mr ship depends on them going forward they have to succeed so it's almost impossible to see them being called off but there are still warning signs on the horizon. 0 these are our top stories south africa says a local study on the johnson and johnson cave in 1000 vaccine showed no major safety concerns however its house decided to suspend its use over concerns raised in the us that it could be linked to blood clots a 2 decade u.s. war in afghanistan is set to end president biden is due to announce that he will withdraw troops by september 11th that means pushing back a deadline set by his predecessor and speaking at a meeting with nato allies in brussels here's actually a state on the brink and hinted that other countries in the alliance will follow suit together we have achieved the goals that we we set

out to achieve and now it is time to bring our forces home we will work very closely together in the weeks and months ahead on a safe deliberate and coordinated withdrawal of our forces from afghanistan but even as we do that. our commitment to afghanistan to its future will remain the u.s. says it's going ahead with the sale of $23000000000.00 worth of weapons the united arab emirates abide ministration confirm the deal that includes advance after 35 a craft arms drains and other equipment that's despite the president freezing the trump agreement one week into his tenure democrats overwhelmingly voted against it when it was 1st raised of affairs it would fuel a saudi led military campaign in yemen. somalia's president has extended his term in office for 2 more years president mohammad up july he signed a bill into law despite opposition from some members of parliament his mandate

ended in february sparking protests and calls for him to step down presidential and parliamentary elections were due to take place this year but leaders of 5 semi autonomous states have failed to agree on how voting should be conducted a police officer who fatally shot a black man in minnesota has resigned dante writes to sing and sparked protests in a minneapolis suburb of brooklyn center where the incident happened despite the resignation of the officer responsible and the police chief demonstrators were out on the streets again ignoring a curfew. you're up to date now with all the world headlines more news continuing in one hour of the inside story.

from low rates of efficacy to concerns over blood costs many coronavirus vaccines are facing setbacks to the benefits outweigh the risks or governments rethink their vaccine rollouts this is inside story. hello and welcome to the program i'm doubting you know china has positioned itself as a leader in the development of coronavirus vaccines it's distributing millions of shots to dozens of countries mainly in the developing world but its top health official now says its domestically produced jobs have low rates of protection and that's a rare admission by the head of the chinese center for disease control and

prevention gala foods said his country is considering options to boost the effectiveness of doses including mixing different brands of china has produced fork over $1000.00 vaccines and some trials suggest efficacy is as low as 50 percent the maker of the set of back jobs is recommending a longer intervals between 2 doses to improve its impact and a spokesman says several factors determine how weak or strong a shot is about we shot it out which showed up on the protection rate of the vaccine is affected by many factors such as the intensity of the local outbreak the vaccine immunization program different virus strains the criteria for determining a case the age range of patients under observation and so on this is one of the reasons for the differ. protection rate of sign of a covert 19 vaccine in a different country. the major side effects of some covert 1000 vaccines have slowed down vaccination drives u.s. regulators have recommended a pause in administering johnson and johnson shots because of reports of blood

clots the vaccine is also under investigation in europe astra zeneca has covered 1000 vaccine is being investigated by european regulators for possible links to blood clots it's been suspended more than a dozen countries and some research found the corona virus variant discovered in south africa can penetrate pfizer bio on texaco with 1000 vaccine to some extent and a new study in the us suggests that modern vaccine might have more side effects than 5 years or the vaccines differ in the way they trigger people's bodies to fight coronavirus china's sin of accu is killed parts of the virus to expose immune systems to it without risking a serious response pfizer and moderne are so-called m r n a vaccines in which part of the corona virus is genetic code is injected into the body the u.k.'s astra zeneca vaccine has modified a version of a common cold virus from chimpanzees to contain genetic material shared by the

