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In our 10 September article Race for a vaccine we explained the journey of a vaccine from pre-clinical “Phase 0” to “phase 3” where it is ready for large-scale efficacy trials and is given to thousands of people to confirm safety, identify rare side effects, and measure effectiveness. Two months on, considerable progress has been made.
On 9 November 2020, the American multinational biopharmaceutical company Pfizer together with its German partner BioNTech announced early efficacy results of their Covid-19 vaccine’s Phase 3 trials of more than 90% from 94 confirmed cases of coronavirus in trial participants.
This was followed by a prediction that around 50 million doses of the vaccines should be available by the end of 2020. “We are reaching this critical milestone in our vaccine development program at a time when the world needs it most,” said Pfizer CEO and Chair Albert Bourla.
“This is an astonishing result for a first-generation vaccine. Many had not dared to hope for efficacy of anything over 70%,” commented The Economist on the news.4 The vaccine uses the genetic code of Covid-19 to start making the virus inside a human body, allowing the immune system to recognise the virus as foreign and attack it with antibodies.
Just over a week later, another US biopharma, Moderna, announced an efficacy rate of 94.5% from analysis based on the first 95 volunteers to develop Covid-19 symptoms from a trial of 30,000 in the US.5 Meanwhile UK-Swedish biopharma AstraZeneca’s CEO Pascal Soriot confirmed in an interview published 5 November that the group’s vaccine could also be ready for large-scale distribution by the end of the year.6
This means that at least two more vaccines could move out of Phase 3 into “approved with authority for use in the general population” phase before the end of 2020, but distribution of enough vaccine to, in effect, vaccinate the world was never going to be straightforward.”
Currently there are 12 candidates are currently in phase 3 trials. Five vaccine candidates among the twelve have already received approval for limited emergency use, including four in China and one in Russia.
However, distribution of enough vaccine to, in effect, vaccinate the world was never going to be straightforward.
Laboure explains why. “In total, the world will need at least 10 to 15 billion doses. That’s because most Covid-19 vaccines will require people to receive two doses by injection. It’s fairly obvious to state but that means this is going to be one of the biggest logistical challenges ever known to humans.”7 She points out that in comparison, 10 billion doses globally across all vaccines and inoculations were utilised in 2018. “Global distribution will face a bottleneck because there are only four-to-six facilities in the world that can reliably mass produce vaccines. Other issues include technology transfer, intellectual property protection, and temperature-controlled distribution.”
The other issue is distribution priorities. Coordinated by the trio of Gavi, the Vaccine Alliance, The Coalition for Epidemic Preparedness Innovations (CEPI) and the WHO, the COVAX initiative sets out to “to ensure that people in all corners of the world will get access to COVID-19 vaccines once they are available, regardless of their wealth”. COVAX says it will achieve this by “acting as a platform that will support the research, development and manufacturing of a wide range of COVID-19 vaccine candidates, and negotiate their pricing”. The first step, it adds, is to have enough vaccine doses to treat at least 20% of the participating countries' populations, which highlights that if large sections of the global population is denied access to the vaccine on grounds of cost, it will be impossible to end the pandemic.