Some of the greatest TV this month was the live footage on CNN of the first doses of the Moderna vaccine being loaded onto FEDEX trucks for distribution in Olive Branch, Mississippi! This is a testament to “Operation Warp Speed” and as the “cool” saying goes might …
spell the “beginning of the end”, for the COVID-19 pandemic.
For non-scientists, it is important to note that the ~10-month timeline for development and approval of safe and effective vaccines is truly unheard of; it typically takes a decade.
The Moderna vaccine is the second mRNA-based vaccine to be approved and distributed across the US. It follows the Pfizer-BioNTech vaccine which was distributed in the US, Canada, UK, and Israel earlier this month. Both vaccines have an effectiveness of ~95%, and 100% for preventing severe COVID-19 disease. The vaccines are safe as highlighted from the phase III trials, and with few incidents reported so far; at the time of writing ~2.1 million doses have been administered in the US. The major concern is an anaphylactic-like allergic reaction which has been observed in a handful of people. This indicates that people with prior allergies should exercise caution, however, for the vast majority only minor and transient side effects – pain at the injection site, and low grade fever – are seen.
Along with the UK (which was first) and the FDA, the European Union has also approved the Pfizer-BioNTech vaccine! This is a great news for the 27 countries (~400 million people), within the European Union; and to a more of lesser extent, countries have already pre-ordered vaccine (e.g. UK = 40 million; Greece = 200 thousand; hopefully, poorer countries will also have fair access to the vaccines).
In the meantime, the major obstacle in the “Endgame” is production and distribution of adequate vaccine to achieve herd immunity, which will involve vaccinating 70-80% of the population. In the initial vaccination program, priority groups were established – as expected health care workers, elderly at risk are prioritized. Some complaints were heard that pregnant women, who represent a high risk group were not prioritized; of course, they must be a priority if there is adequate safety data.
To highlight the difficulties with production, the “adequate vial number issue” which came up with hand sanitizers in March / April has re-surfaced. Another issue is the requirement for cold storage and distribution of the vaccines (-80oC for Pfizer-BioNTech, -20oC); with years of experience in a lab, I know that this is a very tedious and costly exercise! It would be a logistical nightmare but to-date it has been very well handled; again the speed at which cold storage and distribution (in trucks and planes), has been remarkable.
Apart from logistical issues another potential issue is “encouraging” people to actually get the vaccine when it is their turn. There has been some “advertising” with members of the White House, President-Elect Joe Biden, Dr Fauci, and other celebrity TV doctors getting the vaccine on live TV. Initial thinking was that White House staff should get early access to vaccines, and another thought was to give mall Santas, and helpers early access to vaccines in exchange for promotion. Live and early promotional vaccinations are all helpful to boost confidence. You’d think that given the serious nature of COVID-19 disease, most people would be rushing to get vaccinated but … Another thought is to make vaccination mandatory and to issue immunity/vaccination passports to people – I think this is critical, and unless people have a medical exemption – for example, severe allergic reactions – vaccination should be mandatory.
It will interesting and important to track the progress and impact of the vaccination program in week and months; it will be important answer questions like: 1) what % of the population is vaccinated, 2) how long are people protected for after vaccination, and 3) are there any mutant variants emerging that are resistant to vaccination.
Hopefully, vaccination is the Endgame for COVID-19! Even though we may get control over the virus, it is critical that research and development continues to improve production and distribution, and to be prepared for any rogue strains that may emerge. Many groups are working currently working on nasal spray vaccines and hopefully, some of these come to fruition to capture needle-shy people!
Until next time … Tranquilo Polymaths.