The Pfizer/BionNTech vaccine is here but there is still a long way to go

Paving the way for mass vaccination, the UK is the first country in the world to approve the Pfizer/BioNTech vaccine. The emergency authorization came on December 2nd, and in less than a week, on December 8th at 6:31am, the first jab was administered to a 90-year-old grandmother at University Hospital Coventry and Warwickshire. Britain’s medicines regulator, the MHRA, said the jab offers up to 95 per cent protection and according to Pfizer 800,000 doses have already been sent to the UK.

The UK has ordered 40m doses of the mRNA vaccine also known as BNT162b2 – enough for 20m people – with 4m expected to arrive by the end of the year, and the rest throughout 2021. The vaccine will be given as two injections, 21 days apart and will be imported from the site in Puurs, Belgium, where is being produced. Immunity is achieved after the first dose, reaching its maximum effect seven days after the second dose. 73,000 people across a range of ages and ethnicities took part in the clinical trials – half of which were given the active vaccine.

Britain’s Joint Committee on Vaccination and Immunisation recommended that the first phase should prioritize the vulnerable groups: starting with care home residents and their carers, frontline health, social care workers and those aged 80 years or over, decreasing every five years to the age of 50. This is expected to be achieved by the end of April.

Because the vaccine must be stored at -70C, and hospitals already have the facilities to store it, in practicality, the first vaccines will likely go to NHS staff, home staff and patients. It will be transported in special boxes of up to 5,000 doses, packed in dry ice, has 10 days to reach the destination, the destination country can choose to store it in a “freezer farm” for up to six months at -70C, and once delivered it can be stored up to five days in a fridge. Once out it needs to be used within six hours. 

BNT162b2 is the fastest vaccine to ever be created – taking only 10 months from concept to reality – this is due to regulators using a rolling review system which allowed them to study results as they became available. To truly protect everyone, inoculation needs to happen in large numbers and there are several factors to be considered. The logistics behind vaccinating enough people will pose a great challenge even to countries with strong health infrastructure like the UK. Prime Minister Boris Johnson called the rollout “one of the biggest civilian logistical efforts” the UK has ever faced.

For large parts of Africa, Asia, and South America, which do not have sufficient storage and cooling facilities in “the last mile” delivery stages, rolling out the vaccine will “pose the biggest challenge,” German logistics giant Deutsche Post DHL said. Another major concern is the vaccine hesitancy or the so called “anti-vax movement.” This is regarded as one of the top 10 threats to global health by WHO and could cause attaining herd immunity difficult to achieve.

Britain has moved incredibly quickly, and this might be seen as a political move by other countries. The head of America’s Food and Drug Administration (FDA) was summoned to the White House on December 1st and asked to explain why his agency has not moved forward with the Pfizer vaccine.  Both the FDA and the European Medicines Agency have scheduled meetings for regulatory approval in the following weeks. An FDA advisory committee released on Tuesday a briefing document containing data on the Pfizer/BioNTech vaccine, which is to be reviewed this week for emergency authorization in the United States. Other trial results vaccines, including Moderna, Oxford/AstraZeneca, Sputnik V and Wuhan Institute of Biological Products are expected in the coming weeks.

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