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World News

Why Covid-19 vaccines face a new obstacle course

(FINANCIAL TIMES) – The race to find an effective vaccine appears to be on the home straight. The same cannot be said of the race to roll it out everywhere.

Preparing to present a BBC radio series titled How To Vaccinate The World, I’ve been looking at the route ahead. It is less of a marathon, more of an assault course.

So, in no particular order, here is a brief guide to some of the obstacles that remain.

Efficacy (1)

Do these vaccines – of which there are more than a hundred in prospect and about a dozen in last-stage development – actually work?

The recent announcements that the Pfizer/BioNTech vaccine appears to be 95 per cent effective and the Moderna one almost the same are very encouraging and bode well for other vaccines. The good news from Pfizer may be even better than it appears – reading between the lines, some statisticians speculate that the efficacy is closer to 97 per cent.

But the fact that every nerd in the world is trying to reverse-engineer the actual numbers behind Pfizer’s press statement is cause for concern.

It’s understandable that the announcement came by a press statement rather than a peer-reviewed paper; the news was just too big to be kept secret while drafts were circulated. But more data should have been released sooner.

Production lines

A vaccine is one of the most complex products in the world to produce, and the process of scaling up from tens of thousands of doses for a trial to hundreds of millions for mass vaccination is not a trivial one.

Efficacy (2)

Will these vaccines make people less infectious or will they simply prevent severe illness? Either would be good, but preventing the spread of infection would be ideal. The Pfizer press statement leaves us guessing for now.

Since the Sars-CoV-2 virus accumulates in the upper respiratory tract before causing symptoms, there is a real risk that vaccines will not prevent people from spreading the virus even if they are largely immune to the disease.

Missing links

Earlier in the pandemic, testing capacity was limited by the availability of suitable swabs. It’s often the simple stuff that trips us up. There were fears of a shortage of glass vials, but this was predicted and is being addressed.

But now trade publication Gasworld reports an “acute” shortage of dry ice, thanks to increased demand for food preservation this year. That’s a problem, because dry ice is also useful for keeping vaccines cold.

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Logistics

In a major and under-appreciated miracle, more than 85 per cent of children are now fully vaccinated against diphtheria, tetanus and pertussis. Rates of vaccination for tuberculosis, polio, hepatitis B and measles are similarly impressive.

So the cold chain needed to maintain many vaccines, which is the temperature of a beer fridge, is well established. We even have cold chains developed to support the distribution of the polio vaccine, which needs to be kept at minus 20 deg C, a temperature achievable by a domestic freezer.

But the new Pfizer/BioNTech vaccine needs to be kept at minus 70 deg C. This ultra-cold chain will not be trivial to maintain.

Brexit

I don’t want to kill the mood but the advisers surrounding British Prime Minister Boris Johnson have been fighting like rats in a barrel. They seem woefully underprepared for – or perhaps indifferent to – the prospect of a no-deal Brexit on New Year’s Day.

The chemicals industry is seriously worried that cross-border transfers of pharmaceutical drugs and other chemicals will be badly disrupted. If there is a fight to allocate syringes, vials or other hitherto overlooked components in the supply chain, I worry that Britain has made few friends in the past four years.

And even if there is nothing to worry about except a queue at the border, the Pfizer vaccine is going to be manufactured in Belgium and Germany and, remember, needs to be stored at a temperature of minus 70 deg C. Calais can get cold in January but it doesn’t get that cold.

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Crowd control

It would be nice if each vaccine were stored in a single-dose pack. A patient could stroll up to a clinic and get vaccinated at a convenient moment. But the ultra-cold chain will rely on fancy “thermal shippers” storing a thousand doses or more; each glass vial will contain five or 10 doses.

Break the seal on a big batch of vaccines and you’re going to want a large number of people coming through the door in short order.

Getting socially distanced people in the right place at the right time for their shots, especially in rural areas, may not be easy.

