The Daily Telegraph provided a very intuitive synopsis on the Oxford, Moderna and  Pfizer vaccines. Presently, the largest mass vaccination programme in British history  is underway, with the target of millions of vaccinations being administered by spring to  effectively release the country from lockdown.  

As of January 16, over 3.5 million people had received their first dose of the  COVID-19 vaccination – a figure that surpasses the number of confirmed cases of  Coronavirus in the United Kingdom. The United Kingdom has set a target of  vaccinating 32 million people, that is 60% of the United Kingdom adult population by  spring and all adults will have been offered a vaccination by the autumn.  

This will require 2 million vaccinations a week and Boris Johnson has announced that  he is accelerating the delivery of the vaccine with vaccination centres being open  24 hours a day and pharmacies being able to also help.  

The Pfizer vaccine; what do we know about it? 
The rollout of the vaccination has been hindered by safety guidance, which says that  every patient receiving the Pfizer vaccination must be monitored for 15 minutes after  receiving the jab.  

It is 95% effective in preventing COVID-19 after two doses and has passed safety  checks.  

It is only 50% effective after one dose so elderly people have been warned to wait until  they are fully protected with a second dose before hugging relatives.  

How does it work? 

  1. Scientists synthetically create the genetic code which is used by Coronavirus to  produce infectious proteins.  
  2. This genetic message is given a fatty protective coating and injected into the  body. 
  3. The code tricks cells into pumping out solitary Coronavirus proteins which cannot  assemble into a harmful virus. 
  4. The immune system detects these viral proteins and produces a defensive  response.  
  5. If a patient encounters Coronavirus, T cells and antibodies are already primed to  fight it off. 

The vaccination relies on a live piece of genetic code, which needs to be kept at  -70o centigrade. The United Kingdom has ordered 40 million doses of the vaccine.  

Professor Whitty has said that extending the gap between the first and second jab  would mean that the number of people vaccinated could be doubled over three  months. He said “if over that period there is more than 50% protection, then you have  actually won. More people have been protected than would have been otherwise”.  “Our quite strong view is that protection is likely to be a lot more than 50%. Regulators  have agreed that the two doses should be administered between 4 and 12 weeks  apart.” 

What is the latest on the Oxford’s AstraZeneca vaccine?  
The Oxford vaccine is easier to store and handle than the Pfizer vaccine and costs  less. It is likely to make it easier to reach people living in more rural areas. Results  from the phase 3 of the Oxford AstraZeneca’s trial showed that the vaccine is 70.4%  effective on average.  

How does it work? 

  1. The Coronavirus genetic code is inserted into the chimpanzee cold virus to make  the Coronavirus spike protein when it enters cells.  
  2. This engineered virus is injected into the patient (modifications render it harmless  as it cannot replicate inside the body).  
  3. The body produces antibodies to match the Coronavirus spike protein.  4. T cells are also produced that search out and neutralise infected cells.  5. The immune system is able to fight future virus cells.  

The vaccine is much more readily movable as it needs to be stored at a more  convenient temperature than the Pfizer vaccination.  

Moderna vaccine; what is the latest? 
It was confirmed on January 8 that the vaccine will be delivered to the United Kingdon  in the spring. The government has requested another 10 million doses of vaccine,  taking its order to 17 million, enough for 8.5 million to receive the two doses required.  

The vaccine works by injecting a small part of the COVID-19 virus’ genetic code,  which triggers an immune response and creates antibodies in the human body to fight  the virus.  Moderna has reported that the vaccine’s efficacy was 94.1% whilst its efficacy against  severe COVID-19 was nearly 95%. The Moderna vaccine can be kept for six months  at -20o, which is the temperature of a conventional freezer and can be stored for up to  30 days in a standard fridge, but the dose is three times larger than Pfizer’s.

As with the Pfizer vaccine, anyone with a previous history of allergic reaction to the  ingredients of the vaccine should not receive it but those with any other allergies such  as food allergies can have the vaccination.  

What is in development? 
There is a new single shot vaccination being developed by Johnson and Johnson.  The United Kingdom has ordered 30 million doses of the vaccine but has an option to  reserve a further 22 million. 

What about China’s Sinovac and Sinopharm vaccines? 
There is concern about the quality of the vaccines and on November 9, Sinovac was  forced to suspend trials of its vaccine in Brazil after a participant died. Clinical trials in  Brazil reported that Sinovac was 50.4% effective, which is only slightly above the  World Health Organization’s minimum standard of 50%.  

On December 31, China approved the Sinopharm vaccine, its first approved vaccine for general public use. Sinopharm says its vaccine is 79% effective against the novel  Coronavirus.  

What is happening with the Sanofi/GSK vaccine? 
Drug companies Sanofi and GSK have announced a delay in their COVID-19 vaccine  programme after trials showed an insufficient response in the over 50s.  

The London General Practice commends the National Health Service on its rollout of  the vaccination programme and is proud to consider that the United Kingdom is the  only country to have achieved such a high number of vaccinated population in Europe.  

It looks forward to the day that all populations throughout the world are able to be  vaccinated. 

Dr Paul Ettlinger 

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