Coronavirus vaccine: a ‘magic bullet on the horizon’?

Published 23/11/2020   |   Last Updated 27/05/2021   |   Reading Time minutes

The recent good news about the development of safe and effective coronavirus vaccines has left many asking how soon they could be rolled out, and how quickly life can get back to normal.

Three vaccines – Pfizer/BioNTech, Moderna and Sputnik, have now reported good preliminary data from their large scale clinical trials, which indicate that they are more than 90% effective in preventing people getting coronavirus.

More results from other teams, including the latest results of the Oxford coronavirus vaccine are expected later this month.

Early findings from the Oxford coronavirus vaccine, which will be manufactured by AstraZeneca, suggest it could be 94% effective in protecting older people from the virus. Interim data from Oxford University has been published today

While welcoming the findings, Wales’ First Minister, Mark Drakeford has remained cautious. He has warned against over-optimism, stating this doesn’t mean “there’s a magic bullet on the horizon and coronavirus is about to disappear out of our lives”.

The vast majority of people are still vulnerable to coronavirus. It is thought that 60-70% of the global population must be immune to stop the virus spreading easily – that’s billions of people.

Where we are

We don’t yet have a coronavirus vaccine but many potential candidates are being studied. There are more than 200 coronavirus vaccine candidates in clinical trials around the world. Trials of different coronavirus vaccinations are already taking place across Wales, with more to follow. Some of these are open to the public.

Anyone living in the UK can sign up online to take part in the trials through the NHS, giving permission for researchers to contact them via the COVID-19 vaccine research registry.

Experts say we can be optimistic that a successful coronavirus vaccine will be developed, based on promising results from some of the large clinical trials. But these interim results - such as the Pfizer/BioNTech vaccine findings, will need to be peer-reviewed and more studies will follow.

The UK is at the forefront of a huge international effort to develop clinically safe and effective vaccines. The UK Vaccine Taskforce was set up in May 2020, and aims to ensure that the UK population has access to vaccines as soon as possible. It is also working with the World Health Organisation (WHO) and other partners to support equitable access for populations worldwide.

How the coronavirus vaccines are being developed

Scientists around the world are working at pace to develop and test the potential coronavirus vaccines.

The vaccines are all designed to teach the body’s immune system to safely recognise and block the virus that causes COVID-19. The WHO’s publication ‘Draft landscape of COVID-19 candidate vaccines’ explains how the different vaccines generate an immune response to coronavirus.

Like all vaccines, the coronavirus vaccines will go through a rigorous, multi-stage testing process, including large (phase 3) clinical trials that involve tens of thousands of people. These trials, which include people at high risk for coronavirus, are specifically designed to identify any common side effects or other safety concerns.

The WHO’s infographic on page 17 of its vaccine development update shows the speed at which the coronavirus vaccines are being developed.

Approval and licensing

Clinical trials normally take years, but due to the pressing need, significant global investment and scientific collaboration has helped accelerate research processes without compromising safety.

The coronavirus vaccines will need to be scrutinised and approved by the regulators before they can be used on the general population. This includes passing a series of independent reviews to ensure the vaccines meet high standards of safety and effectiveness by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) and the Commission on Human Medicines. The MHRA has insisted “the safety of the public will always come first”.

The Joint Committee on Vaccination and Immunisation (JCVI) will advise the UK Government about the use of a vaccine

When the coronavirus vaccine will be available and who will get it

Once a clinically safe and effective coronavirus vaccine is developed and approved, the next major challenge will be manufacturing the vaccine in huge quantities,. A major challenge is that the global manufacturing capacity for vaccines is vastly inadequate for the billions of doses that are needed.

There are also complex logistical processes involved in distributing the vaccines. The First Minister confirmed in plenary on 10 November that planning for the storage and distribution of a coronavirus vaccine will “be in the hands of the Welsh Government”. He explained;

That is a particularly important responsibility because this [the Pfizer vaccine] is a vaccine that can only properly be stored at very low temperatures indeed, far different to the way in which those who have been to have their flu vaccination at a GP surgery will see it stored in an ordinary fridge and absolutely safely in that way.
The Pfizer vaccine is nothing like that at all, and the logistical issues that will fall to the Welsh Government are very real, but have been in preparation for many months, and when we get to a point where there is a vaccine that is genuinely safe and known to be so and for use in the population, then we will be prepared and ready to do that here in Wales.

Health Boards and the Chief Medical Officer for Wales have been developing plans to deliver a coronavirus vaccine based on a priority system since June/ July. The First Minister has said that “the Welsh plan” is very similar to plans elsewhere in the UK, and will begin by vaccinating priority groups, such as older people and frontline health and social care staff.

This is in line with the Joint Committee on Vaccination and Immunisation’s interim guidance, which says that older adults in care homes and care home workers should get priority, followed by those aged 80 and over, and health and social care workers.

As we don’t yet know which groups in the population different vaccines will be effective for, it is difficult to plan.

What we do know is that the UK Government is procuring coronavirus vaccines on behalf of the UK nations. Wales will receive a ‘population share’ of any vaccine once it becomes properly approved and available. Wales will get a Barnett population share, so 4.78 per cent of the total stock. It will then be the Welsh Government’s responsibility as to how that is distributed to people in Wales.

There is no legal basis for a mandated coronavirus vaccination programme. Vaccines are not mandatory in Wales, or anywhere else in the UK. Back in September, Wales’ Health Minister had said “he hadn’t ruled anything out” in terms of mandatory coronavirus vaccines in Wales, but has since clarified his position. He confirmed at the Welsh Government press conference on 16 November that it wasn’t part of their current thinking, and that mandatory vaccination was “the most extreme and most unlikely outcome possible”.

Managing expectations - what still needs to be done

We don’t yet know exactly when a clinically safe and effective coronavirus vaccine will be ready for distribution, but the WHO estimate that it could be in early to mid-2021.

The Health Minister assured Members of the Senedd last week that “if we are in a position to have a vaccine delivered to us, then we can deliver it and distribute it across Wales this December”.

On 17 November, the Health Minister published a written statement on the deployment of a coronavirus vaccine in Wales, in which he states: “once regulatory approval is received our health and social care staff in Wales stand ready to begin a vaccination programme for the people of Wales”.

The impact of the coronavirus vaccines on the pandemic will depend on their effectiveness, how quickly they are approved, manufactured, and distributed, and how many people get vaccinated. Like most vaccines, coronavirus vaccines are unlikely to be 100% effective.

For now, we can be “cautiously optimistic” that coronavirus vaccines will be successfully developed, but we can’t be certain when a vaccine will be available. That is why the First Minister remains cautious, with government policy focused on using existing tools to fight the pandemic, such as testing, contact tracing, social distancing, and the use of face masks. The Coronavirus Vaccine Taskforce Chair has warned;

The first generation of vaccines is likely to be imperfect, and we should be prepared that they might not prevent infection but rather reduce symptoms, and, even then, might not work for everyone or for long.

Together with more effective treatment, coronavirus vaccines are a key ‘exit strategy’. But for now, in the absence of a vaccine for the general population, restrictions will continue in order to supress the virus and keep it under control. In plenary on 4 November, the First Minister told Members of the Senedd;

This is a long, hard slog, in which we're all going to have to play our part, not just for the next few days or the next few weeks, but well into next year.

Article by Sarah Hatherley, Senedd Research, Welsh Parliament