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COVID-19 UPDATE / Immunity and Vaccine Development

Dr Doug Quarry from International SOS shares the very latest insights on the development of COVID immunity and vaccine development

DR DOUG QUARRY


In this edition:

1.     Pfizer expects to halve COVID-19 vaccine production time

2.     UK says COVID-19 booster and annual vaccinations very probable

3.     US gave 2.1 million COVID-19 vaccinations on 7 February

4.     Reduced viral loads 12 days following Pfizer-BioNTech COVID-19 vaccine

5.     UK to test mixed COVID-19 vaccine dosing strategy

6.     Summarizing the categories of efficacy of the major vaccines

7.     Astra vaccine is less effective against South African variant

8.     Amended Oxford-AstraZeneca COVID-19 vaccine coming

9.     Russian vaccine team in talks with China on combination trial

10.  More US COVID-19 vaccination statistics

11.  Looking ahead to a possible vaccine glut in the US in April

12.  Two different COVID-19 pandemics

13.  Excellent interview of Dr Fauci on JAMA Network

14.  France, Poland, Sweden rule out AstraZeneca vaccination for the elderly


1.     Pfizer expects to halve COVID-19 vaccine production time


USA Today reports that Pfizer expects to cut the time taken to produce a batch of COVID-19 vaccine from 110 days to an average of 60 as it makes the process more efficient.

“Pfizer’s COVID-19 vaccine is made at three Pfizer plants: starting in Chesterfield, Missouri, moving to Andover, Massachusetts, and finishing in Kalamazoo, Michigan.

2.     UK says COVID-19 booster and annual vaccinations very probable


Reuters reports: “A COVID-19 booster in the autumn and then annual vaccinations are very probable, Britain’s Vaccine Deployment Minister said on Sunday…

“Britain has already given over 12 million first doses of COVID-19 vaccines and is on track to meet a target to vaccinate everyone in the most vulnerable groups by mid-February.

“Among coronavirus variants currently most concerning for scientists and public health experts are the so-called British, South African and Brazilian variants, which appear to spread more swiftly than others.”

3.     US gave 2.1 million COVID-19 vaccinations on 7 February


Data Source / Bloomberg

4.     Reduced viral loads 12 days following Pfizer-BioNTech COVID-19 vaccine


A non-peer reviewed paper from Maccabi Healthcare Services, Tel-Aviv, Israel, has found: ”…that the viral load is reduced four-fold for infections occurring 12-28 days after the first dose of the Pfizer BNT162b2 mRNA vaccine.

“These reduced viral loads hint to lower infectiousness, further contributing to vaccine impact on virus spread.”

5.     UK to test mixed COVID-19 vaccine dosing strategy


CIDRAP reports that: “…the UK government said it has provided $9.6 million to back a study that will look at the effects of mixing vaccine types for the two doses, such as AstraZeneca-Oxford first, followed by Pfizer-BioNTech.

“’The goal is to have data to support a more flexible immunization program,’ said Jonathan Van-Tam, MBBS, the United Kingdom’s Deputy Chief Medical Officer.

“He also said the study could shed light on whether combining vaccine types could enhance or prolong immune response. ‘Unless this is evaluated in a clinical trial, we just won’t know.’

“The trial of a mixed-vaccine strategy comes as governments look for ways to protect as many people as possible as quickly as possible with vaccines, amid short supply and the threat of more contagious and lethal coronavirus variants.”

CIDRAP / Center for Infectious Disease Research and Policy, Minneapolis, Minnesota

6.     Summarising the categories of efficacy of the major vaccines


As we have previously said, each vaccine has a different efficacy for different endpoints. The most important efficacy endpoints are:

1.     Prevents hospitalisation / death

2.     Prevents severe disease

3.     Prevents mild disease

Monica Ghandi has constructed an elegant summary table with Columns 6 and 7 being the most important.

Column 6 shows all vaccines fully protect from hospitalisation/death

Column 7 shows four vaccines fully protect against severe disease, one provides 85% protection and data is not shown for one.

Note: this table does not contain the reduced efficacy against milder disease of the AstraZeneca vaccine against the B.1.351 variant.  See below…

Source / Monica Ghandi MD, MPH, an infectious diseases and HIV doctor at University California, San Francisco

7.     Astra vaccine is less effective against South African variant


AstraZeneca’s COVID-19 vaccine does not appear to offer protection against mild and moderate disease caused by the 501Y.V2 variant (B.1.351) which accounts for around 90% of cases in South Africa, the Financial Times reported, citing a study which has not been published. 

