Tuesday 10 November 2020

Day 239 of self-isolation - a vaccine!

A vaccine!

The results from the BioNTech/Pfizer vaccine are in. 43,500 people were tested in six countries, there were no safety concerns, and the vaccine was 90% effective. Half of the volunteers got the vaccine, half got a placebo. 94 people got Covid during the trial.

90% is much better than I dared hope. 90% is up there with the best vaccines, such as that for measles.

You need two doses, three weeks apart, and you get 90% protection, seven days after the second dose. 

It works in a similar way to a computer antivirus; a snippet of the RNA (the spike protein that attaches to the cell) is used to recognise the virus. The cell then produces the protein fragment, and that trains the immune system to detect and destroy the virus.

One difficultly will be in logistics - the vaccine needs to be stored at -70 or -80 degrees Centigrade.  Liquid nitrogen boils at -196 C.

Pfizer will have 50 million doses by the end of 2020. The UK has 10 million doses expected by the end of 2020, with 30 million on order. Priority will be given to care homes, then healthcare and frontline staff, then the people most at risk on account of age.

This will probably get emergency approval by the end of November, and then vaccinations can start.

I would hope that the Oxford University/AstroZenica vaccine will be close behind. It will be nice to have a choice of two vaccines. The Oxford vaccine will be easier on the logistics, because it doesn't need to be stored at such a low temperature.

The next task will be to roll out the vaccination program, probably starting in December, if all goes well.Here's the priority list - it isn't definitive, and could change to respond to various underlying conditions that increase risk.

  • older adults’ resident in a care home and care home workers
  • all those 80 years of age and over and health and social care workers
  • all those 75 years of age and over
  • all those 70 years of age and over
  • all those 65 years of age and over
  • high-risk adults under 65 years of age
  • moderate-risk adults under 65 years of age
  • all those 60 years of age and over
  • all those 55 years of age and over
  • all those 50 years of age and over
  • rest of the population (priority to be determined)


    1. New vaccine - questions and decisions:

      Logistics - the vaccine needs to be stored at -70 or -80 degrees - how did they find that out. Maybe by storing at more conventional temperatures and seeing it go off?

      How would they have trialled that two doses, three weeks apart are necessary? By varying the time periods amongst the 43,500 and counting how many caught the virus at 2 weeks, 4 weeks etc?

      When vaccine number 2 becomes available, if it is 95% effective but 2 weeks later, would it be worth waiting? Could I have both?

      If another vaccine is ready earlier, but only 80%, would you go for it? Could I have both?

      Will paranoid older people sign themselves into care homes for a while in order to jump the queue?

      Lastly, for now, will people who can afford it be able to pay to be vaccinated privately to avoid the priorities queue all together? Is this moral?

    2. It would have been very easy to try storing the vaccine at various temperatures until they found how much cold it needed.

      They might not have trialled different time periods. They might have decided that, on the basis of how the vaccine works, that a week would be a good period. And then the trial confirms that this is enough.

      Could you have both? Maybe. I would hope that the NHS would be able to answer.

      Is it moral to pay for health care, or to pay more for better health care? I know that, for example, if you aren't eligible for the free flu jab, you can pay for it at a pharmacy, I think it's something like £10 to £15. I don't see why that would be unethical.

    3. A ministerial source at the Department of Health said that while private healthcare providers are permitted to source vaccines from manufacturers such as BioNTech/Pfizer and Astrazeneca/Oxford, any orders intended for sale to their customers will be put “at the back of the queue” and not delivered until the UK Government has received all of its orders.

      The insistence by the Government may reassure those concerned that wealthy people could jump the queue.