SARS CoV 2 Vaccine summary

1. Dr Arifa Akram
Assistant Professor
NILMRC, Dhaka.
COVID-19 vaccines: Global and in-country
updates

2. Approved vaccines
 Pfizer
 Moderna
 Oxford AstraZeneca
 Sputnik V (formerly Gam-Covid-Vac)-Russia
 Sinovac Biotech-limited use in China

3. Vaccines in Phase 3 trial
(https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html)
 Sinovac Biotech
 CureVac
 Covaxin (also known as BBV152 A, B, C)
 AG0302-COVID19
 Sputnik V (formerly Gam-Covid-Vac)
 Convidecia (also known as Ad5-nCoV)
 Ad26.COV2.S
 EpiVacCorona
 NVX-CoV2373
 ZF2001
 CoVLP
 BBIBP-CorV

4. Effectiveness
 Oxford data indicates the vaccine has 62.1 % efficacy when one full
dose is given followed by another full dose, but when people were
given a half dose followed by a full dose at least a month later, its
efficacy rose to 90 %. The combined analysis from both dosing
regimes resulted in an average efficacy of 70.4 per cent.
 The Pfizer vaccine has an efficacy of 95 per cent a week after the
second dose.
 Moderna's results indicate 94.5% effectiveness but it said the trials
are ongoing and the final number could change.

5. Storage
 During shipment and storage, the Pfizer vaccine must be kept at
around -70C (-100F) to maintain optimal efficacy and it also has to
be mixed with another liquid before it can be administered.
 Pfizer has developed its own packaging to keep doses cold with dry
ice so they can be stored for 10 days without specialised freezers,
but doses still have to be flown from Belgium then sent to
vaccination centres in trucks with thermo sensors and GPS trackers.
 The Moderna vaccine has been shown to last for up to 30 days in
household fridges, at room temperature for up to 12 hours, and
remains stable at -20C - equal to most household or medical
freezers - for up to six months.

6. How COVID-19 Vaccines Work
 COVID-19 vaccines help our bodies develop immunity to the virus
that causes COVID-19 without us having to get the illness. Different
types of vaccines work in different ways to offer protection, but with
all types of vaccines, the body is left with a supply of “memory” T-
lymphocytes as well as B-lymphocytes that will remember how to
fight that virus in the future.
 It typically takes a few weeks for the body to produce T-
lymphocytes and B-lymphocytes after vaccination. Therefore, it is
possible that a person could be infected with the virus that causes
COVID-19 just before or just after vaccination and then get sick
because the vaccine did not have enough time to provide
protection.

7.  VACCINE NAME: Comirnaty (also known
as tozinameran or BNT162b2 )
EFFICACY: 95%
DOSE: 2 doses, 3 weeks apart
TYPE: Muscle injection
STORAGE: Freezer storage only at –94°F (–70°C)
 Pfizer-BioNTech COVID-19 Vaccine-On December 11, 2020, the U.S.
Food and Drug Administration issued the first emergency use
authorization (EUA) in individuals 16 years of age and older.

8. Time trial
 BioNTech partnered with Pfizer in March to scale up the research,
launching a clinical trial in May.
 On July 27, the companies announced the launch of a Phase 2/3
trial with 30,000 volunteers
 On Dec. 2, the United Kingdom gave emergency authorization to
Pfizer and BioNTech’s vaccine, becoming the first Western country
to give such an approval to a coronavirus vaccine.
 Pfizer and BioNTech expect to manufacture over 1.3 billion doses
worldwide by the end of 2021.

9.  VACCINE NAME: mRNA-1273
EFFICACY: 94.5%
DOSE: 2 doses, 4 weeks apart
TYPE: Muscle injection
STORAGE: 30 days with refrigeration, 6 months at –4°F (–20°C)
 Vaccine-On December 18, 2020, the U.S. Food and Drug
Administration issued an emergency use authorization (EUA) for
the second vaccine for the prevention

10.  VACCINE NAME: AZD1222 (also known as Covishield in India)
EFFICACY: Up to 90%
DOSE: 2 doses, 4 weeks apart
TYPE: Muscle injection
STORAGE: Stable in refrigerator for at least 6 months

