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The Covid-19 vaccine is on its way, creating additional challenges

What’s Happening? Pfizer and BioNTech have announced that their Covid-19 vaccine candidate has been found over 90% effective in participants who showed no evidence of previous SARS-CoV-2 infection. According to a press release, the first interim analysis of the Phase III trial of BNT162b2 evaluated 94 confirmed cases of Covid-19. The trial, which has enrolled 43,438 participants to-date, will continue until 164 cases have been confirmed for final analysis. No serious safety concerns have been identified. The companies expect to have enough safety data for a potential US Food and Drug Administration Emergency Use Authorization by the third week of November.

Why does this matter? “Today is a great day for science and humanity”, exclaimed Pfizer Chairman and CEO Albert Bourla when announcing the results, with much of the world no doubt sharing a collective sigh of relief.

The 90% effectiveness rate surpassed expectations – the US Food and Drug Administration said that inoculations need to be at least 50% effective to be considered for use.  The vaccine also still needs approval, but, given the urgency of the situation, we can assume this will go ahead. Shortly, the challenge of vaccinating billions of people worldwide will begin.

Perhaps the biggest hurdle, aside from getting people to take the vaccine, is logistics. It requires temperatures of at least -70C for safe storage and transportation, which could spell trouble for countries subject to high temperatures and/or poor infrastructure.

Even once the vaccine meets its destination and is defrosted, it can only be refrigerated at 2C to 8C for five days before it spoils. To try and combat this problem, Pfizer has designed a container to keep doses of the vaccine at a safe temperature for up to 10 days during transportation. It’s also working on a powdered form that could be released next year while a heat-stablevaccine is reportedly being developed by scientists in India.

On a positive note, there are over 170 Covid-19 vaccines in development, 11 of which are in Phase III clinical trials. Moderna, AstraZeneca/Oxford and Johnson & Johnson all expect to publish their trial results imminently. Should all three be approved, it is likely in early 2021 we will see several vaccinations become available. It must be remembered, however, that these will be given out on a priority basis, and some people may not receive them at all.

It’s not yet time to ditch the mask and forget about social distancing. Testing will also continue to hold significant importance in allowing people to return to “normal life”. This week, for example, the CEOs of three of the world’s largest airline alliances urged the adoption of an international standard for testing procedures which would restore consumers’ confidence in air travel. That’s despite the positive news regarding Pfizer’s vaccine.

Lateral thought from Curation – Without trying to put a downer on what is objectively positive news, what happens once the world is inoculated against Covid-19?

During the pandemic, levels of other respiratory viruses have declined due to the non-pharmaceutical interventions we’ve been using. Once the world is back out and about, there is a real risk that outbreaks of infections such as influenza and respiratory syncytial virus will again increase, and government, corporates and wider society should be ready for that.

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Nicola Watts

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