Covid-19 vaccine: Latest updates on Oxford AstraZeneca and Pfizer breakthroughs – and who is eligible for the jab?
More than 21 million people in the UK have now been vaccinated against coronavirus.
As England prepares to take tentative steps out of lockdown on March 8, the drive to protect the populations of all four nations continues.
In positive news for the Oxford-AstraZeneca jab, a single dose of the vaccine prevents hospitalisations in over-80s by more than 80 per cent according to a new report published by Public Health England.
The Health Secretary said jabs were already helping to save lives, as he heralded the study which indicated that the Pfizer and Oxford-AstraZeneca vaccines are highly effective in reducing infections among older people.
Researchers examining coronavirus hospital admissions in Scotland also found that by the fourth week of receiving an initial dose, the Pfizer and Oxford/AstraZeneca vaccines were shown to reduce the risk of hospital admission from Covid-19 by up to 85 per cent and 94 per cent respectively.
As a result of the vaccine roll-out and the fall in the number of cases and deaths, the UK’s Covid-19 alert level was lowered from alert level 5 to level 4, as the country’s top medics said the threat of the NHS being overwhelmed has receded.
It comes as vaccine side-effects have been seen up to three times more often in people who have previously been infected with coronavirus, new figures have shown.
On Mar 3, the Chancellor confirmed during his Budget announcement, an additional £1.6 billion for the coronavirus vaccine roll-out and to “improve future preparedness”.
Although studies suggested that the AstraZeneca jab may be less effective at preventing mild cases of the variant first detected in South Africa, the Prime Minister said the Government remained “very confident in all the vaccines that we’re using”.
The team behind the Oxford jab said a vaccine against new coronavirus variants should be ready by October. In a media briefing hosted by AstraZeneca on Feb 3, Professor Andrew Pollard, director of the Oxford Vaccine Group, said work on designing a new vaccine could be completed rapidly.
A universal vaccine that would work on all Covid-19 variants by targeting the core of the virus instead of just the spike protein could be available in as little as a year, researchers say.
Dr June Raine, Chief Executive of the MHRA, said: “As of today there’s no imperative that we fast-track a new variant-effective vaccine – but we are prepared.”
Matt Hancock has also said that there may be a need for a third Covid-19 vaccination dose over autumn against new variants.
He told the Commons: “Now, we know for sure that we seek to vaccinate with two doses every adult in the UK, there may well be a need for a third vaccination over the autumn against variants and there is currently a clinical trial considering the vaccination of under-18s.”
Public Health England (PHE) said on Sunday that six cases of the concerning P.1 variant first detected in the Brazilian city have been confirmed in Britain, three in England and three in Scotland.
What we know about the Pfizer vaccine
The Pfizer vaccine is being rolled out across the UK, with the most vulnerable and care workers being vaccinated first.
The vaccine was first administered to a 90-year-old grandmother from Coventry, Margaret Keenan, marking the start of a historic mass vaccination programme.
Pfizer and German firm BioNTech said in November, their vaccine is 95 per cent effective in preventing Covid-19 after two doses and has passed its safety checks. The jab only has 65 per cent efficacy after one dose, so scientists warned elderly people to wait until they were fully protected with a second dose before hugging relatives.
On Feb 22, scientists in Scotland said that the vaccine also reduces hospitalisations by up to 85 per cent, after comparing those who had received the first dose of the vaccine to those who had not.
However, scientists have warned that people’s risk of infection doubled in the first eight days after the Pfizer vaccine jab, citing people becoming less cautious as a possible cause.
The Clalit Institute for Research released results of the first detailed and controlled study on Feb 14, covering 1.2 million vaccinated and non-vaccinated people
The study found there was a 94 per cent decrease in the rate of symptomatic infection and a 92 per cent decrease in the rate of serious illness in those vaccinated, compared to 600,000 who were not vaccinated.
Significantly, vaccine efficacy was found to be maintained in all age groups, including those over 70 – an age group in which vaccine efficacy could not be evaluated in Pfizer’s original clinical trials due to there being too few in this age group who participated.
According to latest results, the Pfizer vaccine no longer needs to be kept at super cold temperatures. If approved by regulators, this means the vaccine can be stored in standard medical freezers for two weeks, which will have a significant impact on distribution.
Scientists said on Feb 27, the findings could “potentially accelerate vaccine roll-out” if those going for jabs were offered tests to see whether they had antibodies first.
Pfizer Inc and German partner BioNTech SE had produced over 70 million doses of their Covid-19 vaccine by the end of 2020. Overall, the UK has ordered 40 million doses.
BioNTech said on Jan 11 the companies were raising the 2021 delivery target for their Covid-19 vaccine to 2 billion doses, up from 1.3 billion, as they add new production lines and as more doses can be extracted per vial.