None of the participants in the study died or was hospitalized, however the study had a relatively small sample size of around 2,000 individuals.

Consequently, the rollout of the Oxford AstraZeneca COVID-19 vaccine in South Africa has been suspended. The other licensed vaccines, including Pfizer and Johnson & Johnson, will be given while the Oxford-AstraZeneca vaccine is reviewed, reports the British Medical Journal

8.     Amended Oxford-AstraZeneca COVID-19 vaccine coming


Oxford researchers expect to have a modified vaccine to cope with the B.1.351 variant later in the year.

“’We have a version with the South African spike sequence in the works,’ Sarah Gilbert, lead researcher for the Oxford team, told the BBC on 7 February.”

9.     Russian vaccine team in talks with China on combination trial


Bloomberg reports that following the recent publication of the high efficacy (91.6%) of Sputnik V vaccine, Russian developers are in talks with China’s CanSino (vaccine efficacy not released yet) to test if a combined regimen of their shots can better protect against new virus strain

Currently a trial is being designed which would replace Sputnik’s second shot with CanSino’s.

Researchers are looking at whether combining different developers’ vaccines in a two-shot regimen produces results that are as good as, or better than, using the same product as a booster. That flexibility could help to relieve pressure on individual vaccine makers if they run into manufacturing difficulties.

10.  More US COVID-19 vaccination statistics


As of 7 February:

·       31.7 million had received 1st dose (9.6%)

·       8.8 million had received both doses (2.7%)

·       Total of >40.5 million vaccine doses have now been given

·       There are still 32% doses distributed but yet to be given

Data from Tweet by Eric Topol  

Eric Topol

·       A professor of Molecular Medicine at The Scripps Research Institute, and a senior consultant at the Division of Cardiovascular Diseases at Scripps Clinic in La Jolla, California. He is editor-in-chief of Medscape and theheart.org.

11.  Looking ahead to a possible vaccine glut in the US in April


Scott Gottlieb and Mark McClellan discussed, in the Wall Street Journal, the possibility of a vaccine glut in the US, especially if demand is weaker than expected

“…by the end of March, the monthly vaccine supply may reach 100 million doses. To keep pace, the vaccination rate would have to double and then some. This will require an all-of-the-above approach to administering vaccines, tapping substantial capacity in pharmacies, primary-care practices and other trusted health-care providers.

“…with improved delivery, at some point, perhaps in April, supply will start exceeding demand. The challenge won’t be how to ration a scarce resource, but how to reach patients reluctant to get vaccinated.

“Based on the latest Kaiser Family Foundation tracking surveys, more than half of Americans say they don’t want to get vaccinated. Some may simply want to wait; others may be set against getting it.

Scott Gottlieb / The 23rd Commissioner of the Food and Drug Administration from 2017 until April 2019

Mark McClellan / Director of the Robert J Margolis Center for Health Policy and the Margolis Professor of Business, Medicine and Health Policy at Duke University.

12.   Two different COVID-19 pandemics


Dr Eric Ding has provided a table using Danish data to show how the number of new cases of the “old variants” is dropping while the more contagious B.1.1.7 strain looks as though it will dominate.

Source / Eric Ding, Senior Fellow at the Federation of American Scientists, Washington DC

13.  Excellent interview of Dr Fauci on JAMA Network


Dr Howard Bauchner discusses topics including:

·       Mutation and the need for global vaccination

·       Will COVID-19 vaccination become annual?

·       Sputnik V and the Chinese vaccines, including would/could they be licensed in the US?

·       Apparent lack of progress on treatments

Recommended viewing

Dr Howard Bauchner / Vice chairman of Pediatrics at the Boston University School of Medicine, is the Editor-in-Chief of the Journal of the American Medical Association (JAMA) since July 1, 2011

Dr Anthony Fauci / Physician-scientist and immunologist serving as the director of the National Institute of Allergy and Infectious Diseases since 1984 and chief medical advisor to President Joe Biden since 2021.

14.  France, Poland, Sweden rule out AstraZeneca vaccination for the elderly


Euronews reports that France, Poland and Sweden issued recommendations on 2 February not to use the COVID-19 vaccine developed by AstraZeneca for the elderly. They join Germany and Italy, which issued such recommendations last week.

Authorities in France and Sweden say the vaccine should be prioritised for people under the age of 65, both citing insufficient clinical trial data for older people.

Sweden’s public health agency said it expects such data “to come later in the spring from an ongoing and large US clinical trial in Phase 3.”

“It will include sufficient number of older participants to be able to draw more certain conclusions regarding the protective effect,” it added.


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