/ 15 November 2020

Lowdown on Pfizer’s Covid vaccine

Phase 3 Vaccine Trial Developed Against Covid 19 Started To Be Injected To Volunteers In Ankara
A healthcare worker holds an injection syringe of the phase 3 vaccine trial, developed against the novel coronavirus pandemic by the US Pfizer and German BioNTech company, at the Ankara University Ibni Sina Hospital in Ankara, Turkey on October 27, 2020. (Photo by Dogukan Keskinkilic/Anadolu Agency via Getty Images)

The recent announcement of a promising Covid-19 vaccine is good news. But don’t get too excited, cautions Simon Allison: other more affluent countries have already bought up most of the doses, and we do not own the expensive technology necessary to store and transport it

How excited should we be about the new vaccine? Is the pandemic over?

According to pharmaceutical companies Pfizer and BioNTech, their new vaccine has exceeded all expectations so far in clinical trials. They said it is more than 90% effective at preventing Covid-19 symptoms. 

But there are important caveats: the trials are still in an early stage, and the results have not been peer-reviewed.

About 44 000 people have enrolled in the clinical trials for this vaccine, which are taking place in several countries, including South Africa.

Even in the best-case scenario, the vaccine will take years to roll out around the world — and that’s assuming that everyone can afford it. So no, the pandemic is not over yet, even if there is room for cautious optimism. 

Vigilance is still required, and the World Health Organisation’s (WHO’s) advice remains unchanged: wear a mask, keep a social distance and wash your hands.

How does the vaccine work?

The Pfizer/BioNTech vaccine exploits new technology that has never before been used in vaccines — another reason to treat it with caution. It uses mRNA (messenger ribonucleic acid) to tell the body to produce viral proteins which stimulate an immune response in the body. 

Although effective, there are considerable logistical challenges associated with this approach. The mRNA is not especially stable and must be stored and transported at a temperature of -80°C. The vaccine is administered with two injections, spaced three weeks apart, so another difficulty will be to make sure that people return on time for the second injection.

When can we expect to receive the new vaccine?

Not any time soon.

Pfizer says it can only make about 1.3-billion doses of the vaccine next year. Between them, the United States, the United Kingdom, the European Union, Canada and Japan have already bought about 1.1-billion doses. That leaves just 200-million doses to be shared between nearly seven billion people.

Even assuming that the vaccine is available, it is going to be difficult — and expensive — for developing world countries to build and maintain the extreme cold supply chain necessary to keep the vaccines at -80°C. No countries on the African continent have this capacity.

The WHO has argued that the vaccines should be given first to people who need them most, to “slow and change the trajectory of the pandemic”. This would be health workers, older people and people with underlying conditions.

Why can’t we make the vaccine ourselves?

Egypt, Senegal and South Africa have the most developed pharmaceutical sectors on the African continent. But Pfizer has already said that it does not intend to manufacture the drug in South Africa and will use its existing manufacturing facilities instead.

South Africa and India have led global diplomatic efforts to waive patents and other intellectual property protection for any potential Covid-19 vaccines. 

Civil society groups, including Doctors Without Borders, have strongly supported these efforts, arguing that this is not the time to be “profiteering” on drugs. 

If countries that have capacity can make and sell the vaccines for themselves, this will increase availability and drive down prices.

Pfizer has so far refused to commit to waiving its intellectual property. On the day of the announcement of its new vaccine, as the company’s shares soared to its highest-ever price, Pfizer chief executive Albert Bourla sold $5.6-million in stock.

Are there any other promising vaccines on the way?

There are dozens of other vaccines in development around the world, including 10 in late-stage development. 

The positive results in the Pfizer/BioNTech trials are encouraging for all of these, because they indicate that the Covid-19 virus is susceptible to the kind of interventions used in most vaccines. 

Other vaccines may not require extreme cold storage or double-dosing, which are significant barriers to widespread distribution.