Though, deliveries of the Pfizer vaccine to the UK will be cut by between 15 and 20 per cent from Jan 25, due to delays in shipments because of work to increase capacity at its Belgian processing plant, sources said.
What do we know about side-effects?
A King’s College study has shown that vaccine side-effects are seen up to three times more often in people who have previously been infected with coronavirus.
The latest data from the King’s College ZOE app, which has logged details from more than 700,000 vaccinations, found those with a prior infection were far more likely to report side-effects than people who have not had the virus.
The difference between the two was particularly pronounced among those who had been given the Pfizer jab.
More severe side-effects are often a sign of better immunity, and emerging research suggests just one dose of vaccine gives a similar protective effect to two doses in people who have had a previous infection. Experts have now started to question whether people with prior immunity from a natural infection need a second dose at all.
The ZOE data shows that 12.2 per cent of people reported side-effects after their first Pfizer jab, but that jumped to 35.7 per cent of those with a previous infection.
For the Oxford/AstraZeneca jab, 31.9 per cent of people reported symptoms following their first vaccine, rising to 52.7 per cent of those who had previously been diagnosed with diagnosed with the virus. Most people reported muscle aches, feeling groggy or headaches.
The Oxford vaccine, which is easier to store and handle than the Pfizer jab and costs less, is likely to make it easier to reach people living in more rural areas.
Results from phase three of the Oxford/AstraZeneca trial, which had over 11,500 volunteers from the UK and Brazil, show the vaccine is 70.4 per cent effective on average.
On Feb 2, a study by Oxford University researchers found that efficacy increases from 54.9 per cent when the doses are administered at an interval of less than six weeks, to 82.4 per cent when spaced 12 or more weeks apart. Transmission of the virus is also reduced by 67 per cent following the first jab, according to analysis of volunteers in the UK arm of the phase three trial.
Researchers involved in the trial said the findings supported the decision made by the UK to extend the interval between initial doses and booster doses of the shot to 12 weeks.
It was also found by researchers in Scotland that the Oxford vaccine reduced coronavirus hospitalisations by up to 94 per cent.
The AstraZeneca vaccine has now been approved for adults in the EU. This news followed a draft recommendation from Germany’s authorities which called for its use to be restricted to those aged between 18 and 64, citing limited data on the drug’s effectiveness.
But Germany changed their position on Mar 3, to allow people over 65 to receive the AstraZenca vaccine after the recent studies had now provided enough evidence to approve it for all ages, Chancellor Angela Merkel said.
The change will see Germany follow the UK’s example and space out the first and second jabs of the vaccine by a maximum of 12 weeks, in order to quickly give more people initial protection against the virus.
France, Belgium, Greece, Sweden, and Spain who all had a similar stances, have now also authorised its roll-out to people over 65s.
Boris Johnson said on Jan 28, that evidence shows the jab “provides a good immune response across all age groups”.
The Vaccines Minister, Nadhim Zahawi, has also told the public to keep the faith in the Oxford vaccine, despite evidence which shows that it is less effective against the South Africa variant of coronavirus.
Moderna Inc said that “the study showed no significant impact” on the level of neutralizing antibodies elicited against the UK variant.
A six-fold reduction in antibody levels was observed on the South African variant. However, these levels are thought to remain above what is required for protection against Covid-19.
The vaccine approved for use in the UK by the MHRA on Jan 8, making it the third Covid-19 vaccine to be approved for use and the second mRNA vaccine besides the Pfizer jab. The vaccine will be delivered to the country in the spring.
The Government has requested another 10 million doses of the vaccine, taking its order to 17 million, enough for 8.5 million people to receive the two doses required.
The vaccine works by injecting a small part of the Covid-19 virus’ genetic code, which triggers an immune response and creates antibodies in the human body to fight the virus.
Moderna has reported that the vaccine’s efficacy was 94.1 per cent, while its efficacy against severe Covid-19 was nearly 95 per cent. Moderna is also testing its jab against the faster-spreading version of the disease.
Unlike the Pfizer jab, the Moderna vaccine can be kept for six months at -20C, the temperature of a conventional freezer, and can be stored for up to 30 days in a standard fridge – but a dose is three times larger than Pfizer’s.
The deployment of the vaccine will be similar to the roll-out of the Pfizer and Oxford/AstraZeneca vaccines. As with the Pfizer vaccine, anyone with a previous history of allergic reactions to the ingredients of the vaccine should not receive it, but those with any other allergies such as a food allergy can have the jab.
Moderna has also produced a vaccine that works specifically against the South African variant of coronavirus, with trials due to start in the US.
The firm announced on Feb 24 that it is experimenting with several potential methods of combating new variants of coronavirus, with a view to potentially offering new or booster shots.
