.

“UNUSUAL” SYMPTOMS

AstraZeneca’s shot was among the first and cheapest to be developed and launched at volume since the coronavirus was first identified in central China at the end of 2019 and is set to be the mainstay of vaccination programs in much of the developing world.

Thailand announced plans on Monday to go ahead with the Anglo-Swedish firm’s shot after suspending its use on Friday but Indonesia said it would wait for the WHO to report.

The WHO said its advisory panel was reviewing reports related to the shot and would release its findings as soon as possible. But it said it was unlikely to change its recommendations, issued last month, for widespread use, including in countries where the South African variant of the virus may reduce its efficacy.

The European Medicines Agency (EMA) has also said there was no indication the events were caused by the vaccination and that the number of reported blood clots was no higher than seen in the general population.

The handful of reported side-effects in Europe have upset vaccination programs already under pressure over slow rollouts and vaccine skepticism in some countries.

The Netherlands said on Monday it had seen 10 cases of possible noteworthy adverse side-effects from the AstraZeneca vaccine, hours after the government put its vaccination program on hold following reports of potential side-effects in other countries.

Denmark reported “highly unusual” symptoms in a 60-year-old citizen who died from a blood clot after receiving the vaccine, the same phrase used on Saturday by Norway about three people under the age of 50 it said were being treated in hospital.

“It was an unusual course of illness around the death that made the Danish Medicines Agency react,” the agency said in a statement late on Sunday.

One of the three health workers hospitalized in Norway after receiving the AstraZeneca shot had died, health authorities said on Monday, but there was no evidence that the vaccine was the cause. They said they would continue their probe and that no more suspected cases had been reported since Saturday.

AstraZeneca said earlier it had conducted a review covering more than 17 million people vaccinated in the European Union and the UK which had shown no evidence of an increased risk of blood clots.

Investigations into potential side-effects are complicated as the history of each case and circumstances surrounding a death or illness are examined. Austrian authorities have said their review of the AstraZeneca batch will take about two weeks.

The EMA has said that as of March 10, a total of 30 cases of blood clotting had been reported among close to 5 million people vaccinated with the AstraZeneca shot in the European Economic Area, which links 30 European countries.

The WHO said that as of March 12, more than 300 million doses of COVID-19 vaccines had been administered around the world with no deaths found to have been caused by any of them.

(Reporting by Panarat Thepgumpanat in BANKOK and Andreas Rinke and Paul Carrel in BERLIN, Angelo Amante in ROME, Christian Lowe in PARIS, Toby Sterling in AMSTERDAM, Jacob Gronholt-Pedersen in COPENHAGEN and Stanley Widianto in JAKARTA; writing by Philippa Fletcher; editing by Nick Macfie)

Kenya hails first vaccine ‘bazookas,’ Rwanda secures Pfizer shots

By Omar Mohammed and Clement Uwiringiyimana

NAIROBI/KIGALI (Reuters) – Kenya received over a million doses of the AstraZeneca COVID-19 vaccine on Wednesday, while Rwanda said it was the first in Africa to secure shots from Pfizer, as efforts to inoculate the world’s poorest nations accelerated.

With fewer resources and tougher logistics than other regions, African nations are racing to secure the doses needed to protect their roughly 1.3 billion people and allow the safe reopening of economies.

Africa has been relatively lightly hit by the coronavirus compared with other regions, recording 104,000 deaths, according to a Reuters tally. That is lower than national tolls in the United States, India, Brazil, Russia and Britain.

Kenya’s batch, which arrived on a Qatar Airways passenger flight, is the first of an initial allocation of 3.56 million doses by the global COVAX facility.

“We have received … machine guns, bazookas, and tanks to fight this war against COVID-19,” Health Minister Mutahi Kagwe exulted as the doses arrived at Nairobi’s main airport.

COVAX, which is led by the GAVI vaccines alliance along with the World Health Organization (WHO) and other partners, aims to deliver over 1.3 billion doses to 92 lower- and middle-income countries, covering up to 20% of their populations.

Backers of the initiative hope to level a playing field that has seen wealthier nations quickly vaccinate millions, ahead of poorer regions. Only a few African nations have started inoculating citizens with vaccines acquired outside of COVAX.

First shots under COVAX are arriving at several African nations this week, including Nigeria, Senegal and Uganda.

Senegal, which received 200,000 doses developed by China’s Sinopharm last month, got an additional 324,000 shots of the AstraZeneca vaccine on Wednesday, via COVAX.

COLD STORAGE

In Kigali, officials said Rwanda will get the first doses of the Pfizer COVID-19 shots to be dispatched to Africa under the vaccine-sharing scheme. The Pfizer vaccine presents an extra logistical challenge because it requires ultra-cold storage.

The batch of 102,960 doses were due in Kigali on Wednesday, hours after a flight landed carrying 240,000 AstraZeneca doses from the Serum Institute of India, the health ministry said. The government has installed special infrastructure to keep the vaccine at -70 degrees.

