Public Health – Developing a vaccine for Covid-19
By World Healthcare Journal-
As we all know, over the past year, we have never seen a more imminent need for a vaccine. The world as we knew it ground to a halt - solely because of the menace that is Covid-19. Even now, many months since the pandemic officially began, we see the impact that this has caused in every aspect of our daily lives: lockdown, restrictions, curfews, and so on.
But this is not to say that nothing is being done. Quite the opposite, in fact. Throughout 2020, researchers right across the entire spectrum of public health have been toiling tirelessly towards developing this much-needed vaccine, at a rate which we have never seen before.
We have seen unprecedented collaborations between nations, companies, universities, and institutions - we have seen tens of thousands of people offer themselves up for research in order to move us ever closer to a potential vaccine. But still, there are many questions on our minds. How is the development process going? Can we be assured of its safety and efficacy? How can we ensure fair access to the vaccine when it is ready? Do we even have the capability to manufacture such enormous quantities of a vaccine?
This was the purpose of the Public Policy Projects virtual roundtable, chaired by The Rt Hon Nicola Blackwood. The session brought together speakers including The Rt Hon Professor The Lord Darzi, The Rt Hon The Lord Bethell, Hugo Fry, Managing Director of Sanofi, and Ben Osborn, UK Managing Director of Pfizer.
Current situation and challenges
Perhaps one of the most challenging aspects of developing the coronavirus vaccine is not only creating a safe vaccine, but rather, the struggle to develop a lasting and effective vaccine, and of course, the political issues surrounding development and delivery. Speaking on this and providing an update on the current progress of the vaccine was Lord Bethell, Minister for Innovation.
“The progress we have made on the vaccine has been astonishing. I am hugely encouraged by the updates that we are getting from the Oxford vaccine in particular, but also from a whole cohort of other candidates,” said Lord Bethell.
“But, we have to have some expectations management. This is being made crystal clear by the Secretary of State and others that quite often the first vaccine is not the one that delivers a knockout killer blow to last a lifetime against the disease.
“That said, all the signals we're getting from the market are extremely encouraging. But even if the first vaccine, doesn’t completely knock it on the head, there are some fantastic opportunities coming from therapeutic drugs - like the neutralising antibodies - that I think offer great hope to render this virus less threatening than it is today. ”
Naturally, if and when there is an effective vaccine available, the big question is - who will receive it first? We already see this throughout the world with the other vaccines, but can we even compare these to Covid-19? We know that the coronavirus is far deadlier than, for instance, the flu - but how can we even begin to decide who will receive the first batches of the potential vaccine? And further to that, do we even have the capability to physically create enough vaccines for our populations?
“Prioritisation is a very delicate issue. We've seen it with the flu vaccine - we started with the over 65s, and then there's a waterfall of priorities that come down from that. We've already published a similar set of priorities around the coronavirus vaccine, making sure those are fully understood and that there's confidence around the rollout,” said Lord Bethell.
“Secondly is the practical logistics of a rollout. If a vaccine takes one or two shots in the arm and there are tens of millions of people who want to have the vaccine, that's a huge national undertaking that has massive logistical demands. There is the issue of procuring enough doses, lining up enough pharmacists and doctors who could deliver it, and the data administrative component and communications - it is huge.
“Thirdly, we have a global agreement, and Britain has really led the way in terms of being an advocate of open-source distribution of vaccine IP, and around the production. Our work with GAVI has been really important on that. We will continue to champion at the most open-hearted and open source approach to vaccines that we can. ”
Also speaking on the current development of the vaccine was Lord Darzi, commending the speed and rapid rate at which the world has managed to progress with the creation of a viable Covid-19 vaccine.
“In the old days, vaccines would take about 15 years to produce - and this whole vaccination programme is less than one year old. We're already talking about phase three trials, including the safety and efficacy of the vaccine, let alone what the health department is planning to do, including operationalisation and getting the whole programme off the ground once we have a viable vaccine. ” said Lord Darzi.