corona virus then there's the johnson and johnson vaccine which also contains cold viruses that deliver the genetic blueprint of the corona virus spike protein to body cells it's the 1st to be administered and one shots. let's bring in our guests in doha is patrick tang who is the division chief of microbiology at sidra medicine in johannesburg regina osi who is the medical doctor and infectious diseases specialist at the arom institute and in barcelona is geoffrey lazarus who's the head of health systems research group at barcelona institute for global health welcome to the program thanks for speaking to us on al-jazeera regina so this is a rare admission of weakness by china what do you read into it. well i think it's very difficult to understand exactly what it is that they're talking about because we haven't actually seen the data are i think the data has been submitted to the w h o's. expert

a group called states and we're waiting for a decision to be pending but we also don't know what post a post where a lot of information that someone has that may not be part of the initial clinical trial so it's really difficult to understand when they say you know it's may not be as if acacias all we know is that we've got a more fair go been given a favor for gov about 70 percent efficacy at the time a while ago and we don't know what exactly the figures are now and i'd be really great to see these data and have to understand better what it is that war deal with jeffrey chinese companies as regina was just saying have not publicly published peer reviewed data on the final stages of clinical trial research into the vaccines and they've been criticized in fact in the past for the lack of transparency so could the lack of transparency and now this hamper the vaccines credibility. i think it absolutely will happen in the next year's credibility and we saw the same thing happen with pfizer and my dad when they released their dream and i think you

see the figures i mean press releases it's important to get this into the medical into the pure the journalist to make the data you know freely available and transparency and can be well analyzed and the chinese have not done that and we heard of imagery a much higher figure than what we're hearing now so that definitely brings into question the credibility of the vaccine patrick the chinese official who spoke didn't seem to backtrack a day later when he said that he was speaking about the effect of us rights for vaccines in the world and not particularly about china and he said this is all a misunderstanding i mean do you think officials in china are now concerned that this may have an impact on china's vaccination program because it's aiming to inoculate its as 40 percent of its population by the end of june. well i think this is a complicated issue and there's many many things that we might be able to read from that message so i think one of it is that you know there is a call. from from those officials that we need to develop the same m.r.

and a technology which i think that's what they're trying to do their scientists there that that this is a good technology and we need to adopt this in china they may have overstated the lack of africa if the u.s. we do sepic you see it the other back to their own so yes there are because it needed to be for it that data is coming out every week this new study coming out looking at the real world. impact in the new area regina the official also listed 2 options to solve the problem he said this one is to increase the number of doses or adjust the dosage or interval between shots and the other is to mix vaccines developed from different technologies let's break those down and look at the 1st option what do you make of the 1st one increasing the number of doses or adjusting the dosage. or interval between 2 shots. i think that you know a strategy where you provide to. basically antigen several times for the body to be

able to develop an immunity to it definitely is something that has been used in vaccine development but again it is very unclear to me how exactly that would work because we don't know what the original data shows what the post sort of rollout data is showing now and whether you know this would be a strategy that we could retain in terms of adding a boost with the same back. to the existing people the already been vaccinated. right so and on the other notes on the other point that he raised jeffrey is mixing vaccines a strategy that should be considered to boost their effect of this we've also been hearing that researchers over in the u.k. are studying a possible combination of pfizer biotech and the astra zeneca vaccine so i think all 3 of those options that are being considered. are important what needs to be done though is they need to be studied more carefully if you're going to increase

the interval if you're going to add a 2nd or in this case a and if you're going to combine different vaccines and even different sexes of different technologies it needs to be well studied and then what we're seeing with the chinese study is that of the 60 countries where the chinese next you know the 60 countries and approved it we haven't even had an the data publicly available published in the peer reviewed literature and that's what's really concerning yeah and on that note jeffrey brazilian trials of the set of at vaccine showed an efficacy rate of around 50 percent and if you compare that to the trials we saw in turkey and internees up the same vaccine those stood at between 91 and 65 percent how do you explain the varying level of effectiveness. well again without all the details you know we can only speculate we can wonder if it has to deal if it's related to the very end that if it mutates the iris we know that the brazilian very enters been more transmissible and then it can also bring into question about how