“Rwanda is one of the first countries among the low income countries to have ultra-cold chain,” said Fode Ndiaye, the United Nations’ resident coordinator.

Rwanda plans to start its vaccination drive on Friday, prioritizing frontline health workers and others at high risk. It hopes to vaccinate 30% of its roughly 12 million people before the end of this year.

Despite Africa’s comparatively low fatalities, fragile economies across the continent are reeling from lockdowns.

Kenya, which has so far recorded 106,470 infections and 1,863 deaths, has taken a major economic hit from the virus, which cut the flow of tourists, a crucial source of foreign exchange and jobs.

Nairobi plans to prioritize 400,000 health workers nationwide in a vaccination campaign starting on Friday, the health ministry said.

It will join Ivory Coast, Ghana and South Africa among the nations in sub-Saharan Africa to start vaccination drives.

(Writing by Duncan Miriri; Editing by Andrew Cawthorne)

COVAX vaccine program to deliver 237 million doses to 142 nations by end-May

GENEVA/LONDON (Reuters) – The COVAX vaccine-sharing program said on Tuesday it will deliver 237 million doses of AstraZeneca’s COVID-19 shot to 142 countries by the end of May as it steps up the global roll-out of its vaccine supplies.

The timeline for the delivery of doses, made by AstraZeneca and by India’s Serum Institute, will be split into separate two-month schedules, COVAX said in a statement, with the first in February-March and the second in April-May.

“These timelines are dependent on a variety of factors including national regulatory requirements, availability of supply, and fulfillment of other criteria such as validated national deployment and vaccination plans,” the statement said.

COVAX is the World Health Organization-backed program to provide vaccines for poor and middle-income countries. It began its roll-out last week with the first deliveries of shots to Ghana and Ivory Coast.

Hailing the campaign as an “unprecedented partnership,” WHO Director-General Tedros Adhanom Ghebreyesus said Angola, Cambodia, Democratic Republic of Congo and Nigeria could also expect deliveries of COVAX-supplied vaccines on Tuesday.

“This is an unprecedented partnership that will not only change the course of the pandemic but also change the way the world responds to future health emergencies,” Tedros told a joint media briefing with the U.N. Children’s Fund UNICEF, the GAVI vaccines alliance – which co-leads COVAX – and others.

Ghanaian President Nana Akufo-Addo told the same briefing that his West African country, which this week began its inoculation campaign with COVAX doses, aimed to vaccinate 20 million people by the end of 2021.

COVAX added in a statement that as well as the first round of allocations of the AstraZeneca vaccine, some 1.2 million doses of the Pfizer-BioNTech COVID shot were also anticipated for delivery in the first quarter of 2021.

(Reporting by Emma Farge and Stephanie Nebehay in Geneva and Kate Kelland in London; Editing by Mark Heinrich)

EU warns it could block vaccine exports, wields legal threat at drugmakers

By John Chalmers and Philip Blenkinsop

BRUSSELS (Reuters) – Europe’s fight to secure COVID-19 vaccine supplies intensified on Thursday when the European Union warned drug companies such as AstraZeneca that it would use all legal means or even block exports unless they agreed to deliver shots as promised.

The EU, whose member states are far behind Israel, the United Kingdom and the United States in rolling out vaccines, is scrambling to get supplies just as the West’s biggest drugmakers slow deliveries to the bloc due to production problems.

As vaccination centers in Germany, France and Spain cancelled or delayed appointments, the EU publicly rebuked Anglo-Swedish drugmaker AstraZeneca for failing to deliver and even asked if it could divert supplies from Britain.

European Council President Charles Michel said in a letter to four EU leaders that the EU should explore legal means to ensure supplies of COVID-19 vaccines it contracted to buy if negotiations with companies over delayed deliveries are unsuccessful.

“If no satisfactory solution can be found, I believe we should explore all options and make use of all legal means and enforcement measures at our disposal under the Treaties,” Michel said in the Jan. 27 letter.

EU rules on monitoring and authorizing exports of COVID-19 vaccines in the 27-nation bloc could lead to exports being blocked if they violated existing contracts between the vaccine maker and the EU, an EU official said.

The European Commission is to lay out the criteria under which such exports would be evaluated on Friday.

VACCINE CRUNCH

The swiftest mass vaccination drive in history is stoking tensions across the world as big powers buy up doses in bulk and poorer nations try to navigate a financial and diplomatic minefield to collect whatever supplies are left.

Israel is by far the world leader on vaccine rollout per head of population, followed by the United Arab Emirates, the United Kingdom, Bahrain and the United States. Behind them are Italy, Germany, France, China and Russia.

The African Union (AU) has secured another 400 million doses of the AstraZeneca COVID-19 vaccine, a regional health leader said on Thursday, in a push to immunize 60% of the continent’s population over three years.

Under fire from the EU, AstraZeneca CEO Pascal Soriot said the EU was late to strike a supply contract so the company did not have enough time to iron out production problems at a vaccine factory run by a partner in Belgium.

