The Prime Minister has said the scientific cavalry is on its way with the news of a coronavirus vaccine. Numerous organisations have released data from their vaccine trials, and whilst the reports show of a decent success rate tackling the virus is being met with relative positivity, there are still many who are anti vaccine. 

Here is our guide to the Covid-19 vaccine to help you form your own opinion.

So far four organisations have released their phase III data from their trials, they are the Oxford/AstraZeneca, Pfizer/BioNTech, Moderna and Sputnik V.

How have they managed to develop a vaccine in less than a year?

The question on many people’s minds is has the COVID-19 vaccine been rushed through. The misconception is that work on the vaccine started when the coronavirus outbreak began. The plans to tackle a global outbreak began a few years ago following the 2014 Ebola outbreak. The team at Oxford say that they already had the vaccine technology to produce vaccines against a number of diseases including the Flu, Zika and Middle East Respiratory Syndrome (MERS), another type of coronavirus. When the disease emerged in China, they moved quickly. As soon as the genetic sequence was available, they began work on a trial. Which enables them to quickly release their own coronavirus vaccine named ChAdOx.

Dr Albert Bourla, Pfizer Chairman and CEO said “The study results mark an important step in this historic eight-month journey to bring forward a vaccine capable of helping to end this devastating pandemic. We continue to move at the speed of science to compile all the data collected thus far and share with regulators around the world,”

Stéphane Bancel, Chief Executive Officer of Moderna said “Since early January, we have chased this virus with the intent to protect as many people around the world as possible. All along, we have known that each day matters. 

What is in each of the vaccines?

There are now 48 potential vaccines going through clinical trials around the world, according to the World Health Organisation.

Boris Johnson delivering the news of the vaccines purchased by the government

Critical stages of vaccine development and production have been run in parallel with each other. The UK government is supporting efforts to research and produce an effective, safe and widely available vaccine as early as possible. 

The Oxford vaccine uses a harmless virus altered to look a lot more like Sars-CoV-2 – the virus that causes Covid-19.

Pfizer/BioNTech and Moderna’s vaccines use bits of genetic code to cause an immune response and are called mRNA vaccines.

These do not alter human cells. They only present the body with instructions to build immunity to Covid.

Vaccines sometimes contain other ingredients, like aluminium and gelatine, that make the vaccine stable or more effective.

However, vaccine manufacturers have not yet released the full array of ingredients their jabs use and this can be a concern for those with religious beliefs or vegan or vegetarians.

Prof Andrew Pollard, Director of the Oxford Vaccine Group

What were the trial results?

There are normally three phases in trials which is why we’ve seen released data after phase III as that involve the highest number of participants.

During the trials, there are normally two controlled groups, a vaccinated test group and a placebo group where they aren’t actually given the vaccine but given a dummy vaccine. The researchers and participants are not told which group is which until after the results have been analysed.

Pfizer reported that during their trials that there were 10 severe cases of COVID-19 observed in the trial, with nine of the cases occurring in the placebo group and one in the vaccinated group.

Oxford reported that there were 30 cases of Covid in people who had two doses of the vaccine and 101 cases in people who received a dummy injection. 

Moderna reported that in 95 cases, 90 cases of COVID-19 were observed in the placebo group and only 5 cases observed in the vaccinated group.

How do they differ?

Pfizer was first to release their phase III data.

 It said that their vaccine stopped more than 90 per cent of people developing Covid symptoms

The vaccine is given in two doses, three weeks apart. However, the vaccine must be stored at a temperature of around -70C which is not helpful for vaccinations at home.

Moderna were next and as already mentioned they use the same approach as Pfizer. But their findings show their vaccine is 94.5 per cent effective in protecting people. It is given in two doses, four weeks apart. It is easier to store than Pfizer’s, because it stays stable at -20C for up to six months.

Oxford say their vaccine is 70 per cent effective in stopping people developing Covid symptoms. 

The data shows a strong immune response in older people who are most at risk from the virus. It is given in two doses, however their analysis showed that by giving a smaller first dose followed by a larger second dose the effectiveness could rise to 90 per cent. This may be one of the easiest vaccines to distribute, because it can be stored in a standard fridge. 

One question surrounding all of the coronavirus vaccines is whether they prevent asymptomatic infections.  Asymptomatic infections are when people can spread the virus without knowing it.  The Oxford data found some evidence of reduced asymptomatic infections in those who received the half-dose followed by a full dose later.

Are the vaccines safe?

In a worldwide race to come up with the first vaccine, it’s fair to ask whether all the normal safety procedures have been followed, or whether some corners have been cut leading to potential side effects.

The Russian government approved the Sputnik vaccine for use in the general population back in August, before it had undergone proper safety testing. The move led to outrage from scientists around the world. Shortly afterwards, nine leading drug companies put out a joint statement saying they would only submit a vaccine for approval “after demonstrating safety and efficacy through a Phase 3 clinical study”.

In the UK, any potential vaccine must be looked at by the Medicines and Healthcare Products Regulatory Agency. This means that, once the data is submitted, scientists and clinicians will carefully and scientifically review the safety, quality and effectiveness data, how it protects people from COVID-19 and the level of protection it provides. They will do this as quickly as possible without cutting corners while also seeking advice from another independent body – the Commission on Human Medicines, before advising the government on their findings, as creating a safe vaccine is of the highest importance. So far the only noted side effects of the vaccine are pain at the injection site, muscle aches and headaches.