the trial was run and details around the clinical trials i can't really speculate but it does you know concern me when we see 50.4 percent in brazil and gay 3 percent in turkey that's a very wide range it's not unusual to have different numbers in different rates in different settings but we need to understand why and that's what we're lacking is really just flying blind and you know we always speak about in the companies and the government speak about this efficacy right patrick if you look at pfizer and bio on tech and what they are now vaccines they claim to have an efficacy rate of 97 percent and 94 percent i just wonder if you can really break it down for us in the simplest terms and tell us what efficacy actually means and how it's measured. the level of protection that you get from the back teeth or lack of care the number of people and get infected in any group getting back to a good number of people that they are getting back in

a group bet not exactly and really if they show up that you can come up back in africa be so at it what you're quoting 'd are some of your vision of a b. or the average or the variance going to the region where with the new variant that we're not travelling yet that will highlight africa never reply to your original stream. article you are and that may not. work there is actually one route from africa that we're going to look at the variance in just a 2nd but regina let me ask you this how concerned should we be about the efficacy rates of a vaccine when a person if they have a choice goes to choose what type of vaccine they should take is efficacy the major factor that they should be looking at when i think the efficacies what we try to do to compare apples to apples basically but one thing that is very important and i

think what we shouldn't forget is that most of these vaccines the ones we have data on actually prevent severe disease mortality from corner virus almost by about 200 percent so the few escape illnesses that people mostly have mild and moderate disease and therefore do not overburden the house systems and actually the mortality is reduced and i think that that's something that we have to keep in mind and if you look at all of the vaccines that are currently sort of been tracked in the western world and you look at the real life scenarios of these vaccines very few people would have died all had a very severe case of corner virus after being fully vaccinated of course we're going to see a little bit more of that as we go on and that's it millions and millions of people but i think we shouldn't forget that these vaccines have to grow. one is preventing the disease occurrence 1st and foremost and of course to preventing transmission but the 2nd role is also seeing whether we can have a decrease in the severity of cases that do develop once you've been vaccinated i

think if we get that 2nd point right and these vaccines definitely do that then i think that we have a leg up in terms of fighting the pandemic i can show that especially go ahead complete your thought i had was just doesn't fit in places like south africa where the health system is relatively constrained it really helps us but when governments me thinking there are a rift thinking there vaccine rollouts regina considering that now you have a claim from the chinese that there vaccine is not effective as originally thought and also just earlier today we heard that johnson and johnson is being put on pause . well i think it's a matter of looking at the risk benefit scenarios in each case right i think for the chinese that it would be helpful if governments could actually get information that they can base of decisions on and have clear transparent data that we can look at x. and make a recommendation and for the other vaccine for johnson and johnson it's been paused

in the us because of a few cases of. events and i think that it is important to always watch the side effect profile but when you look at the grand scheme of things in terms of what a virus has done and the havoc that is wreaked on different economies and different especially in south africa for example i think that it is very important to weigh those that respond if it very carefully and i wouldn't just throw out the vaccines because of the few hurdles that have come up i think we have to keep in mind that we want to keep people healthy we want to keep people out of hospitals and if we can. become more covered 1000 become more of a mild disease like a regular flu or something like that that doesn't cause mortality i think that's something that we definitely have to keep in mind jeffrey companies and governments say that the short term safety data looks good because that is what we do have data on but there is questions and concerns surrounding the long term safety in the long term effects of the vaccines of which we just don't know. i'm not as

concerned about that i mean we have very strong very robust short term safety data and the question was what does long term i mean the vaccines like astra zeneca and johnson and johnson's are based on a technology that's that's well known and has been proven to be safe in the long term and we have to remember that even if the m.r.i. and any other fire and down a vaccine haven't been used in humans before the trials in 2020 they've been under development for over a decade they're not totally unknown to us and they're expected in many ways to be a an even cleaner and and safer a vaccine and then the other host and then just going back to it you know regina said in terms of johnson and johnson we're seeing right now you know one reported case of blood clots per 1000000 so again when you weigh up the risk then if it and you look at the havoc that the corona virus could be $100.00 causing on the economy health analysis done it would i wouldn't surprise me if it does get approval the