Tensions have risen as both New York-based Pfizer and AstraZeneca, headquartered in Cambridge, England, have had production problems.

Britain, which has repeatedly touted its lead in the vaccine rollout race since leaving the EU’s orbit on Jan. 1, said its deliveries must be honored.

“I think we need to make sure that the vaccine supply that has been bought and paid for, procured for those in the UK, is delivered,” Minister for the Cabinet Office Michael Gove told LBC Radio.

Just a day ahead of a decision by European regulators on whether to approve the drugmaker’s shot, Germany’s vaccine committee said AstraZeneca’s vaccine should only be given to people aged between 18 and 64.

“There are currently insufficient data available to assess the vaccine efficacy from 65 years of age,” the committee, also known as Stiko, said in a draft resolution made available by the health ministry on Thursday.

Britain’s Johnson said health authorities in Britain believed the vaccine was safe and worked across all age groups.

APPOINTMENTS CANCELLED

In the northern French region of Hauts-de-France, France’s second-most-densely-populated region, several vaccination centers were no longer taking appointments for a first jab. In several other French regions, some online appointment platforms closed booking options.

Spain’s Madrid region has ceased first vaccinations for at least this week and next and was using the few doses it has to administer second shots to those who have had the first one, said deputy regional government chief Ignacio Aguado.

Germany’s most populous state, North Rhine-Westphalia, last week postponed opening its vaccination centers until Feb. 8, while the state of Brandenburg has also had to push back vaccination appointments originally scheduled for the end of January due to delivery delays.

AstraZeneca is prepared to publish the delivery contract it has with the European Union and aims on Friday to make proposals to the European Commission on which sensitive parts to black out, the Frankfurter Allgemeine reported.

The newspaper quoted an EU source as saying that while AstraZeneca would not be able to deliver the 80 million doses expected for the first quarter, volumes should significantly exceed the 31 million doses that had earlier been reported.

(Reporting by Emma Thomasson and Paul Carrel in Berlin and Matthias Blamont in Paris and Kate Holton, Paul Sandle and Alistair Smout in London; writing by Guy Faulconbridge; editing by Keith Weir and Nick Macfie)

Africa secures 400 million more COVID-19 vaccine doses

By George Obulutsa

NAIROBI (Reuters) – The African Union (AU) has secured another 400 million doses of the AstraZeneca COVID-19 vaccine, a regional health leader said on Thursday, in a push to immunize 60% of the continent’s population over three years.

As richer nations race ahead with mass immunization campaigns, Africa is scrambling to obtain supplies for its 1.3 billion people. Only a handful of African nations have begun giving doses.

John Nkengasong, director of the AU’s disease control and prevention body, told an online briefing that in addition to 270 million doses previously secured, the bloc would get 400 million shots from the Serum Institute of India (SII) – all AstraZeneca/Oxford University shots.

A spokesman for the SII declined comment.

The AstraZeneca vaccine is the cheapest option and one of the best-suited to African health systems as it does not require storage at ultra-low temperatures like the vaccine from Pfizer and German partner BioNTech.

Separately from the AU’s efforts, Africa is to receive about 600 million vaccine doses this year via the COVAX facility co-led by the World Health Organization (WHO).

Health authorities hope to vaccinate about 30-35% of Africans this year, rising to 60% in two to three years. The AU has said vaccines secured by its vaccine task team will be allocated according to population.

Though COVID-19 has not hit Africa as badly as some experts had feared it would, wealth disparities, logistical difficulties and “vaccine nationalism” by developed nations may put the world’s poorest continent at a disadvantage.

Africa has reported 3.5 million infections and 88,000 deaths, according to a Reuters tally. That is fewer fatalities than individual nations the United States, Brazil, India, Mexico and Britain.

OUTLIER TANZANIA

In an implicit rebuke to Tanzanian President John Magufuli, who has discouraged mask-wearing and social distancing, discontinued data publication and called vaccines a malign foreign plot, WHO Africa director Matshidiso Moeti urged Tanzania to implement such measures, prepare vaccinations and share data. “Africa is at a crossroads and all Africans must double down on preventive measures,” she told an online news conference on Thursday, saying WHO officials were in touch with Tanzanian officials. “Science shows that vaccines work.”

Magufuli’s government has published no coronavirus data since May 8, when the country had 509 cases and 21 deaths.

On Wednesday, he said, without evidence, that vaccines were a foreign plot to spread illness and steal Africa’s wealth. He urged Tanzanians instead to trust God and use alternative remedies such as steam inhalation.

“We in Tanzania managed to stay for a year without corona. Even here, no one has put on a mask. Our God is beyond Satan and Satan will always fail using different diseases,” he said in a speech in his western home area.

Nkengasong said the Africa CDC was exploring obtaining more vaccines from China, Russia and Cuba, and would work with any partner whose vaccine was safe and effective.

(Reporting by George Obulutsa, Nairobi newsroom and Alexander Winning; Writing by Andrew Cawthorne; Editing by Alex Richardson and Frances Kerry)