What is the Novavax vaccine?
An experimental Covid-19 vaccine appears to offer strong protection in late-stage UK and South Africa studies, manufacturer Novavax said on Jan 28.
The UK has secured access to 60 million doses of the vaccine, called NVX-CoV2373, but it will need to be approved by the Medicines and Healthcare products Regulatory Agency
The protein-based vaccine candidate was shown to be 89.3% effective at preventing coronavirus in participants in its Phase 3 clinical trial in the UK, which enrolled more than 15,000 people between 18-84, of which 27% were older than 65, Novavax said.
The Novavax vaccine works like other vaccines by teaching the immune system to make antibodies to the coronavirus spike protein, and is given in two doses.
Researchers inserted a modified gene into a virus, called a baculovirus, and allowed it to infect insect cells. Spike proteins from these cells were then assembled into nanoparticles which, while they look like coronavirus, cannot replicate or cause Covid-19.
These nanoparticles are then injected into the body via the vaccine where the immune system mounts an antibody response. If the body encounters coronavirus in the future, the body is primed to fend it off.
The trial was carried out in conjunction with the UK Government’s Vaccine Taskforce, with its chairman Clive Dix saying in a statement: “These are spectacular results, and we are very pleased to have helped Novavax with the development of this vaccine.”
Prime Minister Boris Johnson has said it is “good news” that the experimental coronavirus vaccine from Novavax appears to offer strong protection in late-stage UK and South Africa studies.
When can I get the Valneva vaccine?
Large-scale manufacturing of a coronavirus vaccine candidate from French biotech company Valneva has begun in Scotland.
If approved, it would deliver up to 60 million doses to the UK by the end of this year.
The Government also ordered an extra 40 million vaccines, with the first batch due for delivery in 2022, whilst also retaining options over a further 90 million doses for supply between 2023 and 2025.
Valneva’s offering falls into a category of jabs known as inactivated whole virus vaccines.
These vaccines contain viruses whose genetic material has been destroyed by heat, chemicals or radiation so they cannot infect cells and replicate but can still trigger an immune response.
This technology is well-established and has been used in seasonal influenza, hepatitis A, polio and rabies vaccines.
Sars-Cov-2, the virus that causes Covid-19, is studded with spike proteins which it uses to enter human cells.
While the genetic material virus in the Valneva vaccine candidate has been destroyed, the inactivation process preserves the structure of the spike protein, which helps the body identify the substance as a “foreign invader” and induces an immune response.
So later, when a vaccinated person comes into contact with the virus, the immune system is primed for attack.
Like the Oxford/AstraZeneca jab, the Valneva vaccine conform with the standard cold chain requirements, which is between 2C and 8C.
The Valneva candidate vaccine is being tested on 150 volunteers at testing sites in Birmingham, Bristol, Newcastle and Southampton.
These tests will show whether the vaccine produces a safe and effective immune response against Covid-19.
If successful, larger tests will be planned for April 2021, with more than 4,000 UK volunteers taking two doses.
These trials will include those aged 18-65 as well as over-65s.
What’s happening with the Johnson & Johnson vaccine?
Johnson & Johnson, which owns the pharmaceutical firm Janssen, announced on Jan 29 that its single-dose vaccine was effective in preventing COVID-19.
Clinical data from phase 3 trials show the vaccine is 66 per cent effective at preventing moderate to severe Covid-19 but offers high protection against people needing to go to hospital.
In the trial of nearly 44,000 volunteers, the level of protection against moderate and severe COVID-19 was 66 per cent in Latin America and 57 per cent in South Africa, where a particularly worrying variant of the novel coronavirus is circulating.
However, J&J said the jab was 85 per cent effective in preventing severe disease “and demonstrated complete protection against Covid-19 related hospitalisation and death as of day 28”.
Those results compare to the high bar set by the Pfizer Inc/BioNTech SE and Moderna vaccines, which were around 95 per cent effective in preventing Covid-19. However, those trials were conducted mainly in the United States and before the spread of new more infectious variants.
Unlike the Pfizer/BioNTech and Moderna vaccines, J&J’s does not require a second shot weeks after the first or need to be kept frozen, making it a strong candidate for use in parts of the world with weak transportation infrastructure and insufficient cold storage facilities.
The vaccine uses a common cold virus known as adenovirus type 26 to introduce coronavirus proteins into cells in the body and trigger an immune response.
The United States government authorised Johnson & Johnson’s single-dose Covid vaccine on Feb 28. The US Food and Drug Administration announced the emergency-use authorisation of the J&J vaccine for people over the age of 18.
The UK has already pre-ordered 30 million doses of this vaccine but has the option to reserve a further 22 million, which will assist the Government in its aim to vaccinate the four most vulnerable groups of citizens by mid-February.