same way astra zeneca did after additional regulatory scrutiny in the or opinion in your own bout point or a jeffrey a patrick i'll come over to you with this m r n a technology that's being used then and and pfizer so just as jeffrey just said this is the 1st vaccine of this technology to be used on humans. how can we be assured of its long term safety. well i think long term safety is not something that we're that worried about is the short term safety that people have been up in arms over recently with the blood clots and that there are sort of side effects that been reported but but we do have a robust system for monitoring vaccine back in the long term we went back to going to need to recall the base of the role of. we doctors do

report any unusual side effects. so it's not something that we're really we're you i think we should be more worried about are the long term effects kogut 19 infection and i think when we disproportionately put too much emphasis on private back versus the very real and very more near side effect at 19 i think the 2 things happy weight. regina what can you tell us about booster is because now we know that more there and is trialing a booster to protect against what's known as the south african variant how worrying are these variants and. how much work is going to be has to be done on these vaccines going forward to protect against these variants. well i think the advantage of having these platforms is that we know now how they function and you know what i meant pfizer biotech actually develop vaccines based on the m.r.

in a platform and they can tweak them based on what circulates and we do know that the current virus is probably going to be circulating for quite a while yet and will develop new strains that may be concerning so i do think it's completely reasonable for vaccine developers to continue looking around and see whether they can add a little bit more function in terms of what are the different properties of the circulating variants that might not be as responsive to the vaccines so i do think that that's a welcome development boosting has always been a strategy that's been used in vaccines for the longest time and therefore it's something that we know sometimes work where you prime your immune system and then you provide a 2nd dose or 3rd or 4th those to make sure that as many antibodies or. as are necessary to fight off the infection so i do think that it's a welcome development and we're going to have to consider looking and we're going to have to continue working as we try to make we're going to have to adapt as the

virus adapts jeffrey it's not only in fact it's also pfizer in biotech they were said that they were testing a 3rd of the vaccine to better understand the immune response against variance how do you see this playing out. i think that's great news and it makes perfect sense as we've seen with the variance to variance of concern as well that we're going to need to be thinking in the long run i mean the 1st goal is to get you know some kind of global herd immunity we're far from that but at the same time we need to be looking at the different mutations that met the variants of concern and seeing it do we need that 3rd jab do we need a boost or do we need to rejig the vaccine itself so that maybe the down are as are other vaccines will actually just be different in happy years time and more responsive to that scene to the variants that we've already identified on the issue of herd immunity patrick we only have a few months worth of data when it comes to immunity generation so what is the risk

that if they mutate declines before that herd immunity is actually achieved then vaccinated people will just become susceptible to infection again and these rollouts might fail. the preliminary data from. people that had factors like the pfizer vaccine are that good at the mine and possibly going to last even longer than that more and more people have had the back in for longer and longer periods of time and from what we know of the other vaccine we should expect a longer duration of protection and and in the worst case we could come up with their doses as you know the previous speakers had talked about but i think that one point that they think that we need to reframe some of all of this. all about whether the fact that you left efficacious at the mine where they're going to work against their parents or not i think we have to focus on the real task at hand

which is back to the everybody as many people as possible and as many countries as well i think we have. that main goal and we can't be diverted into thinking about character with this new variant back in the other things that match that research is definitely going to go on but that we can't refocus the goal how do you explain the patrick that over in the u.s. one of the latest poll that i was reading this is according to gallup it was saying that some 26 ameri 26 percent excuse me if americans say that they wouldn't get a vaccine right now so there's real vaccine hesitancy and that same refusal why do you think that is. well that's a very complicated issue that would take a long time to discuss and and you know part of it is the communication but how how we communicate and that rules out 100 politics part of it readership there there's so many facets to you back in president but but the thing is but i also don't want

