Vaccination is the most important strategy to end the pandemic. However, emergence of multiple SARS-CoV-2 variants with reduced susceptibility to disease- and vaccine-induced immunity threatens progress. Despite these ongoing threats, the efficacy of SARS-CoV-2 vaccines provides a real measure of hope for 2021.

This month, a team of vaccinologists from Oxford University began recruiting 800 or so people age 50 or older for a complex study to see whether vaccine switching could actually work.Using an eight-armed clinical trial, they’ll test vaccine regimens using various combinations and intervals of the two vaccines currently being dispensed in Britain: one made by Pfizer and BioNTech, and another developed by Oxford and AstraZeneca.

In announcing the mix-and-match vaccine trial, Dr. Matthew Snape cited experiments in mice in which combinations of the Pfizer and AstraZeneca vaccines boosted immunity better than two doses of either one alone. Perhaps it would work in humans as well.

Both vaccines prime the immune system to target the coronavirus’ spike protein, which plays an instrumental role in the infection process. But they home in on different parts of the spike, and they deliver their payloads by two very different means.

Millions of AstraZeneca shots 'ineffective' if South Africa variant in PH not contained, expert warns
- OCTA Research fellow and molecular biologist Fr. Nicanor Austriaco quoted several studies showing that the South Africa variant lowers the efficacy of some COVID-19 vaccines. He specifically stated the vaccines made by British-Swedish multinational pharmaceutical Oxford-AstraZeneca, saying the variant dramatically decreases the vaccine's efficacy from 70% to mere 10%. "It's no different than injecting water into the patients. With 10% protection, basically, most people would still get mild and moderate COVID-19," he said in a media briefing.

The Philippines is set to receive its second batch of vaccines on Thursday — 487,200 doses of AstraZeneca through the COVAX facility. This is on top of more than 17 million doses procured by the government and private firms through tripartite agreements. Austriaco, who is developing an oral COVID-19 vaccine in the United States, said the presence of the South Africa variant could also affect the rollout of the national vaccination program if the spread is not cut off. –

Pediatrician and epidemiologist Jonas Ludvigsson of Sweden’s Karolinska Institute has been a staunch defender of his country’s unorthodox coronavirus policies. Among them was the decision in the spring of 2020 to keep preschools and schools open for children through grade nine, despite limited understanding of the virus and with few precautions to prevent school outbreaks. But Ludvigsson’s research, which suggested that policy was relatively safe—and has been widely cited in arguments against school closures—has repeatedly come under fire from critics of Sweden’s approach.

The latest example is a research letter, published online by The New England Journal of Medicine (NEJM) on 6 January, that looked at severe disease and deaths among children and teachers in Sweden between March and June 2020. Critics—including the authors of two letters NEJM published on 1 March—have said the study was beside the point and a distraction. It’s well known that children are less likely to be hospitalized or die from COVID-19; instead, schools worldwide have shut down to slow the spread of the virus in the wider community.
But Science has learned that another complaint sent to NEJM makes a more serious allegation: that the authors deliberately left out key data that contradicted their conclusion.The complaint comes from Bodil Malmberg, a private citizen in Vårgårda, Sweden. She used the country’s open records law to obtain email correspondence between Ludvigsson and Swedish chief epidemiologist Anders Tegnell, the architect of the country’s pandemic policies, that shed light on how the paper came about. Malmberg says she requested the emails because the data in the NEJM paper “did not add up.” Ludvigsson does not dispute the content of the emails, but stands by the study’s conclusions. However, he says the barrage of criticism and personal attacks has made him decide to quit COVID-19 research.

Ludvigsson, whose prepandemic research focused on gastroenterology, was one of the 47 original signers of the Great Barrington Declaration, a controversial document published in October 2020 that argued that pandemic policies should focus on protecting the vulnerable while the rest of the population builds up immunity through natural infection.

Ludvigsson’s research seemed to support those ideas. In a review about children’s role in the pandemic, published in Acta Paediatrica in May 2020, he reported there had been “no major school outbreaks in Sweden,” which he attributed to “personal communication” from Tegnell. But as critics noted, Swedish media had reported several school outbreaks by then, including one in which at least 18 of 76 staff were infected and one teacher died. (Children were not tested.)

His NEJM letter sounded another reassuring note. It reported that in all of Sweden, only 15 children, 10 preschool teachers, and 20 school teachers were admitted to intensive care units for COVID-19 complications between March and June 2020. The authors noted that 69 children ages 1 to 16 died of any cause in Sweden during that same period, compared with 65 between November 2019 and February 2020, suggesting the pandemic had not led to an increase in child deaths.

But the emails obtained by Malmberg show that in July 2020, Ludvigsson wrote to Tegnell that “unfortunately we see a clear indication of excess mortality among children ages 7-16 old, the ages where ‘kids went to school.’” For the years 2015 through 2019, an average of 30.4 children in that age group died in the four spring months; in 2020, 51 children in that age group died, “= excess mortality +68%,” Ludvigsson wrote. The increase could be a fluke, he wrote, especially because the numbers are small. Deaths in 1- to 6-year-olds were below average during the same period, so combining the age groups helped even out the increase, he noted.

The emails “cast a serious shadow” on the research letter, Malmberg wrote in an email to NEJM. (The journal declined to comment on her complaint.) Epidemiologist Jonas Björk of Lund University agrees that the time comparison used in the paper was unusual. “I can see no good reason to compare with previous months,” he says. “It is standard to compare with 
the same period in previous years” to account for seasonality and to decrease statistical uncertainty.