11. Time trial
 On Dec. 8, researchers with the University of Oxford and the British-Swedish
company AstraZeneca published the first scientific paper on a Phase 3 clinical
trial of a coronavirus vaccine
 Oxford researchers developed the vaccine by genetically engineering an
adenovirus that normally infects chimpanzees.
 In April they followed up with a Phase 1/2 trial. The vaccine began Phase 2/3
trials in the United Kingdom and India, and (where it’s known as Covishield). In
addition, AstraZeneca later launched Phase 3 trials in Brazil, South Africa, and
the United States.
 On Sept. 6, AstraZeneca halted global trials of the vaccine to investigate one
volunteer, who developed a form of inflammation called transverse myelitis.
 On Oct. 23, the F.D.A. authorized the restart of the U.S. trial.
 On Nov. 19, researchers published the first findings from the Phase 2/3 trials in
the United Kingdom.
 On Nov. 23, AstraZeneca and Oxford announced that the vaccine had good
efficacy, based on a study of the first 131 cases of Covid-19 in the trials in the
United Kingdom and Brazil.
 On Dec. 7, the Serum Institute of India announced it was applying to the Indian
government for emergency use authorization of the ChAdOx1 vaccine. In India,

12. How the Oxford COVID-19 vaccine works
 The ChAdOx1 vaccine is a chimpanzee adenovirus vaccine vector.
This is a harmless, weakened adenovirus that usually causes the
common cold in chimpanzees.
 ChAdOx1 was chosen as the most suitable vaccine technology for a
SARS-CoV-2 vaccine as it has been shown to generate a strong
immune response from one dose in other vaccines. It has been
genetically changed so that it is impossible for it to grow in humans.
This also makes it safer to give to children
 The Oxford vaccine contains the genetic sequence of this surface
spike protein. When the vaccine enters cells inside the body, it uses
this genetic code to produce the surface spike protein of the
coronavirus. This induces an immune response, priming the immune
system to attack the coronavirus if it later infects the body.

14. The vaccine was approved for emergency use in
the UK in December 2020.
 Phase I: The phase I trial in healthy adult volunteers began in April 2020.
More than 1,000 immunisations were given in the UK.
 Phase II: The phase II part of the study expands the age range of people
the vaccine is assessed in, to include a small number of older adults and
children. Researchers will be assessing the immune response to the
vaccine in people of different ages, to find out if there is variation in how
well the immune system responds in older people or children. The group
of children will be recruited later in the trial, once extensive safety data is
available from the adult studies. The results of the Phase I/II trial were
published in July 2020.
 Phase III: The phase III part of the study involves assessing how the
vaccine works in a large number of people over the age of 18. This group
will assess how well the vaccine works to prevent people from becoming
infected and unwell with COVID-19. It involves multiple locations,
including other countries. Initial Phase III results were published in
December 2020.

15. Advantage
 The Oxford-AstraZeneca vaccine for Covid-19 is more rugged than
the mRNA vaccines from Pfizer and Moderna. DNA is not as fragile
as RNA, and the adenovirus’s tough protein coat helps protect the
genetic material inside. As a result, the Oxford vaccine doesn’t
have to stay frozen. The vaccine is expected to last for at least six
months when refrigerated at 38–46°F (2–8°C).
 The cost of producing one dose of the Oxford vaccine is about a
quarter of what it costs to make a dose of the Pfizer drug, and even
less compared to the Moderna vaccine.

16. Bangladesh scenario
 Bangladesh hopes to get Oxford-AstraZeneca COVID-19
vaccine in January
 They said the mRNA technology-based vaccines developed by
Moderna and Pfizer need to be stored at minus 70-80 degrees
Celsius temperature, but the country has a cold chain having the
capacity of preserving life-saving drugs and children's vaccines at
temperatures as low as minus 20 degrees Celsius under the
Expanded Programme on Immunisation (EPI) framework.

17.  On December 13, an agreement was signed for collecting three
crore COVID-19 vaccine doses developed by the University of
Oxford and AstraZeneca.
 Under the agreement, Bangladesh government will get three crore
COVID-19 vaccine doses from the Serum Institute of India.
Bangladesh would get 50 lakh vaccines per month from the institute.
 On November 5, a tripartite Memorandum of Understanding (MoU)
was signed for collecting these three crore COVID-19 vaccine doses
from the University of Oxford and AstraZeneca. The MoU was
signed among the Bangladesh Government, Beximco
Pharmaceuticals Ltd (BPL) and the Serum Institute of India (SII).
 The health ministry sources said 1.5 crore people will be
administered by these three crore vaccine doses. As each person
needs to be vaccinated twice they said, adding 50 lakh people in the
country will be administered per month.