The Malta Independent 27 November 2021, Saturday

Vaccine – a magical butterfly of hope

George M Mangion Tuesday, 1 December 2020, 11:46 Last update: about 13 months ago

Governments are understandably desperate for anything that would forestall the deaths, closures and quarantines resulting from Covid-19. Hope for a speedy resolution for devolving, testing and manufacturing a vaccine for millions of users was de rigueur when experts recently announced that a vaccine could be over 90% safe - subject to final approval.

The waiting time is usually attributed to extensive clinical trials needed to ensure it is safe in human test subjects before distributing to the wider public. Hot on the heels of such topic came the news on 23 November that researchers at AstraZeneca, a big pharmaceutical company, and Oxford University reported that their vaccine is highly effective.  

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It comes with a big bonus: it is expected to be cheaper and easier to distribute globally than other vaccines. The results are estimated from a peek at interim data gathered from trials in Britain and Brazil, involving more than 23,000 volunteers. Like other vaccines with results so far, AstraZeneca's is administered in two jabs. Of those volunteers given the vaccine, none was hospitalised or even suffered a severe case.

The researchers also say that their vaccine may reduce the transmission of the virus; something not yet known about the two other vaccines for which results have been reported.  More good news is coming from Pfizer and BioNTech and Moderna.

These tested their vaccines which reached a 95% effectiveness. The President of the European Commission, Ursula von der Leyen, suggested that regulatory approval for an eventual vaccine might be expedited. The question follows that as the world is gripped in this pandemic and close to three million persons are infected, many ask: what is slowing down laboratories in their quest to launch a successful vaccine beyond the Phase 3 test?

There are many issues, for example quoting The Economist it reports that the Pfizer vaccine needs ultra-cold storage of -70°C and can be kept in a fridge for only a few days; the Moderna vaccine can be kept in a fridge for a month. This means that the AstraZeneca vaccine must be clinically stored in a surgery or pharmacy around the world. Moderna says its offering is 94.5% effective. Pfizer says the efficacy of its vaccine reaches a respectable 95%. Moderna's figure is an estimate based on a peek at data being gathered in a continuing trial involving 30,000 volunteers. Pfizer's comes from the final analysis of a trial involving 43,000 people, in which 170 cases of Covid-19 volunteers.

The next question is: which sector of the population is the first to be inoculated? All agree that front liners and medical staff should be given preference. It seems that a few countries that look likely to be oversupplied with vaccines, such as America and Britain, will try to vaccinate as many people as possible before the winter of 2021, and the EU is trying to place advance orders to ensure a fair distribution to all its members. The logistical dilemma is that vaccines have to be manufactured in huge quantities and distributed effectively. Again, people must be willing to have the jabs. This may prove surprisingly problematic. According to a poll taken by Ipsos-MORI, less than three-quarters of adults say they are keen to get vaccinated for Covid-19. In Malta, the number of infected persons has reached up to three digit figures on a daily basis and the health authorities warn us not to relax and keep maintaining social distancing and wear face masks. Elderly people over 65 years and other vulnerable persons are strongly advised to stay at home.  It is now almost five months since a partial lockdown has paralysed the economy as all hotels, bars, gyms, shops, schools, university, international airport, seaports and the central court were closed.  

Employers speculate that the apex of jobless totals will be reached by March next year, as the wage supplement to furlough workers will be tapered. Some advise a second lockdown linked to a curfew will save us from more deaths this winter.  

A bleak situation is facing the commercial community (not listed on Annex A, B & C) which are not covered by an €800 monthly grant by Malta Enterprise. In fact all professionals like accountants, auditors, private clinics, consultants, lawyers, notaries, engineers, fund advisers and estate agents are branded by Castille as persons with deep pockets and consequently need no subsidy. One hopes a reality check hits the political team in Castille and more aid is given this winter by reducing fuel and electricity rates.  

Still, it is not all doom and gloom, as Malta succeeded to be among the first countries to be approved for its EU quota of vaccines. Let us talk a bit about what it takes to produce an effective vaccine that can be produced in sufficient numbers to be distributed globally. Normally a vaccine is developed in the lab before being tested on animals. If it proves safe and generates a promising immune response in this pre-clinical phase, it enters human or clinical trials. These are divided into three phases, each of which takes longer and involves more people than the previous one. Phase 1 establishes the vaccine's safety in a small group of healthy individuals, with the goal of ruling out debilitating side effects. Phases 2 and 3 test efficacy and in an outbreak like the present one they are conducted in places where the disease is prevalent.

The irony is that various medical experts caution us to be patient since there is no scope in rushing to produce a defective cure. Another important developer is Inovio. It has been well ahead of other pharmaceutical companies with regard to getting a working coronavirus vaccine into worldwide circulation.  

In conclusion, as many vulnerable persons are cooped up at home, trying to maintain their sanity and work offline, one appreciates that our health authorities are doing a sterling job advising how to best control the spread of infections. On the other hand, as the festive season approaches, there is a natural drive for islanders to go out and enjoy a long-awaited moment of liberation particularly during Black Friday shopping and spectacular light shows in Valletta.

This needs to be meticulously controlled since the massing of shoppers in close proximity will fan the spread of the virus. If we restrain ourselves by keeping a social distance, wear masks and stay away from groups, all this will regale us with a butterfly of deliverance to grace our balconies and windows beyond the Yuletide season.

 

The writer is a partner in PKF Malta, an audit and business advisory firm


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