NEWS
20/07/2020 21:35 BST | Updated 02/12/2020 15:09 GMT

Pfizer's Covid Vaccine Has Been Licensed. What About All The Others?

The UK has become the first Western country to have a clinically approved vaccine. Here's where things stand with the others jabs being developed.

The Pfizer/BioNTech vaccine is being rolled out in the UK after it was approved by the Medicines and Healthcare products Regulatory Agency (MHRA).

Studies have shown the jab to be 95% effective and works in all age groups. No safety concerns arose from clinical trials and it will be made available from early December.

Some 40m doses have been secured in total, with 10m due in the country by the end of the year.

People will need two doses, meaning enough has been bought for 20m Brits.

In total, the UK has secured 355m future doses of Covid-19 vaccines being produced by Oxford University in partnership with AstraZeneca, Moderna, Valneva, Novovax, Johnson & Johnson and GlaxoSmithKlein (GSK) with Sanofi Pasteur, as well as BioNTech and Pfizer.

In November Oxford University and AstraZeneca announced interim analysis from the latest phase three trial showed their vaccine can stop 70% of people from getting Covid-19, with one dosing regimen showing it could be as high as 90%.

The UK government has already placed orders for 100m doses of the Oxford vaccine, with rollout expected in the coming weeks if the jab is approved.

In November US biotech firm Moderna also announced preliminary results showed its vaccine was 94.5% effective. The UK has secured five million doses, enough to give to 2.5m people, no earlier than the spring.

Hundreds of vaccines are currently under development across the world, according to the WHO

So how advanced are the seven vaccine programmes the UK government is pinning its hopes on?

BioNtech/Pfizer

BNT162b2 – a messenger RNA vaccine developed by German biotech firm BioNTech and the US pharmaceutical giant, Pfizer – was approved on December 1 by the MHRA.

It had been found to be more than 90% effective in preventing Covid-19 in early tests.

The vaccine, which uses ribonucleic acid (RNA), has been tested on 43,500 people in six countries and did not uncover any serious safety concerns, the companies said.

In November the firms said they were aiming to produce up to 50m doses by the end of the year and up to 1.3bn doses by the end of 2021. 

The UK government has procured 40m doses of the candidate vaccine. Provided it receives approval by regulators, 10m of those will be available to the UK by the end of the year.

The vaccine needs to be kept at an ultra-low temperature, between minus 70C and minus 80C, until a few days before use when it can be transferred to a standard medical fridge.

Health secretary Matt Hancock said the rollout of the vaccine will be “one of the biggest civilian logistical efforts that we’ve faced as a nation”.

It will need to be stored in regional hubs – including wholesalers and hospitals – before being shipped to GP surgeries and vaccination clinics.

Each person will require two doses each, so the UK’s order could provide enough vaccine for five million people by the end of the year, or 20m people in total.

The vaccine uses the so-called messenger RNA approach, which spurs the body to create specific proteins with its own cells.

BNT162b2 is designed to train the immune system to produce antibodies to recognise and block the spike protein that the virus uses to enter and infect human cells.

To be successful, it will need to make T-cells that can recognise and kill infected cells as well as generate antibodies to block other viral proteins. Nearly all effective vaccines induce an antibody and a T-cell response.

Jeenah Moon via Getty Images
Pfizer and German biotechnology firm BioNTech are aiming to produce up to 1.2 billion doses of coronavirus vaccine by the end of next year.

Moderna 

US biotechnology firm Moderna has announced its coronavirus vaccine is almost 95% effective at preventing the disease.

Interim data from the company suggest its jab is highly effective in preventing people getting ill and also works across all age groups, including the elderly.

Health secretary Matt Hancock revealed in November the UK has secured five million doses of the Moderna vaccine. 

It is understood the vaccine requires two doses, similar to the Pfizer jab, meaning five million doses would inoculate 2.5m people.

On Twitter, business secretary Alok Sharma said the government had “the option to procure more”.

NELSON ALMEIDA via Getty Images
A volunteer takes part in the phase 3 trials of the ChAdOx1 nCoV-19 vaccine, developed by the University of Oxford together with the British pharmaceutical company AstraZeneca, in Brazil.

Oxford University/AstraZeneca

The government has already ordered 100m doses of the vaccine – called AZD1222 or ChAdOx1 nCoV-19 – developed by Oxford University, in collaboration with the pharmaceutical giant AstraZeneca. 

Long described as being one of the world’s “frontrunners” in the race, the vaccine has been shown to stop 70% of people from getting Covid-19.

Interim analysis from the latest phase three trial showed an average efficacy of 70.4% from combining two doses, with one dosing regimen shown to be 90% effective, the other 62%.

The vaccine can be stored, transported and handled at 2-8 degrees Celsius for at least eight months, and has been shown to work in different age groups, including the elderly

Findings from the first phases of the study earlier this year showed “promising” results which suggested the vaccine is “safe and causes few side effects” for healthy adults aged 18-55. 

The phase two research demonstrated a strong immune response in older adults – suggesting one of the groups most vulnerable to serious illness and death from Covid-19 could build immunity.

The vaccine was developed at the University of Oxford’s Oxford Jenner Institute and is made from a genetically engineered virus that causes the common cold in chimpanzees. It is based on earlier work to produce a treatment for MERS (Middle East respiratory syndrome-related coronavirus). 

The chimpanzee virus is modified and engineered to express the coronavirus spike protein so it “looks” more like coronavirus to trigger a strong immune response in the human body.

Health secretary Matt Hancock said manufacturing of the vaccine has already begun in anticipation of positive results.