to say i'm saying some also say it's also the flip flopping for example astra zeneca has image has kind of been shattered in a way right now because of the the reported blood clots and you know now we see this with johnson and johnson so this flip flopping doesn't really help people out doesn't well i think it's too much information and too much emphasis on certain parts of information and where people lose sight of the the overall benefits of vaccine these are exceedingly rare. complications and we think about things that we take all the time so so birth control pills cause like quantrill that i'm coping 19 definitely call it like i mean people are worried about what their should not get cobra 19 that that would definitely give you a clot right things have to be frame all of this instead of just focusing on these very rare kinds that are current jeffrey a patrick was just mentioning the messaging

a moment ago i mean how do you explain the different interpretations when it comes to let's look at astra zeneca for example the concern over a possible link to blood clots to dates for european countries have stopped using astra zeneca vaccine such as denmark in the netherlands while others like germany like france spain where you are have put an age restriction on these shots so how do the different countries and bodies actually come up with their conclusions. well 1st there was a good line of what patrick was saying is certain that we need to reframe things suddenly there's more of a fear of the vaccine then the virus in some settings so we need to turn that around again in a mind people that covered 90 can be a very serious infection and potentially life threatening so in terms of how the different countries have taken their decisions hopefully they've applied some kind of risk benefit analysis but like you said the flip flopping is what confuses people and i think some of those decisions have been taken rather hastily so we've

seen a country like spain you know limit it limit after the m a decision. to 60 to 64 year olds the next day they expanded to 6869 year olds and it hasn't even been clear people get their 2nd booster with astra zeneca or not so as the different countries react differently to the e m a decision it creates confusion among the public i think that you know given that the european medicines agency isn't that this is a safe that scene that if europeans are going to use the astra zeneca vaccine they can finish up the 2nd doses maybe restrict it but really give it to come back to give it to the rest of the world because we do need to create that global herd immunity and there's a lack of that is in almost all countries of the world and europe is lucky enough to have different options with. rights a regina law. out on the extent to which stereotypes and geopolitics play a role into the acceptance of

a certain vaccine in 30 seconds if you don't mind. yes i think that you know the communication is very difficult as you've mentioned i think it's it's very important to keep focus on the main message we do not want to get cold at 19 want to stop the pandemic want to go back to life as usual if we can do that and one way of doing that is getting vaccinated and i think we have to really go back and focus on that thank you so much very interesting to talk to all of you patrick tang regina o.c. and geoffrey lazarus pre-show your time thanks for watching you can see the program again any time by visiting our website al jazeera dot com for further discussion you can go to our facebook page that's facebook dot com forward slash a.j. inside story you can also join the conversation on twitter our handle is a.j. inside story for myself the whole team here in doha thanks very much for watching and goodbye from.

jumped into the story there is a lot going on in this and julian global community when i talk about the misinformation i think we all want a free and be part of the debate don't ever take anybody's one word because there's always a difference when no topic is off the table we have been disconnected from our land we have been disconnected from who we are good enough to keep the new and e.t.p. part of today's discussion the stream on out is there. from the al-jazeera london. to people in thoughtful conversation people use the lowest get

agreement they describe the outsider with no host and no limitation to the difference between a migrant and refugee is purely a choice when you are refugee you are forced to think of as maicon and has sat back at what has happened a lot in the west is that culture and for the separated studio to be unscripted on al-jazeera seems a promising paul thought of the pandemic but implementing the greatest inoculation in history is testing the global community around the world already a clear gap as the match between rich nations and poor ones when it comes to vaccinating the populations from the geopolitics to the pure economics the misinformation and the latest developments what's going on here is very different for a start look that's incomes in the form of the nasal spray special coverage of the corona virus pandemic are not just. what's most important to me is talking to people understanding what they are going through here and i just we believe

everyone has a story worth hearing. move. the the a. car. elemental out the top stories here on al-jazeera and south africa says a local study on the johnson and johnson cave in $1000.00 vaccine showed no major safety concerns and yet it's decided to suspend its use over concerns raised in the us that it could be linked to blood flows the single dose vaccine was the only one being administered but it does have other doses on order from finds a professor henry says a member of south africa's ministerial advisory committee on covert 19 and his vaccines and she says the pause is done out of an abundance.