Research Update: COVID-19 vaccines

 

Sitting in the sunshine, sipping my latte, no mask requirements, looking at where I’m going to surf each morning, I’m more than a little embarrassed to admit I still feel so very frustrated and ‘over’ the whole impact Covid's produced.

I’m sure most people understand vaccination isn’t going to be a magic bullet, but how far off are we really?

Will they be effective? Are there side effects? How will vaccination work?

There is little doubt that vaccines hold the key to ending the pandemic. A recent modelling study predicted that vaccinating just 40% of adults over the course of 2021 would reduce the coronavirus infection rate by around 75% and cut hospitalisations and deaths more than 80%.

However, with a fast-moving pandemic, no one is safe, unless everyone is safe.

Instead of the vaccine being equitably distributed across the world, some countries have secured enough of the initial production to vaccinate their entire population 5 times over. Whereas Brazil with over 8 million cases and over 200 thousand deaths has secured just half a dose per person. Covax, launched by the World Health Organization (WHO) has managed to secure less than that for poorer nations, a third of the global population.

While vaccine developers typically follow a linear sequence (pre-clinical animal studies to Phase 1/2/3/4 human trials), the urgency of COVID-19 means many have sped up their timelines.

In some cases, Phase 1 and 2 trials are being squashed together (testing safety and effectiveness of the vaccine at the same time), or Phase 1 human safety trials are running before animal efficacy data is in.

Of the hundred Covid vaccines in development less than a dozen have made it to human trials so far. Most vaccines that reach clinical trials don't make it to market.

Nevertheless pre-orders are rolling in. The arrival of the new year sees dozens of countries scramble to grant regulatory approval to one or more of the vaccines created by Pfizer, Moderna, AstraZeneca and Sinopharm, among others. Australia has agreements with each of the major vaccine manufacturers and has announced a vaccination program will start within 5 weeks.

Who’s leading who?

The United States has distributed 15.4 million vaccine doses and 4.56 million of which had already been administered, according to the US Centres for Disease Control. That represents less than 1.5% of the US population. The UK has administered a vaccine to less than 2% of its 68-million people.

In France, where 66,282 deaths and 2.68-million cases are reported, none of the countries 67-million people have received vaccination.

Of China’s 1.4-billion people, less than 0.5% have received vaccination.

In contrast, Israel has managed to vaccinate over 15% of its 9 million people. Bahrain has inoculated 4.15% of its population, more than any country bar Israel.

While these nations have prioritised health workers, the elderly and the clinically vulnerable in a bid to soften the immediate risk to their populaces, Indonesia is about to undertake the incredible task of vaccinating its 273 million people by starting with their healthy workforce.

The fact Indonesia is doing it differently is of tremendous value. It gives the rest of the world an opportunity to ascertain if the process might provide a different result.

The fact we have vaccine programs in place at this stage is an incredible achievement but how will the vaccination process work?

In one word, slowly.

🦠 It’s important to remember, supplies of the various vaccines are limited, distributing them is challenging, immunity takes a few weeks to develop and the protection they offer isn’t forever or even 100% effective.

🦠 Even in wealthy countries with adequate doses of covid-19 vaccines, immunising the entire population will take time. In the UK, their task force expects it will take at least a year. Large parts of Africa may not get covid-19 vaccines for several years.

🦠 As vaccine trials only began a few months ago and this coronavirus is new, we don’t know how long immunity lasts, whether from infection or from a vaccine.

🦠 Not only do we not know how long a vaccine confers immunity for, but also whether it stops people from incubating the virus and passing it on. 👀 👀 👀

🦠 Certificates showing vaccination date as well as which product received will most likely become as mandatory as passports for International travel. The CEO of Qantas, Alan Joyce, has said he envisages this becoming necessary for all passengers on the airline’s long haul flights.

Many are eager to get vaccinated but what if you aren’t?

President-elect Joe Biden has said people in the US won’t be forced to have the vaccine. Australia along with the UK has no plans to make it mandatory but the UK hasn’t ruled it out. In Brazil coronavirus vaccination will be required by law.

Here are a few quick points about Coronavirus vaccination.

👉👉 You can't get COVID or spread it from the vaccine. The new mRNA vaccines don't contain the virus. They instruct your body to make a protein found on the virus that triggers an immune reaction, creating immunity.

Incidentally, messenger RNA (mRNA) technology has never been approved for a vaccine before. This technology is fast, relatively inexpensive and has incredible potential not only for helping us now with the covid-19 pandemic, but also in the future for tackling many other diseases, from flu to cancer.

👉👉 For Covid vaccination, for now, two shots will be required. At best, you only get about 50% protection from the first shot but 95% after the second. Which has to be 21- 28 days later for the second dose. You will also need to report side effects.

👉👉 Be prepared for them, especially after the 2nd shot. Injection site pain is one side effect (typical for any vaccine) and flu-like symptoms are the most common side effects reported so far. These side effects are typically short-lived and not severe.

👉👉 Don't assume you're protected from COVID-19 immediately after receiving the second shot, and certainly not during the 21 to 28 days between the first and second shot.

How long will immunisation last?

Hopefully a year, but more likely 6 months. Peter Doshi associate editor of The British Medical Journal raises a good point, the current trials aren’t designed to answer the most important questions about COVID.

We could end up with vaccines that reduce risk of mild infection but not risk of death, according to Paul Offit, of the FDA’s Vaccines and Related Biological Products Advisory Committee.

Even after being fully vaccinated, guidelines for social distancing and wearing masks in certain situations will still be required.

Realistically, we’re in for a longer ride than we’d hoped for.



Signorelli C, Zucchi A, Tersalvi CA, et al., High seroprevalence of SARS_COV-2 in Bergamo: evidence for herd immunity or reason to be cautious? Int J Public Health. 2020 Dec;65(9):1815-1817.

Ioannidis JPA. Global perspective of COVID-19 epidemiology for a full-cycle pandemic. Eur J Clin Invest. 2020 Dec;50(12):e13423.

Lv H, Wu NC, Mok CKP. COVID-19 vaccines: Knowing the unknown. Eur J Immunol. 2020 Jul;50(7):939-943.

Lurie N, Saville M, Hatchett R, Halton J. Developing Covid-19 Vaccines at Pandemic Speed. N Engl J Med. 2020 May 21;382(21):1969-1973. doi: 10.1056/NEJMp2005630. Epub 2020 Mar 30. PMID: 32227757.

Doshi P. Will covid-19 vaccines save lives? Current trials aren't designed to tell us. BMJ. 2020 Oct 21;371.


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