Is a COVID-19 vaccine really just around the corner? We explain the latest developments with Covid vaccination, what safety measures are in place for rapidly produced vaccines and what this all means for hopes of a return to ‘normal’ life.
Multiple vaccines now have released results from the final trial phase, with promising-sounding efficacy rates being reported.
But there are still many logistical and practical challenges that lie between us and widespread Covid vaccination.
Latest COVID-19 vaccine updates:
- A vaccine developed by Pfizer and BioNTech has been reported as having a 95% success rate in preventing COVID-19 infection in participants without evidence of prior infection.
- A vaccine developed by Moderna seems to also be 95% effective, and looks promising for efficacy in people over 65.
- Both of these vaccines require two doses and need to be stored at extremely low temperatures – below 70 degrees Celsius.
- The Oxford/AstraZeneca vaccine has reported 70% efficacy as a single dose and up to 90% efficacy if a half dose is given followed by a full dose. It is easier to store as it doesn’t need to be kept at such low temperatures as the other two.
- The UK government has already ordered millions of doses of each vaccine. NHS plans say that highest-priority people (care home staff and residents) could start to be vaccinated in December.
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When will a vaccine be available?
Excitement has followed the news that the vaccine may be available to certain priority groups, including care-home workers, residents and social care staff before Christmas – and more widely by spring 2021.
But, as with all coronavirus progress estimates, we advise taking this with a pinch of salt.
Pfizer estimated that it could be manufacturing up to 50 million vaccine doses in 2020 and up to 1.3 billion doses in 2021. AstraZeneca said it is on track to produce 3 billion doses in 2021.
This is still a fair way off covering a large chunk of the global population, taking into account that the vaccines are likely to be needed in two doses per person.
Thinking about all the vaccines in progress (there are several more possible vaccines in various stages of development), the World Health Organisation (WHO) has estimated that there won’t be widespread global dissemination of COVID-19 vaccines until the middle of next year at the very earliest.
What needs to happen before the vaccines are rolled out to the public?
The data we’ve seen from Pfizer, AstraZeneca, and Moderna were from phase three trials, which is the final stage of testing a vaccine for safety and efficacy – so it’s an important step, and the numbers are looking good.
But the trials need to continue for a bit longer to build up more data (these are ‘interim’ results), and then they have to undergo regulatory approval, involving more safety studies and a peer review of the data.
The Oxford University Vaccine Group told us: ‘Because a vaccine may be less effective in younger or older individuals due to differences with their immune systems, you need to include studies to show the vaccine works in such individuals before the vaccine would have full approval for use in those age groups.’
After this, the logistical challenges of producing and disseminating huge volumes of vaccines around the world need to be met. In the case of the Pfizer and Moderna vaccines, one stumbling block is the very low temperature the vaccine needs to be stored at (-70°C).
The AstraZeneca/Oxford vaccine could be easier to disseminate as it can be stored in regular refrigerated conditions.
Any vaccine that gets to this stage will also need to be monitored once it’s rolled out to the public. This monitoring will look out for things that may only start to be picked up with widespread use – for example, rarer side effects and long-term risks/benefits.
There are several more vaccines that are currently in phase three trials and yet to release results.
Who will get the COVID-19 vaccine first?
According to the Joint Committee on Vaccination and Immunisation (JCVI), which advises the government, the provisional ranking of priority groups for COVID-19 vaccination is:
- elderly care-home residents and care-home workers
- 80 years of age and over and health and social care workers
- 75 years of age and over
- 70 years of age and over
- 65 years of age and over
- high-risk adults under 65 years of age
- moderate-risk adults under 65 years of age
- 60 years of age and over
- 55 years of age and over
- 50 years of age and over
- rest of the population
This is subject to change, based on a few factors such as the suitability and/or efficacy of the first available vaccine for older people, and the transmission dynamics of COVID-19 in the UK population at the time a vaccine is ready to be deployed.
Some have noticed the absence of BAME people as a priority group on the list. Earlier in the year there had been suggestions that BAME people could be among the first to be vaccinated, due to their higher risk level.
