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Sixty-two per cent. Ninety-four point five per cent. Ninety-seven per cent. In recent months, the released data on the high efficacy rates and the approval of several vaccines has sparked hope that the repressive reign of SARS-CoV-2 is about to end sooner than expected.
But is this really the case or do we still have a long way to go until we beat the pandemic?
In December, the downpour of reassuring news prompted the United Kingdom to set an example by starting its biggest vaccination campaign to date using Pfizer-BioNTech’s and AstraZeneca’s vaccines.
The rest of the world quickly followed suit, with the U.S. and several wealthier countries in the EU having already pre-ordered close to four billion vaccine doses and standing at the ready to acquire an additional five billion at current prices, if need be. At the same time, we still know very little about these vaccines, and what we do know has been published exclusively by manufacturers.
This has, understandably, made some people question the true effectiveness of vaccines and the real motives of the governments that are tasked with supplying them. In this article, we will take a close look at how the vaccines work, how companies in the field have achieved such high efficacy rates, and what other challenges lie ahead on the path to immunising the global population against the virus.
How do COVID-19 vaccines work?
Before we dive into the analysis of effectiveness rates and data from clinical trials, let’s first take a look at how the virus has managed to spread worldwide.
Coronaviruses are anything but new, but what makes the current variety particularly troublesome is that it takes full control over the human cells in our bodies. To do so, COVID-19 first enters a person’s body through either the nose, mouth or eyes.
Once the virus has gained access into the cells, it releases the so-called ribonucleic acid or RNA – a nucleic acid present in all living organisms. In a healthy body, the role of RNA is to act as a messenger between a person’s DNA and the body’s cells in order to create proteins. COVID-19’s RNA essentially acts as its own DNA. Once released, the virus’s RNA is confused by the cells for the body’s own RNA.
The cells are then forcefully reprogrammed to manufacture more of the virus’ genetic material, essentially acting as well-oiled COVID-19 photocopiers and spreading the virus further into the host’s body and – by means of saliva and other bodily fluids – to other human beings.
Enter the vaccines
The approved vaccines of Moderna and Pfizer-BioNTech both carry a specific genetic code of the spike protein, delivered to our immune systems through the so-called messenger RNA, or mRNA.
Once this genetic recipe is injected and reaches our cells, it instructs them to fabricate fragments of the spikes sitting atop the coronavirus, thus helping the immune system create antibodies and fight off the intruder. The fact that both Moderna and Pfizer have independently achieved similar efficiency rates using this technology is quite promising and will most likely considerably speed up future vaccine development efforts.
“Using this technology, vaccine candidates can be produced substantially faster in the future to combat virtually any infectious disease by producing vaccines against both existing pathogens and future, currently unknown pathogens.”
Zoltán Kis, research associate at the Imperial College London
That being said, not all companies on the market are opting for mRNA technology. AstraZeneca’s vaccine, for instance, is derived from a modified chimpanzee virus, and there are many other manufacturers currently working on vaccine formulas of their own.
How effective are current vaccine treatments?
“A swift emergency approval implies taking the risks of a lower (or) shorter efficacy than may be reached with mRNA vaccines.”
Claire-Anne Siegrist, vaccinology and immunology head at Geneva’s University Hospitals
How high are the chances of someone resisting the effects of COVID-19 will most likely boil down to whether they have received an mRNA-based vaccine or not, as well as whether that person has received two or just a single dose of the vaccine.
Pfizer and Moderna’s mRNA offerings, for example, are reported to exceed efficacy rates of 95%, while the UK-approved AstraZeneca vaccine is capable of delivering anywhere between 60% and 90% protection after two shots.
There are other non-mRNA vaccines in the works that promise to achieve similar results to those of Pfizer and Moderna, such as China’s non-mRNA based CoronaVac vaccine which was tested in Indonesia and has supposedly shown an efficacy rate of 97% in preliminary trials.
According to the U.S. Food and Drug Administration, the data provided by both Pfizer and Moderna suggest that the vaccines start to offer partial protection against the virus about two weeks after the person has received their first dose.
New COVID-19 strains
Since SARS-CoV-2 is an RNA virus, it tends to mutate once almost every month due to three reasons:
– As a response to certain medical treatments
– In order to slip by our immune system’s antibodies undetected
– Due to genetic errors stemming from the virus’ rapid multiplication efforts
It is only logical then for people to wonder if these mutations, such as the strain discovered recently in the UK, will render current vaccine treatments obsolete. The good news is that mutations do not seem to affect the efficacy of vaccines as all treatments have been designed in such a way as to allow our immune systems to fight back even against new COVID-19 strains.