The Pfizer-BioNTech vaccine team has handed all its trial data to the MHRA to be assessed.

The Oxford-AstraZeneca team is likely to do the same soon, and other vaccine developers will follow.

At this point, no-one knows which vaccine will be approved first.

In the event the UK has a choice; the Joint Committee on Vaccination and Immunisation would decide which vaccine should be used for different groups of people.

The vaccine developed by Oxford scientists

Which vaccine will I get?

This will depend on approval by the Medicines and Healthcare Products Regulatory Agency and which category you fall into.

The government want to have those who are most susceptible to coronavirus immunised sooner rather than later. 

The Joint Committee on Vaccination and Immunisation has decided that care home workers and health and social care staff are also a priority, because they could transmit the virus to vulnerable patients. After these groups, the plan is to offer the vaccine to everyone else based on their age, from the oldest to the youngest by next spring.

Saying that, the Government has announced agreements with seven separate vaccine developers and has ordered over 355 million doses of the vaccine, in a hope that more than one will be passed for use. 

Will the vaccines be compulsory?

In the UK, vaccination is the choice of the individual or parent whether they or their child is vaccinated.

While it’s highly recommended, the government doesn’t have the power to order any medical treatments, including vaccinations.

At a press conference on 23 November, Prime Minister Boris Johnson and the Chief Medical Officer Professor Chris Whitty denied a vaccine would be mandatory.

Prof Chris Whitty, Chief Medical Officer 

Speaking of the vaccine in May the Health Secretary Matt Hancock hoped the scale of the pandemic would encourage people to accept the vaccine.

“The question of whether it’s mandatory is not one that we’ve addressed yet. We are still some time off a vaccine being available. But I would hope, given the scale of this crisis, and given the overwhelming need for us to get through this and to get the country back on its feet, and the very positive impact that a vaccine would have, that everybody would have the vaccine.”

Enforcing mandatory vaccination would be an infringement of civil liberties and human rights.

While it is clear current legislation explicitly says, mandatory vaccinations are not possible, the Coronavirus Act 2020 does outline the Government has “reasonable”, “proportionate” and “necessary” powers – each of which is likely to change over time and is subject to interpretation.

Exercising these powers must be proportionate to the scale of the crisis, but subjective means this legislation may change at different times depending on the surrounding circumstances.

Professor Melinda Mills FBA, Director of the Leverhulme Centre for Demographic Science at the University of Oxford said: “Vaccines and vaccination are two very different things. To achieve the estimated 80% of uptake of the vaccine required for community protection, we need a serious, well-funded and community-based public engagement strategy.

“There needs to be a frank conversation with the public about just how long it will take and that things will not immediately go back to normal when vaccines arrive. We must learn from lessons of history and move away from the one-way provision of information and instead generate an open dialogue that addresses misinformation and does not dismiss people’s real vaccine concerns and hesitancy. And critically, when the time comes, we need to make vaccination itself convenient.”

In order to encourage vaccinations parents could be compelled to go to the doctor’s surgery, read the information leaflet and discuss with the doctor if needed. Even if they ultimately chose not to vaccinate, at least this would be through an informed choice, rather than down to a mixture of apathy and ambivalence.

 Several countries, including France, Italy and Australia have banned unvaccinated children from state schools or limiting benefits for the parents of unvaccinated children in the past. More recently the CEO of the airline Qantas said that those who were unvaccinated would be prevented from travelling on the airline.  In August, Australia’s Prime Minister Scott Morrison said it was likely that any successful vaccine would become “as mandatory as you could possibly make it”.

The latest UK data indicates the take up of childhood vaccinations in 2018 to 2019 declined for the fifth year in a row.

Recent research published by YouGov after the announcement of the Pfizer suggests that 67 percent of Brits are likely to take the Pfizer vaccine, with just one in five respondents claiming they were unlikely to take it.

Around 12 percent said they were unsure, and the research found that almost half of those who said they were unlikely to take it wanted to see if the vaccine was safe first.

Twenty percent of people said they did not trust the specific vaccine.

Another survey of more than 1,200 people published earlier this month by the London School of Hygiene & Tropical Medicine (LSHTM) found that almost 90 per cent of parents and guardians said they would definitely or probably have themselves and their children vaccinated against coronavirus.

One finding in the LSHTM study is that people who described themselves as Black, Asian, Chinese, Mixed or Other were almost three times more likely to say they would reject a COVID-19 vaccine than people who gave their ethnicity as white.

Conservative Tom Tugendhat spoke to the Huffington Post podcast, he said he could ‘certainly see the day’ when people weren’t allowed into the office until they could prove they’d had the vaccine.  Venues may also demand to see vaccination certificates on the door before people are allowed inside.

However, the government cannot currently separate different parts of the community, based on whether they’ve had the vaccine or not.

Whatever side of the fence you sit, whether you are pro or anti-vaccine, the government and society need to start thinking now about the moral, ethical and practical implications of compulsory vaccination.

The only question that remains is whether or not you feel satisfied with the vaccine and the study results. Would you feel confident taking one of the vaccines to protect you and your loved ones from COVID-19?

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