Recent news from pharmaceutical powerhouse Pfizer that a promising vaccine for the COVID-19 virus may soon be made available worldwide, including in New Zealand, has provided optimism in a time of significant anxiety, as infection rates soar internationally.
We spoke with vaccinologist Helen Petousis-Harris about what the latest vaccine news means for the pandemic and a possible endpoint.
Helen Petousis-Harris is an Associate Professor in the Department of General Practice and Primary Health Care at the University of Auckland. She is also the Director of the Vaccine Datalink and Research Group.
This interview has been edited for clarity and length
Who/where was this vaccine produced?
Helen Petousis-Harris: The vaccine is truly a multinational collaboration. It was developed by a German biotech company called BioNtech which is founded by scientists with Turkish/German/Austrian roots. To bring their candidate vaccines through the clinical development process – the human testing part – they partnered with pharmaceutical giant Pfizer, who have a lot of experience in bringing vaccines through the development process. Pfizer is an American multinational company headed by a Greek. The vaccines are being produced at BioNTech’s facilities in Germany and Pfizer’s facilities in Belgium.
How effective could it be?
HP: While the data still needs to be unpacked and formally reported, it is fair to say the vaccine works. The information released so far is based on the number of symptomatic COVID cases in those vaccinated compared to the unvaccinated study participants. To arrive at an estimate of 90% there must have been nine or less cases in the vaccinated participants out of the 94 cases recorded so far in the study. As time goes on this could be revised up or down as further cases in the study participants occur. There are many things we do not know yet, such as how long this protection will last and if the vaccine will stop transmission of the virus, as well as disease.
How long before New Zealand gets it?
HP: The first shipment is due to arrive in NZ in the first quarter of next year, there is no exact date yet.
Who will have first access?
HP: Decisions on those to be offered the vaccine first will be based on a bunch of factors. There will not be enough vaccine for everyone straight away. The decisions will consider who is most at risk of catching the disease, such as front line workers coming into contact with infected people, those most likely to get very sick such as the elderly and people with certain health conditions. If the vaccine is able to prevent people spreading the infection then consideration may be given to those most likely to spread the disease in order to protect others. These decisions are currently being deliberated and as you can imagine it is not an easy task!
How will it be distributed?
HP: This vaccine is unusual in that it requires storage at a chilly minus seventy degrees. Keeping something this cold required special freezers. While these are common in laboratories NZ has purchased more to store these vaccines. The super cold freezers can be distributed across the country and the vaccine can be shipped from a central storage location out to the regions. When the vaccinator providers need the vaccine it can be shipped and stored in a normal vaccine fridge for up to five days. This is a logistical challenge but not insurmountable. There is a lot of work going on right now preparing for this.
Is it safe?
HP: So far the safety data are very encouraging. There have been more than 44,000 people studied so far, some getting the vaccine and others a placebo. No serious events of concern have halted the study. The safety will continue to be monitored closely as the vaccine is rolled out and the data will accumulate quickly. What people do need to be prepared for is what we call reactogenicity. These are the common reactions associated with the body making an immune response. Most common is a sore arm and redness where the injection was given. But some people will feel a little fluey for a day or so with symptoms such as a fever, headache, ache and feeling tired. These are common vaccine reactions but they may be a bit more common with this vaccine. People like me see this as a positive sign that the body is doing what it needs to do to develop detective immunity. It is also encouraging to note that the other vaccines using this RNA technology are progressing well with no serious safety concerns reported.
How many people need to be vaccinated to stop covid being a big issue?
HP: I don’t think we really know exactly, the estimates vary. What I can say is that it will be far less than 90%. However, community immunity (aka herd immunity) will only be possible if the vaccine is able to prevent transmission. This is an answer we will need to wait a bit longer for.
What about people who refuse?
HP: The vaccine will not be mandatory. However, I think there may be an ethical argument for an employment requirement for some groups working with vulnerable people should the vaccine be proven effective at preventing transmission. For example, people working in aged care facilities.
Will this end the pandemic?
HP: Depends on what you mean by ending the pandemic. We may not be able to completely get rid of the virus but we will be able to get back to our lives without this virus dominating us. That said, if the vaccines turn out to be as good as our best vaccines (such as measles) and we reach all of the world’s people equitably then perhaps we can. This is a very lofty goal though. We got rid of smallpox, we have almost gotten rid of polio. However vaccine programmes are often derailed by things like civil war, politics, vaccine hesitancy and scares. The scientific achievements of the past few months show just how much can be achieved when we work together and remove the financial barriers to discovery and development.