Health secretary Matt Hancock said this week that the priority list currently looks this way because age is the strongest determining factor of morbidity (whether someone dies from the disease).
The JCVI noted that ‘as evidence of at-risk groups emerges, this work will inform the review of the composition and order of priority of groups for vaccination’ and also stressed that ‘any COVID-19 vaccination programme will need to ensure every effort is made to get good coverage in BAME groups, in areas of higher socio-economic deprivation, and in areas with outbreaks or high levels of community transmission.’
Will the vaccine be mandatory?
So far, it looks like the COVID-19 vaccine will be voluntary for adults and children (who are low down the priority list anyway due to their age).
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Are rapidly developed vaccines safe?
Some may feel concerned that vaccines are being ‘rushed out’. But COVID-19 vaccines are still going through the normal trial phases and regulatory processes for approval – these are simply being sped up.
The Oxford Vaccine Group explains that to produce a vaccine more quickly than normal (the current record time is five years), phases are being run in an overlapping manner where possible, and provisions for regulatory approval, funding, manufacturing and logistics are being prepared earlier than they would be normally.
This is to make sure that once a vaccine has gone through successful trials, the necessary structures are in place to get it going quickly.
There’s also been more money pumped into these vaccine trials by governments, which wouldn’t be the case in a non-emergency situation.
Safety data so far for the Pfizer vaccine, for example, is very good – only showing mild side effects – and phase three trials are designed to expose any serious safety concerns.
In some cases, vaccines need specific safety approval for certain groups. The Oxford University Vaccine Group said: ‘the easiest example for a special case minority group is pregnant women. Without specific trials in pregnant women, no vaccine would carry approval for use for them.’
Will a COVID-19 vaccine mean a return to ‘normal’ life?
It’s thought that if we want to return to ‘normal’ life, we need a vaccine, but scientists have stressed it’s not a silver bullet, and as the UK is currently experiencing a ‘second wave’ of cases, it’s definitely not a time to relax our guard.
There are significant issues in disseminating a vaccine globally. Depending on the type of vaccine, it may have specialist storage requirements that make it trickier in areas where the appropriate infrastructure doesn’t exist. For example, the Pfizer vaccine needs to be kept in very low temperatures.
We also don’t know how long-lasting the immunity from a vaccine will be, and whether we’ll need booster shots or even a yearly injection, as there is for flu.
It’s also unclear so far whether the vaccine will stop people from spreading the disease, or just stop them from getting very ill.
Either way, whilst there is reason to be positive, this isn’t all going to be over by January.
Will the COVID-19 vaccine be available privately?
With a few vaccines in the mix, each with different levels of reported efficacy and with some requiring two doses, you might be wondering if there will be a choice and if the vaccine will be available to purchase through private healthcare.
What we know so far is that the government has promised that people will not be able to get priority by paying for the vaccine, and there aren’t yet any plans to offer vaccinations outside of the NHS and the agreed priority list outlined above.
The Department of Health and Social Care (DHSC) told us:
“The UK government has secured early access to 350 million vaccines doses through agreements with six separate vaccine developers, giving the UK the best chance of securing a safe and effective vaccine at the quickest speed.
“This will be more than enough to potentially vaccinate the entire UK population, should a vaccine be approved. It will be available from the NHS – for free – to everyone eligible to benefit, starting with those most at risk as currently advised by the JCVI.”
Social distancing and other measures still vital for the near future
Scientists estimate that around 60% of the population would need to be immune to COVID-19 (either through vaccination or by getting the disease and recovering with immunity, if that occurs) before we achieve anything like ‘herd immunity’.
This means that other measures, such as social distancing and mask wearing, are likely to remain in place and vitally important even while the vaccine is being rolled out.
We’ll also need to see testing and tracing programmes across the UK improve drastically to fight the spread of the virus effectively.
That being said, there’s still reason to be cautiously optimistic that this could be the beginning of a turning point in the pandemic.
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This story was originally published on 10 November 2020, but has been updated to reflect the latest developments around the COVID-19 vaccine.