J&J said they would send final results to the Medicines and Healthcare products Regulatory Agency (MHRA) in the week of Feb 1, which would determine whether to approve the jab.
What do we know about China’s Sinovac and Sinopharm vaccines?
Clinical trials in Brazil reported on Jan 13 that Sinovac was 50.4 per cent effective, only slightly above the World Health Organisation’s minimum standard of 50 per cent.
On Jan 11 Indonesia became the first country outside China to grant emergency approval to Sinovac’s vaccine, amid surging infections and deaths, followed two days later by Turkey. Interim data showed it is 65.3 per cent effective, Indonesia’s food and drugs authority said.
On Dec 31, China approved the Sinopharm vaccine, its first approved shot for general public use. Sinopharm, developed by Beijing Biological Products Institute, says its vaccine is 79 percent effective against the novel coronavirus.
What’s happening with the Sanofi/GSK vaccine?
Drug companies Sanofi and GSK have announced a delay in their Covid-19 vaccine programme after trials showed an “insufficient response”in the over-50s.
The UK had ordered 60 million doses of the vaccine. Roll-out is now not expected before the last-quarter of 2021.
What is the vaccination programme’s progress so far?
More than 21 million people have been vaccinated, per the latest figures on March 6. On the same day, those aged between 56-59 began to be invited to receive their first dose of the vaccine as the roll-out continues.
Unveiling the latest official targets, the Prime Minister confirmed all 45 million people living in England will have been invited to receive their first dose two months earlier than previously promised.
Sir Patrick Vallance said on Jan 22 that there is “increasing confidence” that the UK variant will be susceptible to the vaccine.
The chief scientific advisor told a Downing Street press conference: “There’s increasing evidence from laboratory studies that the variant in the UK will be susceptible to the vaccines.
“There’s increasing confidence coupled with a very important clinical observation that individuals who have been infected previously and have generated antibodies appear to be equally protected against original virus and new variant.”
Further new strains have also been located in South Africa and Brazil, with health officials currently hunting for a mystery Covid patient thought to be one of the first in the UK to have a Manaus variant that may spread more rapidly and respond less well to vaccines.
The study, from South Africa’s University of the Witwatersrand and Oxford University, analysed the E484K mutation in some 2,000 people, most of whom were young and healthy. The team found that the vaccine had “substantially reduced” efficacy against the South African variant compared to the original strain of Sars-Cov-2.
The study did not assess protection against moderate-severe disease, hospitalisation or death was not assessed as the target population were at such low risk. But Sarah Gilbert, professor of vaccinology at the University of Oxford, told the BBC she was confident the vaccine would prevent severe illness.
Despite the concerns, on Feb 8, the Deputy Chief Medical Officer, Prof Jonathan Van Tam urged people to still get the vaccine, stating that the South African variant is unlikely to become the dominant variant.
Moderna Inc confirmed on Jan 25 that their vaccine produces virus-neutralizing antibodies in laboratory tests against new coronavirus variants found in the UK and South Africa. The vaccine was approved for use by the Medicines and Healthcare products Regulatory Agency (MHRA) on Jan 8 and will be delivered to the UK in the spring.
Most encouragingly, though, recent lab results suggest the Pfizer and BioNTech vaccine is likely to protect against the more infectious variant of Covid-19. These promising results stem from a trial carried out by the U.S. drugmaker on Jan 8, which concluded the jab was effective against one key mutation, called N501Y, found in both of the highly transmissible new variants in Britain and South Africa.
The Covid-19 vaccine is currently being offered by the NHS to the people most at risk of coronavirus. Representatives of Pfizer have stated that they have no plans to supply the vaccine to the private sector, and private vaccination during the first wave of vaccinations is highly unlikely.
Professor Sir Munir Pirmohamed, chair of the Commission on Human Medicine Expert Working Group, said that the Pfizer BioNTech vaccine will give people immunity “seven days after the second dose” of the vaccine, which requires two doses taken 21 days apart to reach high levels immunity.
Prof Pirmohamed said: “Partial immunity does occur after the first dose and we can see some protection occurring after day 12 of the first dose.”
Immunologist Professor Uğur Şahin, the founder of BioNTech, admitted that he expects the antibody response in patients “will decline over time”, but mooted the idea of combining vaccines for people who no longer had an immune response.
It is still not clear for how long the Pfizer vaccine will provide immunity against Covid-19, due to how quickly it was developed. A vaccine normally takes up to 10 years to develop from scratch; Pfizer’s was created in just 10 months.
But the MHRA has been clear that “no corners were cut” in assessing the safety of the jab, saying experts worked “round the clock”.
It is “highly likely” people will be vaccinated against Covid annually, as with the flu, according to Health Secretary Matt Hancock.
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