The UK has authorized the Pfizer vaccine and gave their first vaccination today; in the US, the FDA is meeting to decide on the Pfizer vaccine this Thursday (12/10).
In the US, each state decides which groups of people will get the vaccine first, but CDC guidance is for at-risk groups and medical professionals first, followed by essential workers.
Between Pfizer+Moderna, about 40 million doses (20M vaccinations) are expected to be available in the US by the end of 2020.
It’s been an exciting few weeks in Covid vaccine news, and we’re finally getting close to deployment. The UK approved the Pfizer vaccine last week, and did their first public vaccinations today. In the US, the FDA is meeting to discuss granting Emergency Use Authorization for the Pfizer vaccine this coming Thursday (12/10). The meeting for Moderna authorization comes a week later, on 12/17. The reason for the delay is because the US FDA re-slices and analyzes the raw data from clinical trials themselves, whereas the UK body tends to use the statistics and derived results from the companies themselves.
That’s not to say that the two companies have been sitting on their hands. They’ve been producing vaccines, and getting them ready. Pfizer has said that it will send vaccines out by the day after FDA authorization.
Municipalities have been pre-ordering the vaccines. When the FDA gives approval, Moderna/Pfizer will start shipping large batches of vaccines to various states. Each state will get a number of doses that correlates to its adult population size.
In terms of prospects: each state will decide what groups get the vaccine in what order. But federal guidance has been:
Healthcare workers and nursing homes first.
Essential workers and at-risk populations next
Young adults and children (trying to stop the superspreaders)
Everyone else.
If you’re a “normal, healthy American”, you’ll probably get access in Spring. Some of the cost will probably be subsidized, but it’s not clear yet. The current set of vaccines cost from $3-$37, and we’ll find out more as more vaccine trials complete and come to market. In terms of production, Pfizer+Moderna expect to have 40 million doses available for the US by the end of the year. Both companies have estimates for the coming year, but there’s still some uncertainty there - for example, Pfizer halved its production estimates for this year, because of shortages in its supply chain.
There are also many more vaccines in the pipeline. In particular, 13 Covid vaccines are still in phase 3 clinical trials right now. And if we expand that to all clinical trials, there are 58 vaccines being tested on humans right now. Six months from now, we’ll likely have a much broader array of vaccines.
In international news - we don’t hear about it much about it here, but Russia and China have both approved locally developed vaccines, and have started vaccinating their citizens. Russia’s vaccine (Sputnik V) was granted approval in August (before phase 3 trials started), but started their local immunization efforts last week. In China, over a million people have already received vaccinations from Sinopharm. Though there isn’t public data from testing in China, the Sinopharm vaccines have been going through a large-scale trial in Brazil, and numbers from there are incoming. For others without large local biotech companies, they’ll just be ordering vaccines from the big players. There’s a large international group (COVAX, made of 189 countries so far) that’s working together to secure access for the rest of the world.
If you’ve got something you’d like to learn about, we can always be reached at (davidren.mailbox@gmail.com)!
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There’s a lot to read about this! Here are some resources we consulted during this. I especially like this first Bloomberg link:
https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/
https://finance.yahoo.com/news/week-ahead-biotech-fda-decide-134131148.html
https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html
https://www.nytimes.com/2020/12/03/nyregion/coronavirus-vaccines-ny.html
https://www.nytimes.com/2020/12/01/health/covid-vaccine-distribution-first.html
In class on Monday, we spoke with Professor Marc Lipsitch (https://www.hsph.harvard.edu/marc-lipsitch/) at Harvard Chan who indicated that the US did not participate in COVAX. Given our political behavior at the time (including removing ourselves from the WHO), it wasn't unexpected.
Another thing to keep in mind is that data for vaccine is only related to mortality/morbidity for the person receiving the vaccine. There is no data (that I know of) that directly measures whether someone can transmit while vaccinated. We noted that, due to this, vaccine roll out should start with those who are most likely to die when it reaches the wider population. It's also too early to talk about "immunity passports" for COVID since we could just create a bunch of vaccinated asymptomatic carriers.