Rolling out the vaccines

The UK became the first country to approve the Pfizer/BioNTech vaccine on 2nd December last year, swiftly followed by the US, the EU, and other countries across the world. The Oxford-AstraZeneca vaccine was also approved on 30th December (in the UK), providing a less expensive and easier-to-handle option. Although the approval of the latter was surrounded by questions concerning trial data and design, the overall news of both vaccines was greeted with delight, as people began to see an end to the pandemic that blighted 2020.

To many, it meant that 2021 would be a happy new year with a return to pre-COVID ‘normality’ restored. Experts continued to warn that it would be several months before the effects of a mass immunization program were felt, but there was a general impression from the public media that things would be ‘better by the spring’, or even ‘over by Easter’. Clearly, we all wanted a little good news. However, while suggestions of imminent normality might have made great headlines, I think they showed a lack of understanding of how long this process is going to be.

Taking the UK as an example (because this is where I live, so I have paid most attention to the UK situation), priority is being given to frontline health workers and people aged over 80 years. The following priority groups will then receive the vaccine: over 75s; over 70s; clinically extremely vulnerable people; over 65s; other people with underlying health conditions; over 60s; over 55s and over 50s. According to the BBC (ONS population mid-2019 estimates, BBC research), these priority groups in the UK total more than 25 million people – close to 40% of the country’s population. They all need two doses (within 12 weeks of the first). The remaining 60% of the population can then get in line.

By 27th December, a total of 944,539 people had received their first vaccine dose – about 1.5% of the UK population. Clearly, the rate of vaccination needed to be a significantly increased, so the UK government announced they would work to a target of 2 million per week, with the latest announced aim of giving 13 million of the most vulnerable people a first dose by mid-February…. It remains to be seen if this target will be achieved but, currently, plans appear to be hampered by a global shortage of glass vials to package up the vaccines, long waits for safety checks and the process of ensuring there are enough vaccinators.

The key learning here, I think, has been that while the UK government was great at securing sufficient quantities of the Pfizer/BioNTech and Oxford-AstraZeneca vaccines to ensure everyone in the country can get their two doses, the tactics of how those doses are going to be delivered is still not quite resolved. I have every confidence that our leaders will find a solution but, with the benefit of hindsight, addressing tactics as well as strategy would seem to be an area that other countries might like to bear in mind when planning their own COVID-19 vaccination programs.

(A second learning is that if you’re in the business of making glass vials for biological pharma, you’re in for a boom year!)

It is not yet known whether compliance with the double-dose requirement is going to be a problem. Currently, it is thought that the first dose provides 70 to 90% protection from the virus (depending on the vaccine chosen, and probably on a variety of inter-individual factors that have not yet been figured out). The second dose is required to achieve full protection of 95 to 100%. I would confidently predict that the very elderly and extremely vulnerable groups will comply fully with the double-dosing requirement, but I suspect many younger people (when their turn eventually comes) will need to be persuaded to return for the second jab.

Even that, of course, assumes that they turn up to get the first one.

Last year, when considering the possibilities of A Post-pandemic Future, we discussed the fact that COVID-19 appeared to be providing an opportunity to extend acceptability for technologies that were until recently viewed with a certain level of mistrust by the public. As concern about the virus (and the perception of ‘risk’) was high, technologies such as vaccines, CRISPR and nanoparticles in pharma were seeing an upsurge in their acceptance. To the best of my knowledge (i.e. from what I have read in the public media), people in the highest priority group who have so far been offered the vaccine have all eagerly received it. However, anecdotally, among groups of people who are less vulnerable, and for whom the benefit-risk advantage is less immediately apparent, the usual concerns over vaccine safety are being voiced.

By early January 2021, the number of allergic reactions worldwide to the COVID-19 vaccine was reported to be about one in 100,000 people. This compares unfavourably with the usual rate of one per one million, but health authorities across the world are still urging everyone to take the vaccine, as the benefits for individuals as well as countries (for herd immunity) outweigh the risk. At the time of writing, there is no way of predicting how these concerns will affect uptake of the vaccine, but I think this will be an interesting factor to watch.

Meanwhile, there are suggestions that the effects of the vaccine are already being felt. Although the UK has seen a surge in COVID-19 cases and deaths in the first weeks of 2021, it has been reported that proportional cases among people aged over 80 have significantly reduced – this has been attributed to protection provided already by the first doses of the vaccines given to this highest priority age group in December last year. Soon, elderly people living in nursing homes, who have had no face-to-face contact with their families for the past ten months, will be able to hug their grandchildren. Our children will be able to return to school again, and maybe by late summer I will be able to have the ‘big’ birthday party that I’ve been anticipating/dreading for the past 3 years…. although perhaps a couple of months late!

Author biography

Sarah Harding, PhD

Editorial Director of Chemicals Knowledge

Sarah Harding worked as a medical writer and consultant in the pharmaceutical industry for 15 years, for the last 10 years of which she owned and ran her own medical communications agency that provided a range of services to blue-chip Pharma companies. She subsequently began a new career in publishing as Editor of Speciality Chemicals Magazine, and then Editorial Director at Chemicals Knowledge. She now focusses on providing independent writing and consultancy services to the pharmaceutical and speciality chemicals industry.