The latter is possible since, besides creating antibodies, all three approved vaccines also boost the development of specific T-cells – white blood cells that are “trained” to seek out and destroy this particular coronavirus. The hopes are that the “memory” of these cells will be superior to that of antibodies and that they will provide us with better protection against COVID-19 even if we no longer have antibodies or when we’re facing new virus strains.
Are there any reported side effects?
As of January 2021, both Moderna’s and Pfizer-BioNTech’s vaccines have been officially approved for use both in the U.S. and the EU, with AstraZeneca’s vaccine being additionally approved in the U.K. as part of its emergency vaccination efforts.
According to European Medicines Agency (EMA), the most common side effects reported from Moderna’s vaccine, administered in two doses 28 days apart, are usually mild to moderate and quickly recede a few days following the vaccination. These include:
– Pain and swelling at the injection site
– General tiredness, chills, or fever-like symptoms
– Headache, muscle and joint pains
Similar symptoms are present in Pfizer and AstraZeneca’s offerings as well. Usually, these symptoms are all very typical of annual flu shots and mean that the vaccine is actually hard at work at stimulating an immune response within our bodies. In addition, none of the participants of both Moderna and Pfizer’s trials became severely ill after the injections.
The release of perfect vaccines is just the beginning
While the world is one step closer to being liberated from the pandemic, highly efficient vaccines alone won’t be enough to solve other pressing concerns, such the lack of sufficient clinical data, the general distrust in governments and big pharma corporations, the issue of negotiating fair market prices, and the Herculean task of manufacturing and distributing billions of doses across the globe.
Health concerns
Even with several vaccines readily available, there are still many unknowns that need to be resolved until any mass vaccination efforts can be rolled out. For instance, we still don’t know how efficient are vaccines at protecting those that are most at risk of becoming infected, such as elderly people or people suffering from chronic illnesses.
Public distrust
While nearly all vaccine manufacturers have stated that they will do their best to maintain data transparency, the second lockdown that governments have enforced on their countries in an effort to curb the pandemic has made some lose faith in the system, especially if we consider that almost everything we know about each vaccine comes from press releases or media interviews.
Many medical experts are also sceptical of the lightning-fast approval process that SARS-CoV-2 vaccines seem to go through and have raised concerns that none of them has still been tested independently to confirm (or disprove) the impressive efficiency rates, as well as manufacturers’ claims that none of the vaccines has caused any serious side effects in patients.
The price factor
The cost per vaccine dose has become a heated debate ever since various manufacturers shifted into high gear in an effort to stop the virus. So far, AstraZeneca has pledged to keep costs low so that all countries can afford it, regardless of economic background. Unfortunately, as of yet, no official statements have been released from Moderna and Pfizer, who plan to sell their vaccines between $10 to $50 per dose and for $20 per dose, respectively.
The logistics problem
Nearly destroyed by the COVID-19 pandemic, airlines of the world are now asked to bear the brunt of the vaccine transportation efforts. The unprecedented task of delivering billions of doses across the world is made harder by the increasingly shrinking fleets.
Another complication lies in the storage conditions of each vaccine. While AstraZeneca’s product can be kept in a standard refrigerator for up to six months, Pfizer’s vaccine needs to be kept in ultracool refrigerators at -70 Celsius. It can then be stored in a normal refrigerator for only up to 5 days. Moderna’s vaccine, on the other hand, needs to be transported at -20 Celsius and can be kept in a refrigerator for about a month before it expires.
Conclusion
So far, the rapid manufacturing and approval of vaccines against COVID-19 is a winning strategy for two reasons. On the one hand, this shows that regulators are open to accepting vaccines that are well below the 95% efficiency rate, achieved by Pfizer-BioNTech and Moderna. The swift approval process will also quickly lead to a tighter competition in the sector, which would reduce the manufacturing and market price per vaccine dose. And while the emergence of new vaccines on the market is slowly, but surely leading us towards achieving herd immunity, the main issue that the world will face now, apart from health concerns, government distrust, and logistical nightmares, is the lack of qualified personnel at local vaccination centres in some regions, as well as the real danger of market oversaturation.
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