The World Health Organization on Monday approved the use of the AstraZeneca-Oxford vaccine, paving the way for the distribution of cheap and easy-to-store shots in low and middle-income countries around the world.

A small clinical study in South Africa recently failed to show that the vaccine could prevent people from getting mild or moderate cases of Covid-19 caused by a variant of the coronavirus that is common there. However, this vaccine had protected all participants from serious illness and death in other studies and could still prevent serious illness and death caused by the variant first discovered in South Africa.

The approval, awaited after a group of WHO experts recommended the use of the vaccine last week, was for the vaccine’s two manufacturers: AstraZeneca and the Serum Institute, the Indian manufacturer that supplies many doses for the Covax initiative is going to bring vaccines to poorer parts of the world.

The WHO approved the Pfizer BionNTech vaccine last year. However, the decision to use AstraZeneca’s vaccine was eagerly awaited as the vaccine is the backbone of roll-out plans in many countries around the world due to its low price and ease of storage.

“Countries that previously did not have access to vaccines can finally start vaccinating their health workers and vulnerable populations, which contributes to the Covax Facility’s goal of equitable distribution of vaccines,” said Dr. Mariângela Simão, WHO Deputy Director General for Access to Medicines and Health Products, said in a statement.

The WHO Expert Panel recommended that the AstraZeneca vaccine be used in all adults and in countries where new variants are circulating. Countries are expected to receive their first tranches of the AstraZeneca vaccine from Covax in February.

When the vaccine was announced on Monday, Dr. Tedros Adhanom Ghebreyesus, WHO Director General, said that while virus cases appeared to be falling in many parts of the world, countries needed to remain vigilant.

“If we stop fighting it on any front,” he said, “it will roar back.”

After the results of the small clinical trial of the AstraZeneca vaccine in South Africa were published, South Africa decided to suspend plans to distribute the vaccine. The country has asked the Serum Institute to take back a million doses of the no longer needed AstraZeneca vaccine, Reuters reported Tuesday, citing The Economic Times.

Instead, South Africa planned to vaccinate health workers with the Johnson & Johnson vaccine, which prevented hospitalizations and deaths in clinical trials in the country.

The WHO panel that studied the AstraZeneca vaccine also recommended that it be given to adults regardless of their age, which goes against France, Germany, Italy, South Korea and other countries that have chosen to stop using the vaccine on younger people to restrict. And it was recommended that the two doses of the vaccine be given four to twelve weeks apart, with evidence suggesting that the vaccine appears to work better when the second doses are delayed.

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