On 9 November Pfizer/BioNTech issued a press release to say that their Covid-19 vaccine is 90% effective. What that means is that only 10% of the people who caught the virus, after having been randomly injected with two doses of either the vaccine or a placebo, were in the vaccine-injected group. Given that this trial has so far involved 38,955 volunteers, with a further 4,543 still to be injected, on the surface this news looks good. The media have made the most of it. It’s encouraging to hear that one vaccine trial is making progress, because vaccines are an essential part of any public health programme.
However, we need to go beyond the media, who largely fall into two groups – those who support the interests of big business and intentionally spin this sort of big business news in its favour, and those that don’t look below the surface.
On 11 November the World Health Organisation (WHO) ran a live-streamed Q&A session with two vaccine experts who did look below the surface. The video link is here. Here’s a summary of the experts’ answers to the questions put to them.
Safety
In the rush to win the race it’s paramount that we persistently ask for evidence of vaccine safety. Pfizer (for short) has so far published no evidence at all about safety (catastrophic mistakes have been made before with new vaccines – most notoriously with the first polio vaccine in 1955 which caused 40,000 cases of polio, leaving 200 children with varying degrees of paralysis and killing 10 – though this catastrophe wasn’t mentioned in the WHO Q&A).
Even if trials show a high level of immunity, we’ll initially have little idea about how long that immunity will last. We’ll only know this once the vaccine has been in use for months and years. An additional issue is that some of the vaccines in development, whatever immunity they give to the recipient in terms of the severity of the illness, don’t necessarily prevent the recipient from catching the virus and excreting infected respiratory droplets. More positive is that so far the virus is mutating more slowly than the influenza virus, so that vaccines are unlikely to need changing.
This is the biggest challenge. Even when a safe and effective vaccine has been developed it will take much longer and require relatively new technology to mass-produce it. There’s also the ‘cold chain’ to develop (the Pfizer vaccine is one of those with ‘ultra-cold’ requirements). Then each country has to decide which people to prioritise for its limited supply. Enough people need to be trained and employed to do the injecting – this is an altogether bigger task than childhood immunisation programmes. All these challenges are amplified if the vaccine needs to be given in two doses – which is the case for most of the vaccines currently in development. One of the WHO experts described this process as being similar to the ascent of Everest. We are currently in sight of base camp, but ahead of us are all the other camps and the final climb to the summit.
The WHO’s estimate is just less than $20 billion. They made the point that if that sounds a lot, it can be compared with the fact that during this pandemic the world economy is losing more than $35 billion every ten days from travel and trade alone.
When?
To continue the Everest analogy, arrival at base camp would be the end of November or early December. The summit is ‘many months’ beyond that. The WHO objective would be 20% of people vaccinated in every country by the end of 2021.
It becomes clear that in issuing this premature and confusing press release Pfizer has betrayed not only their competitors but, more importantly, global solidarity. Global solidarity has to be front and centre in the quest for Covid-19 vaccines, for three reasons. The first reason is global equity – it would not only be scandalously unfair but also bad epidemiology if vaccine access was restricted to rich countries. The second reason is that a great deal of time can be saved if research results are shared internationally. The third reason is that we are going to need several different vaccines, developed in different countries, to achieve the overall quantity of vaccine we need in order to immunise at least one billion people.
So why has Pfizer broken ranks? Nothing new here. As we know, cut-throat competition is embedded in capitalism. There are over 200 vaccines being developed, over 40 of these are at the clinical trial stage, and 10 of them are at the last stage of clinical trials (Stage 3). These consist of randomised, double-blind trials with large numbers of volunteers. It’s a break-neck race between companies to get into first position to take orders. Pfizer has tried the equivalent of nipping across the middle of an oval running-track , hoping they won’t be noticed. It seems that Governments have been conned into signing up, and the Tory Government is hysterically triumphalist. This sort of thing was predictable.
The truth about vaccines gives us an opportunity to strengthen the Zero Covid message – if we grasp that opportunity unequivocally. There’s no chance that safe and effective Covid-19 vaccines will be available in time to prevent many thousands of deaths across the UK over the next months. What this news is about, along with the Government’s triumphalist reaction to it, is once again profit for the few at the expense of the many. In contrast the Zero Covid campaign is offering the many a realistic way out of the epidemic. In weeks, or a small number of months, we could eliminate the virus and put in place a reformed Find-Test-Trace-Isolate-Support system to prevent the virus from returning. The WHO vaccine experts said much the same.
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