Part one of the Covid-19 Series
There are currently three vaccines in use in Ireland right now
(BioNTech-Pfizer, Moderna and AstraZeneca) and a fourth on its way. (Janssen/J&J)
There are at least eight other notable vaccines in existence either under review by the EMA or approved for use in other countries. (Sputnik V, Novavax, Sanofi/JSK, Curevac, Valneva, CanSino, Sinovac, Sinopharm)
According to The WHO, there are over 200 vaccines in the pipeline. It's fair to assume at least one of those might be a cure but for now, the best we can expect is the prevention of serious medical symptoms, death and living with the virus much as we live with the flu.
Back in December, Ireland signed up with at least five advance purchase agreements totalling 14 Million doses with an “optimal period” of rollout expected by Spring. As of March 26th, only 786,569 jabs have been administered. We will get to the topic of distribution issues in part two of the series.
While countries are scrabbling to vaccinate… One should ask, is it worth the rush? After all, we’ve established the vaccine is not a cure… Sure, it prevents serious infection and death, but apart from that, we know little about these 5-month-old vaccines.
Of the roughly 5 vaccines front and centre stage across the world each have their own metrics and differences but essentially do the same thing, reduce the risk of hospitalisation and death. So which one to choose?
Well first of all in Ireland at least we don’t get to choose. You get whatever you're given and that depends on where you get it and the supply available on your designated day. But let's imagine a perfect world where the selection of vaccines was like choosing a flavour of ice cream.
Janssen/J&J stands out to me because it's the only vaccine requiring one jab. All others require a second follow-up jab between 3-12 weeks.
But the benchmarks don't end here. There are much more to a vaccine than this; such as, what is this concoction been injected into my arm?
The WHO report three approaches to vaccine manufacturing.
Whole Microbe approach,
The Whole Microbe approach does what it says on the tin, they inject the virus into you. Okay so it's not a; living, breathing, ready to take over your body and kill you, virus, but a modified laboratory altered instance. This can be done in one of three ways;
Inactivated vaccine - The virus itself or similar bacterium is grown then killed in the lab using chemicals, heat or radiation. Dead gone it can’t grow. The dead virus enters the body and the immune systems pull it apart learns what it is and builds resistance. The Polio Vaccine was made using this technique.
Live-attenuated vaccine - This is a weakened version of the virus, still alive technically but too weak to harm unless you have a compromised immune system and in this case, you should stay away. For those with healthy immune systems, their immunity can understand and build resistance against the virus without allowing the virus to take hold. The Mumps and Rubella vaccine is an example of this technique
Viral vector vaccine uses a safe living virus to carry specific proteins of the actual virus you want immunity from… Kinda like how drug dealers get dope through the airport using innocent backpackers…
Sorry, bad example :) Anyways when the good virus enters the body it delivers the proteins of the bad virus which causes an immune response to start producing antibodies. The Ebola vaccine is an example of this technique
The second vaccine approach is known as the Subunit approach which uses specific parts of the virus known as the subunit and injects that Into your system which the immune system will then recognise when the big bad living virus shows up in a real invention scenario. The Meningitis vaccine utilises this method.
Finally, the third approach is the Genetic approach (nucleic acid vaccine) and here instead of using dead, weakened or spare parts of the virus, it uses the virus’s DNA. The DNA is extracted and sections of the genetic code are delivered to our immune system. Our immunity now has the blueprints of the virus and that’s enough information for our immunity to start building anti-bodies to recognise and destroy the virus when it arrives into the body…. Sounds like the plot of a well-known action movie.
Anyhow this strategy has not been done before… It new and pre COVID the technique was only in the clinical trial stage for certain cancer treatments which means cutting edge stuff if vaccine delivery techniques are your thing.
Anyhow Pfizer and Moderna are vaccines using this technique, while J&J, AstraZeneca and Sputnik V use the Vector method.
Okay, so as consumers of this product, should we care about what technique is used… Eh probably not. The benchmark that has been used particularly by governments in the US is efficacy rates.
You will see from the diagram that the efficacy rate is quite varied,
So should we be avoiding some?
For COVID-19 vaccines the efficacy rate isn’t a relevant metric because it aims to establish whether a vaccine can prevent infection. Although this is the endgame for any vaccine, in the current climate reduced hospitalisation and death is a good first step and all these vaccines can achieve this 100%.
If any vaccine comes onto the market with a 100% efficacy rate then game changer and we can then look towards eradicating the virus entirely. Until then we’ll take anything we can get to bring even some sort of normality.
It's important to point out that these vaccines may reduce the risk of and even prevent contraction entirely of the virus. With Pfizer for example a person has a 95% chance of protection from the virus.
You can check out Vox’s video on this very topic here.
Other considerations include availability and roll out… the cost per vaccine and side effects. US Today have a useful article discussing the latter two points here.
Finally with all that out of the way… once I get the vaccine am I don’t forever?
We just don’t know. Both the HSE in Ireland and CDC in the US have directly stated they don’t know… Some articles floating around suggested top-up vaccines annually are required and others suggesting vaccine effectiveness lasts as low as 4 months.
It's very much a 'wait and see' game at this point.
So let's round-up again
We have several vaccines, some available others pending approval, they all do the same thing in that they prevent serious illness and death but are not a cure. We can't guarantee they will prevent contraction (or spread) and we don't know how long they remain effective in the body. We do know that by having a lot of people vaccinated we have one step closer to managing the virus sufficiently well to get us back to some sort of normally however this is pending on roll-out
That is the topic for part 2
Until then stay sane!
Part 2 - The Roll out problem
Part 3 - The Vaccine Passport
Part 4 - How other countries managed COVID?
Part 5+ The Update - Where are we now?