1st COVID-19 vaccine coming soon

Great news. At least one vaccine – or two – could be approved in record time, raising hopes that the end of the COVID-19 pandemic may be in sight in early 2021.

Drug makers Pfizer and Moderna have announced promising interim results for their respective vaccine candidates. Pfizer, which developed its vaccine with German partner BioNTech, has filed emergency use authorization (EUA) – a temporary approval to accelerate the availability of medical products during a public health emergency – for its COVID-19 vaccine, close on the heels of reports that the vaccine was 95 percent effective in preventing COVID-19 in a large, phase III trial. The  study findings have yet to be published or peer-reviewed though.

Joining Pfizer as a front-runner in the race to contain the raging pandemic, the Moderna vaccine was  94.5 percent effective at protecting against COVID-19 in an interim analysis of the COVE study.

Should the US FDA approve the vaccines, distribution presents a daunting challenge, according to vaccine experts.

The Pfizer COVID-19 vaccine needs to be stored at ultracold temperature – at minus 70 degrees Celsius to be exact, colder than winter in Antarctica. The same is true for the Moderna vaccine which needs to be kept at minus 20 degrees Celsius, the temperature typical of a regular freezer.

Ms Debra Kristensen, a veteran of vaccine innovation and supply chains at PATH, an international non-profit firm focused on public health, said it is feasible to distribute the vaccines, just like how the Ebola vaccine was successfully distributed in a few African countries. “But it’s definitely going to be much more expensive and difficult.”

To smooth ruffled feathers, Pfizer said the vaccine can last in a specialty freezer for up to 6 months. A “cool box” will transport the vaccine, with dry ice around it, to keep the right temperature. “It has actually a device within it that has a continuous GPS and temperature monitor,” said Tanya Alcorn, vice president, Pfizer’s BioPharma Global Supply Chain. 

The Moderna  vaccine, on the other hand, “can be distributed in a standard fashion — health workers are used to it, facilities are used to it — it’s more normal,” explained Kristensen.

“We don’t need [ultracold conditions] as the quality of our product has improved and [it] doesn’t need to be highly frozen to avoid mRNA degradation,” added Moderna spokesperson Colleen Hussey.

“It is great news [that] there may be two vaccines that are effective … that means we can reach more people,” said Ms Christine Finley, immunization programme manager  at Vermont’s Health Department in Burlington, Vermont, US. “We need to show the vaccines are safe and effective. And we need to build public trust.”

The more vaccines the better

With some modicum of excitement and hopes brought about by the possibility of an approval of the first COVID-19 vaccine before Christmas,  infectious disease experts said vaccine development is not a race. They said the more vaccines are approved, the better, because of the sheer number of people needing protection against SARS-CoV-2.

Ten other vaccine makers are now into phase III trials, including studies in Australia, Britain, China, India, and Russia. AstraZeneca and Oxford University recently published favourable phase II/III data for its chimpanzee adenovirus-vectored vaccine, ChAdOx1 nCoV-19. [Lancet 2020;doi:10.1016/S0140-6736(20)32466-1] Some 50 other vaccine candidates are in early stages of testing, including one being conducted in Singapore.

Third wave of pandemic threatens nations

WHO Director-General Tedros Ghebreyesus said the world is at a “critical juncture” and the next few months will be tough, with many countries seeing an exponential increase in cases. Europe, for example, briefly enjoyed sinking infection rates during summer, but are now surging again. It is likely to see a third wave of the pandemic before a vaccine can be introduced, warned WHO special COVID-19 envoy David Nabarro. In the US, cases climbed toward a third peak, trending upward in most states, many of which are setting new case records. 

Alarms were also sounded in Australia, Japan, and South Korea with COVID-19 cases peaking again.

To avert unnecessary deaths, prevent essential health services from collapsing, and schools from shutting again, the WHO urged leaders to take immediate action. Frontline healthcare workers and essential workers, as well as nursing home residents, are among the first to get vaccine jabs in the initial rollout.

Given the size of the global population plus the fact that each vaccine requires two jabs at three weeks apart, universal coverage will take a long way. The approval of the first vaccine is now moving to the fore –  a feat that should be celebrated – but is only one step in the COVID-19 journey.

There are qualms about using an EUA for a vaccine that will be given to millions of people globally, but such a criticism has been muted with hundreds of thousands of fallen bodies hardest hit by one of history’s worst pandemics.