Paperwork

Most of the serious vaccine candidates require two doses. Not only do we have to figure out who is getting vaccinated when, but we need to get them back again for a second dose 21 days later. If this sounds like it shouldn’t be too much trouble for a modern healthcare system to handle, then I have an obsolete version of Microsoft Excel to sell you.

Efficacy (3)

How long does immunity last? Having to vaccinate the entire planet every six months would be quite a performance. Let’s hope the vaccine works for a longer period than that, but for obvious reasons it is far too early to tell.

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The Donald

Yes, him. US President Donald Trump was prominent in spreading the false idea that vaccines cause autism, but last year changed his tune, urging people “to get the shots”. Would an embittered Mr Trump, eager to spite his successor and win attention for his future media or political career, become a prominent anti-vaxxer again? To ask the question is to answer it.

Don’t be depressed about this far from exhaustive list. It is a miracle that, less than a year after the virus was sequenced, we seem to have two effective vaccines and many more on the way.

I am excited and optimistic. But this story has a few twists in it yet.

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Politics

COVID-19 vaccine: UK orders five million doses of new Moderna jab by spring next year

Five million doses of the Moderna vaccine to battle coronavirus have been ordered, the health secretary has announced.

Matt Hancock said preliminary trials showing it to be 94.5% effective were “excellent news” and that, if it proves safe, the jabs can start to be rolled out across the UK by spring 2021.

“We can see the candle of hope,” he declared, but cautioned that people must keep following COVID-19 restrictions until a scientific breakthrough.

The vaccine, which Moderna produced in collaboration with the US government’s “Operation Warp Speed”, is particularly attractive given it can be stored relatively easily.

It has been shown to last for up to 30 days in household fridges, at room temperature for up to 12 hours, and remains stable at -20C – equal to most household or medical freezers – for up to six months.

That would make storage and transportation of it more attractive than a Pfizer/BioNTech vaccine, which was last week announced to be 90% effective at protecting people from coronavirus and needs to be stored at around -70C.

So far, the UK government has secured early access to seven candidate vaccines – totalling more than 355 million doses.

Mr Hancock said Moderna’s progress is an “encouraging step forward”, though cautioned: “This is preliminary, the safety data is limited and their production facilities are not yet at scale.”

Addressing the nation from a Downing Street news conference, he added: “Great advances of medical science are coming to the rescue…

“While there is much uncertainty, we can see the candle of hope and we must do all we can to nurture its flame.

“But we’re not there yet; until the science can make us safe we must remain vigilant and keep following the rules that we know can keep this virus under control.”

Asked by Sky News if the government should have acted earlier to secure more doses from Moderna, Mr Hancock said he had ordered different types of vaccine from other companies already “to make sure that we have a good spread”.

The Moderna results were hailed even more by Prof Jonathan Van-Tam, England’s deputy chief medical officer, also speaking from Number 10.

“Do I feel more encouraged?” he asked aloud. “It’s brilliant news, absolutely brilliant. It’s the second penalty now – that’s also gone into the back of the net, so we’re starting to feel in a better position.”

But on a more sombre note, Dr Susan Hopkins, the interim chief medical officer of Test and Trace, said when England’s second national lockdown ends on 2 December, the rules could be tougher than they were when the country went into it.

“We will have to think about strengthening them in order to get us through the winter months until the vaccine is available for everyone,” she said, adding: “We see very little effect from Tier 1.”

Have you got questions about the vaccine?

Sky News’ Mark Austin will put them to leading experts on his show at 6.30pm tonight.

Get in touch via WhatsApp – 07583 000853.

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Business

Will Pfizer&BioNTech vaccine come too late for struggling airlines

ANALYSIS:

Encouraging news on a vaccine has sent travel industry stocks soaring – international cruise lines, airlines and hotel shares blasted off.

In the United States the Global Jets exchange-traded fund (JETS) soared by 16.6 per cent overnight to the highest prices seen in five months.One of the world’s biggest airlines, United, saw its share price shoot up by as much as 27 per cent.Here Air New Zealand’s share price took off by 14 per cent in early trading today.

