The plague year 2020 has just ended. The virus has caused at least 1.9m recorded deaths and many hundreds of thousands have gone unrecorded. More than 93m people had been infected to date while many were never diagnosed. Millions of people have become jobless and the standard of living have plunged for many. The year left a macabre experience for human race. The only good news is that the vaccine is almost ready. The United States, Britain and many of the European Union countries have already started vaccinating their citizens.
However, in recent weeks two variants of the coronavirus have been spotted in Britain and South Africa which happen to be a lot more contagious due to their mutation. If the new variant spreads massively before the vaccination is completed for a large number of world population, the hospitals may get overwhelmed again and the health workers will struggle to cope. To fetter the spread, Britain has gone into a full lockdown again. Poorer and middle-income countries do not have that luxury. Their economies are open with an instruction to maintain social distancing.
This highly transmissible virus has not permitted the scientists the due time which is normally required to develop a vaccine with all the clinical trials. All stakeholders were in a hurry. Normally a vaccine is developed in five stages from discovery research to manufacturing and delivery. In the meantime, different phases of clinical trials examine that whether the vaccine is safe, can activate an immune response and can protect against the disease. If the results are promising and convincing, only then the vaccine goes for a regulatory review and get approval.
This whole process usually takes more than 10 years and costs millions of dollars. However, with regard to coronavirus, the scientists were forced to condense the timeline and get a vaccine within a year instead of a decade. A vaccine can be the most effective weapon against the coronavirus which can only restore normalcy in public life. It is imperative to note that despite the unprecedented push for vaccines, less than 10 percent of drugs that enter clinical trials are ever approved in the US by the Food and Drug Administration (FDA), the US authority for drug approval.
The rest of the drugs are either not effective or have too many side effects or are not superior to the existing drugs and hence fail to get the approval. The target timeline for the scientists to develop the vaccine against coronavirus was merely ‘18 months’ which the National Academy of Sciences in the US described as ‘Pandemic Speed’. To fast-track the timeline, the scientists had to combine several phases and run testing of the vaccines on more people without much waiting.
The biggest risk of an early developed vaccine is that it might cause a vaccine-induced enhancement, in which the body of the vaccinated person reacts unpredictably and makes the disease more perilous. That has been the case for a few H.I.V. drugs and vaccines for dengue fever according to an New York Times report. However, it is a global rule that the scientists do not start injecting people with experimental vaccines without rigorous safety checks. Simply put, that is why developing a vaccine takes such a long time.
As of first week of January 2021, more than 1,000 drugs and vaccines are in ‘work in progress’ stage aiming to fight the Covid-19. The most talked about vaccine has been developed by the US giant pharma company Pfizer and German biotechnology company BioNTech SE. Pfizer claims that their vaccine is 90% plus effective on the basis of preliminary data. Pfizer’s shots need to be stored at temperatures of -70 degree Celsius or even colder for which the company is building an ultra-cold chain.
The vaccine remains in batches of at least 975 doses. After 21 days of the first shot, the same group of people shall be gathered again to get the booster. Apart from the US, the European Medicines Agency also approved the Pfizer-BioNTech vaccine. Another US company Moderna has developed a vaccine which is said to have 95% efficacy level and can be stored at -20 degree Celsius up to 6 months. 2 injections in 4 weeks gap will serve the purpose.
The University of Oxford and British-Swedish pharmaceutical company AstraZeneca has produced a vaccine with 62-90% efficacy level which, unlike Pfizer’s shot, can be stored in a normal refrigerator which is extremely convenient for distribution. They claimed that their vaccine is safe and it will provoke an immune response in people of all ages. India and Bangladesh have decided to take the Oxford vaccine.
The Beijing-based biopharmaceutical company Sinovac has developed a vaccine named as ‘CoronaVac’ and The Gamaleya National Center of Russia has developed a vaccine named ‘Sputnik V’; both claims to have 92% efficacy level and can be stored in normal fridge temperature of 2 to 8 degree Celsius. The level of efficacy has been announced on the basis of interim trial data.
Apart from Russia, Belarus and Argentina have decided to count on Sputnik V. According to a report of Al Jazeera on 15 December 2020, Pfizer-BioNTech’s and Moderna’s two-dose vaccines will cost about $20 and $33 per dose respectively, while Oxford-AstraZeneca’s is available at a much cheaper price of about $4 per shot. Sputnik V will be sold to the international market at less than $10 per dose.
Now the million-dollar question is whether the vaccine is really capable of producing enough antibodies which can kill coronavirus. Will an inoculated person be able to walk freely like he could in the pre-pandemic time? Pfizer says that vaccination will reduce one’s likelihood of suffering symptoms by more than 90% meaning the vaccine will prevent one from getting sick with coronavirus. At the same time researchers also caution that the vaccinated people may still be silent spreaders of the virus putting the unvaccinated people at risk. Therefore, the use of face mask and maintaining proper distancing in human interaction will still be of the utmost importance.
Researchers are not yet certain about whether the natural immunity is stronger than the vaccine induced immunity. People who had been mildly sick with the virus may have a moderate natural immunity which may wane within a few months and leave them with high chance to get reinfected. Having the knowledge on how the vaccine works, experts suggest that taking the shot will be a far safer bet. One report in the NY Times suggest that volunteers who took the Moderna shot had more antibodies in their blood than people who had been sick with Covid-19 and recovered. Natural immunity may not guarantee the prevention from reinfection.
Covid vaccines are not 100% effective and there are already some reported cases of allergic reactions to Covid-19 vaccines and probably in the coming days as more people will come under vaccination, more reports of adverse reactions will come to light. But researchers are hopeful that the benefit of the vaccine will outweigh the risk. However, in different parts of the world the ‘anti-vax’ sentiment is also strong.
In the US many black Americans are lacking trust in the vaccine and they fear that early taking of vaccines will render them guineapigs for their white counterparts. In Indonesia, a question was raised that whether the vaccine is Halal. A large number of Asian people wants to wait and see for a bit of time before taking the shot when available. However, the researchers strongly believe that salvation lies in fast vaccination.
Given the magnitude of the pandemic and its deadly toll, a rapid vaccination is the thing the world requires most in 2021. But the fact is that the vaccines will remain scarce. The Economist reports that Pfizer, Moderna and AstraZeneca could provide a little over 5bn doses in 2021, enough for around 2.5bn people. Therefore, more than a billion doses of Sputnik V, from Russia, and two vaccines from China are required to bring more people under vaccination. Sensing the trouble, the rich world has allegedly monopolized vaccines.
Canada, the US and Britain has secured a large number of shots. For example, Canada has reserved doses six times higher than their population not knowing in the first place that which vaccine is going to work. However, developing and poor countries probably cannot afford the Pfizer and Moderna vaccines since they require especial logistics support.
Therefore, AstraZeneca or Sputnik V or the Chinese vaccine can be the viable alternative for them as those can be stored in regular fridge temperature. As most of the vaccines, reserved by the rich countries, have high efficacy levels, the rich countries may release their extra doses to COVAX program run by the World Health Organization (WHO) for the fair distribution of vaccines among the population of middle-income and lower-income countries.
The Economist referred to a modelling which suggest that an optimal global distribution of vaccine according to need could save one and a half times as many lives as focusing supplies on rich countries alone. A vaccine induced herd immunity can only fizzle out the virus. The rich countries must not forget that in a pandemic no one is safe unless everyone is safe.
The writer is a freelance columnist.
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