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Indigenous person Guilherme Pimentel Tenorio receives the AstraZeneca/Oxford COVID-19 vaccine from a municipal health worker in the Sustainable Development Reserve of Tupe, in the Negro river banks in Manaus, Brazil, Feb. 9, 2021.BRUNO KELLY/Reuters

Despite a setback in a vaccine trial, the World Health Organization has decided to recommend the use of the AstraZeneca vaccine to protect adults from COVID-19, even in countries where new variants of the virus are circulating.

If Canada approves it, the vaccine is due to begin arriving as early as next month. It is seen as a crucial vaccine worldwide, especially at a time of global shortage, since it is relatively inexpensive and can be stored without freezers. Hundreds of millions of AstraZeneca doses are scheduled to arrive in Africa, Asia and Latin America this year.

A new study, released on Sunday, found that AstraZeneca was ineffective in preventing mild or moderate illness from a highly transmissible new variant that has become dominant in South Africa. The variant has been detected in more than 40 countries worldwide, including Canada.

South Africa immediately suspended its rollout of the AstraZeneca vaccine. But the WHO announced on Wednesday that it is still recommending the vaccine worldwide, since it is likely to be effective in preventing severe illness, hospitalization and death from the new variant.

The WHO is also recommending that the AstraZeneca vaccine be used for adults of all ages, even though several European governments advise it only for those younger than 65 – or even 55 in some countries.

“It is an important vaccine for the world, given the short supply that we have in vaccines,” said Katherine O’Brien, director of the WHO’s department of immunization and vaccines.

On the question of the new variant detected first in South Africa and now believed to be triggering surges of deaths in several African countries, the WHO said there is “indirect evidence” that AstraZeneca will be effective in preventing severe illness from the variant.

“Extrapolating from immunological insights, it may still protect against severe COVID-19” from the new variant, a WHO expert advisory group said in a background document released on Wednesday.

The WHO’s chief scientist, Soumya Swaminathan, said there are “tradeoffs” among various vaccines on the questions of cost, storage and effectiveness, and governments can consider those factors, but they need to begin using vaccines as soon as possible.

“Right now, it’s important to get the vaccines out to high-risk groups so that they’re protected,” she told a WHO briefing.

“The pandemic is raging, and we need to prevent deaths and protect our health workers so that they can serve others. That should be our priority now, using the vaccines that we have.”

The global shortage of COVID-19 vaccines, combined with aggressive early ordering by wealthy countries, has meant that vaccination today is happening primarily in a handful of rich countries – which makes AstraZeneca even more important for fighting the pandemic globally.

So far, more than three-quarters of the world’s vaccinations have occurred in just 10 countries, most of which are high-income, according to a statement on Wednesday by the WHO and UNICEF.

“As of today, almost 130 countries, with 2.5 billion people, are yet to administer a single dose,” they said.

South Africa was the country most affected by the latest study of AstraZeneca, since it received a million doses of the vaccine last week and planned to begin using them this month. Its government is under heavy political pressure to begin vaccinations as soon as possible after early delays in obtaining supplies.

South Africa suspended its vaccination plan on Sunday when it learned the study had found AstraZeneca to be ineffective against mild and moderate illness from the new variant. The variant has fuelled a dramatic surge in COVID-19 in South Africa, accounting for more than 90 per cent of cases in the country’s second wave, which began in December.

South African Health Minister Zweli Mkhize told journalists on Wednesday that his government might sell some of the AstraZeneca doses it received last week. Other governments are interested, as they would still be effective in countries where the new variant is absent or rare.

But according to the WHO, the South African government is still planning to use the AstraZeneca doses it received last week. It would give the vaccine to health workers in a carefully monitored way, while collecting data to assess its effectiveness. “It’s a phased rollout of the vaccine,” Dr. Swaminathan said.

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