Plane maker Boeing’s shares also went up 14 per cent.

In pre-market trading in the US cruise line stocks surged up to the tune of between 20 to 30 per cent based on news from Pfizer and BioNTech that its trial vaccine prevented more than 90 per cent of infections in a pool of volunteers.

Hotel shares of Marriott International were up 21 per cent while reservations website owner Expedia spiked by 22 per cent.

Besides Pfizer and BioNTech several other vaccine trials are making promising rapid progress too.

Two things are certain, there’s a promising vaccine and travel industry share prices went berserk when markets opened. But from here what happens is less certain.

Share prices retreated from initial exuberance throughout the day and health experts caution the Pfizer research has so far just produced preliminary analysis from a phase-three trial and more evidence is needed about how safe and effective it is and regulatory approval is needed.

Still the companies say they will apply for emergency approval to use the vaccine by the end of November and have described the research results as great for “science and humanity”. Great news for the travel industry and it needs it badly.

The share price surge was off an extremely low base and the airline industry has a lot of ground to make up when recovery comes.

The International Air Transport Association has estimate revenue into next year down 46 per cent on the $1.2 trillion of last year.

Figures out today from OAG show the worrying and steady weekly decline in global capacity continued into a fourteenth consecutive week of capacity cuts with another 1 million seats wiped out across the world’s scheduled airlines.

Current trends will take airlines below 50 million seats a week by year end which in turn would be somewhere around 54 per cent below the 106 million reported in the last week of 2019.

The analyst says more than 10 per cent of the world’s scheduled airlines have failed to survive the pandemic and, heading into the darkest parts of the northern winter, more casualties are expected. Hundreds of thousands of staff have been laid off or furloughed with many lost to the airline industry for good.

Thousands of planes have been parked in deserts in deep storage.Even when demand improves and some of the more efficient of these aircraft are needed it could take up to two months to bring them back into service.

The airlines that do survive will be different than before. Corporates will travel less and this means the high yields from the front of the plane will give airlines less scope to keep a lid on fares in economy. While there could be a surge in deals to get twitchy travellers back in planes, long term if there are fewer seats this could lead to higher prices.

Cruise companies have been worse off.While there have been some flights, ships are tied up, some have been broken up and cruise could be the last part of the travel sector to get back anywhere near normal.

Pfizer said it could have 50 million doses of the vaccine ready for shipment this year, and 1.3 billion in 2021 and it will be airlines which will play a crucial role in distributing it in what has been described by IATA as the “mission of the century”.

The vaccine must be stored in temperatures below 80C which makes distribution around the world challenging. Air New Zealand has already done work on being part of the cold chain.

Other issues for travellers and travel companies include; what will the role of the anti-vaxxers be in diminishing the international rollout of a vaccine and how will a vaccine passport regime work?

Negative tests for sale and discredited pre-flight testing, as seen in the case of the Russian mariners who came to New Zealand, emphasise the need for a legitimate, standardised global system.

The return of the United States to a multi-lateral co-leadership role under Joe Biden would help this.

Vaccine aside, the pandemic has forced airlines and other travel operators to develop a range of new health measures ranging from issuing PPE to passengers to contactless biometric passage through airports such as Dubai.

These measures can be baked into travel and, in tandem with a vaccine, will help fight Covid-19 but also other bugs that travellers are now acutely aware of.

Flight Centre’s New Zealand boss David Coombes says there is a strong pent-up demand for overseas travel.

“We’re on the cusp of exciting times. Imagine the euphoria when we’re all getting on planes again and going and seeing family and friends or going on holiday.It’s intoxicating.”

A return the Golden Age of Travel beckons but there’s a long way to go before regulators – and travellers – are comfortable to kick travel into gear.

As Harbour Asset Management’s Shane Solly says: “We can see the boarding queue but we’re nowhere near the plane yet.”

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