“We have a lot to celebrate. But the absolute end of it is to create a viable vaccine and start a massive vaccination programme, hopefully by the end of the year, if not early in the New Year. ”
International collaboration and regulatory progress
Providing insight and a detailed account of the collaborations that are being created not just within the UK, but across the world, was Ben Osborn, UK Managing Director of Pfizer, and Hugo Fry, Managing Director of Sanofi.
“The scientific community is coming together in a way like never, ever before. We've truly come together as one force to fight one common enemy, and that is the virus itself,” Ben Osborn said. “Partnerships across companies, academia, governments, health care systems are now commonplace to overcome Covid 19, where race not against each other, but against time and against the virus.
“Earlier this month, we signed a joint pledge with eight pharmaceutical companies around the world, outlining a united commitment to upholding the integrity of the scientific processes as we work towards potential global regulatory approval of vaccines against Covid-19.
“We've got to work together to reinforce with consistent messaging, the robust science and ethical standards that are in place to build public confidence in a potential Covid 19 vaccine. ”
“We have seen absolutely unprecedented collaboration between major vaccines producers, pharmaceutical companies, governments, university institutions and other academic centres. It’s astonishing what’s been achieved. ” said Hugo Fry, Managing Director of Sanofi.
“Normally, when you develop a vaccine, you do it sequentially - one stage after another. In preclinical, it probably has an 80 per cent chance of success going into the clinic. Then from phase one to phase two, it's near 30 per cent, then 50 per cent into phase three, then another 50 per cent for registration. Now, that sounds quite a high probability of success, but that means it's only got a 12 per cent chance from the beginning to end.
“But the UK government, and many other governments, have been extremely rapid in understanding these issues - which has allowed development stages of the vaccine to progress at the same time. This doesn’t hinder the efficacy or safety of the vaccine, but it means that the risk is shared, so we're able to do everything in parallel, and scale up the manufacturing at the same time. ”
Ensuring vaccines for all
One of the major issues surrounding Covid-19 vaccine production is the inevitable problem of providing such a large quantity of people with it in such a short space of time. We’re looking at potentially 15 billion doses to be produced if we have a two-shot vaccine - which will not only be an enormous challenge to produce quickly - but we must also ensure that all people, no matter where they are in the world, have fair and equitable access to a vaccine when it is available.
“We're committed to ensuring that this vaccine reaches all of those around the world who need it in order to solve this global crisis. Successful delivery requires vaccines to reach every corner of the world. That’s why I'm proud that Pfizer is working with GAVI, UNICEF and the Gates Foundation to provide doses through the COVAX facility, a mechanism that we've used for the past decade at Pfizer to supply our vaccines. We've seen first hand how this model helps the most vulnerable communities around the world gain access in a sustainable and affordable way,” said Ben.
As human beings we care deeply about our personal security and safety. We like to feel secure as individuals, within our homes, our workplaces - even in our nations at large. But, as Lord Darzi explores, we take a far different approach in regards to the security of our own health.
“When it comes to our health security, we've always had this approach of being more fatalistic,. ” said Lord Darzi.
“I think that Covid has taught us our health security will become as important as our physical security in years to come - and vaccines are one of those weapons for to develop our health security.
“For reference, the first UK polio vaccine was made in the 1960s. In those in those days, there were about 26 or 27 pharmaceutical companies producing vaccines. By 2015, there were only five.
“This is because vaccines are not easy to produce. It costs very large sums of money, and you are giving the vaccine to a healthy population, you hope that the vaccine will be ‘one of’ the ones used, and the price is usually capped - because governments are buying - so it's no surprise there hasn't been much in health security. ”
“But if you see what's happened since February in this country, with the government's absolute focus, the only way out of this is a vaccine.
“There's been as huge focus on this and an amazing promise, that I believe we will see in the next few months. ”
As Lord Darzi says, the only way out of the Covid-19 pandemic is simple – a Covid-19 vaccine. However, with the enormous amount of uncertainty, logistical issues, regulation, and potential bumps in the road with regards to the vaccine’s efficacy – only time will tell if the first vaccine will be sufficient to bring us back to normality.
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