ASSOCIATED PRESS
French president Emmanuel Macron visits an industrial development laboratory at French drugmaker's vaccine unit Sanofi Pasteur plant.

GlaxoSmithKline (GSK)/Sanofi Pasteur

The UK has signed a deal for the supply of 60m doses of a potential vaccine produced by Sanofi and GlaxoSmithKline (GSK), which together have the largest vaccine manufacturing capability in the world.

The vaccine is based on the existing DNA-based technology used to produce Sanofi’s seasonal flu jabs.

Clinical trials began in September and Sanofi, which is leading the programme’s clinical development, said if trials were successful regulatory approval could be achieved by the first half of next year.

Manufacturing of the vaccine is already being scaled up to produce up to a billion doses a year.

In May it was at the centre of an international political storm after Sanofi chief executive Paul Hudson appeared to promise priority to the US market because it had “the right to the largest pre-order because it’s invested in taking the risk”.

The company later retracted that promise after French prime minister Edouard Phillipe said access for all was “non-negotiable”.  

GSK and Sanofi have said they do not expect to profit from the vaccine and are committed to making their vaccine available worldwide, including to lower-income countries.

The firms have committed to providing 200m doses to the World Health Organisation’s global immunisation Covax programme, which will focus on vaccinating the most high-risk people in every country. 

Valneva 

The UK government has signed a deal worth £422m (€470m) to produce 60m doses of the Valneva vaccine VLA2001, with an option of 40m more if it proves to be safe and effective.

Developed in France, the vaccine is currently in the pre-clinical stage and is expected to enter clinical trials by the end of the year and potentially reach regulatory approval in the second half of 2021. 

VLA2001 uses a more traditional method of vaccine development – taking the whole coronavirus, inactivating it and then injecting it. It has already previously been approved for active immunisation for the prevention of Japanese encephalitis.

Valneva’s scientists hope that, if the vaccine proves successful, it could be suitable for wider use including for at-risk groups, because the jab does not contain a live virus that could cause viral replication. It is the only company signed with the UK that is basing its development on an approach that has worked for almost a century.

“We’re taking an approach that already works, using tried and tested older technologies,” David Lawrence, CFO of Valneva, told HuffPost UK. 

Unlike the previous two, Valneva is not in the lead of the coronavirus vaccine race, but the French company has agreed to manufacture the product at its facilities in Livingston, Scotland in return for the government contributing to the cost of UK clinical studies.

Clinical trials are set to begin in December, with commercial production expected to start in January 2021.

ASSOCIATED PRESS
More than 150 vaccines are currently under development across the world, according to the WHO.   

Novavax

A potential vaccine by the US biotech company Novavax has recently begun trials in the UK, and besides the Oxford University/AstraZeneca jab, is only the second to enter large scale trials in the country. Early-stage clinical trial data showed the vaccine appeared to be safe.

The Novavax vaccine – NVX-CoV2373 – uses a more traditional approach than Pfizer or BioNTech, consisting of a recombinant protein from the coronavirus and a chemical, called an adjuvant, to intensify the immune response.

Conclusive results from the trial are not expected for several more months, probably early 2021, but Novavax’s scientists are hopeful that the vaccine’s proven approach will give it a reasonable chance of producing an effective vaccine. 

The UK government has already ordered 60m doses in case it proves successful. 

Johnson and Johnson

The UK has ordered 30m doses of a potential vaccine from the Belgian-based Janssen Pharmaceutical Company, owned by Johnson and Johnson. Ministers have also agreed in principle to co-fund a global clinical study of the vaccine. 

The Ad26.COV2-S is an adenoviral vector vaccine which is developed from a weakened cold virus. Proteins that appear on the outside of the coronavirus are injected into the body to stimulate an immune reaction.

Phase 3 trials of a one-dose regimen were launched across three continents in September, and plans to conduct a separate phase 3 clinical trial for a two-dose regimen are underway. The company has said it hopes to receive results from the one-dose regimen trials by the end of the year. 

Janssen Pharmaceuticals have also struck a £758m ($1bn) deal with the US government for 100m doses. If successful, Johnson and Johnson have said it aims to supply more than a billion doses on a not-for-profit basis. 

Why does it take so long to develop a vaccine?

One of the main obstacles to developing a vaccine is that scientists currently do not know what level of immunity people need to prevent infection.

If successful, any vaccine will need to be introduced very cautiously as normal full trials will not take place. Vaccines normally require years of testing, plus time to produce to scale.

Vaccines must follow higher safety standards than other drugs, because they are given to millions of healthy people.

There is also a huge difference between finding a vaccine and producing it. Growing a virus needs to be done in a very controlled manner, with each stage monitored carefully by a highly trained workforce.

When could I get a vaccine?

Health and care workers and the over-80s are among the first in line for the newly-approved Pfizer/BioNTech Covid-19 vaccine.

The “second phase” of the programme could also include specific occupations  at most risk, the watchdog said. Among those under 50, teachers, bus drivers, taxi drivers, the military, civil servants and emergency services could then get the jab as a priority.

The government had previously said people from Black, Asian and minority ethnic groups could be among the first to get the vaccine, though in the priority list published online BAME people are not mentioned.

Widespread vaccination for the public could be available next year at the earliest, with most experts saying it will likely become widely available by mid-2021.

Can I volunteer for trials?

The government is calling on members of the public to sign up for trials of vaccines through the NHS Covid-19 vaccine research registry website.

It said almost 72,000 people have volunteered in the past week to receive information about joining clinical studies to find a vaccine but many more are needed.

At least eight large scale vaccine trials are expected to take place across the country.