Highlights
- In 1796, when Edward Jenner first gave the smallpox vaccine to an 8-year-old boy, the technique used was rather crude. But it worked.
- Today, in the face of COVID-19, scientists are working in 6 continents to develop a vaccine.
- The $20 price Pfizer announced for their COVID-19 shot could set the cap for the rest of the world.
- Indian, Chinese and Brazilian manufacturers could make per-unit price even cheaper.
- "Micro-factory" technology solution for a new breed of vaccines could potentially disrupt the entire vaccine industry.
DUBAI: Vaccines are a hard-won progress in scientific knowledge of how our own internal defense system works.
It sort of started in 1796, when English physician Edward Jenner first gave the smallpox shot to an 8-year-old boy. The technique used was rather crude. But it worked. Thus evolved the science of immunology.
Today, given the near-eradication of polio and measles, the value of vaccines has never been felt more acutely.
Mass immunisation, via the so-called “pentavalent” (5-in-1) shots, have protected children from major infectious diseases. New vaccines also help protect against Ebola and cervical cancer – among others.
With the global COVID-19 contagion, there’s an urgent effort to deploy safe and effective shots rapidly, equitably, and at a massive scale.
How and when can this happen?
Various forecasts give a general timeline: Between end-2020 (as early as September-October) till mid-2021, a successful vaccine could become widely available.
Most of the vaccine development projects on six continents are progressing on a fast-track mode.
What's the definite time a good vaccine would be approved?
The Chinese government has already approved the COVID-19 vaccine for military use.
As for Oxford’s vaccine, the aim is to get millions of doses vaccine out — before the end of 2020 — even while waiting for final phase of the trial (Phase-III) results and final government approval.
AstraZeneca, which works with Oxford, said they aim to supply their candidate vaccine by September 2020. The Pfizer CEO said their their mRNA vaccines could be approved by October 2020.
How much would it take to vaccinate the world?
The world has 7.8 billion people. According to one estimate, at least $20 billion would be needed to make a COVID-19 vaccine available to everyone.
Numerous countries and private charities have pledged to make COVID-19 vaccine widely available.
On July 1, that same year, Jenner inoculated the boy again, this time with smallpox matter, and no disease developed. The vaccine was a success.
A previous similar procedure had become established in China by at least as early 1700. The technique was called "variolation". This was derived from the name of the infective agent — the variola virus.
As early as 430 B.C., it was thought that if one survived a disease, the person thereafter became "immune" to any subsequent exposures. However, this was never recognised as scientific evidence of some type of internal defense system.
How would this happen?
One is through Gavi, the Vaccine Alliance. Numerous governments have pledged more than $8 billion last month to the initiative.
What is Gavi? Who funds it?
Gavi claims to have already prevented 13 million deaths through mass immunisation in the last 20 years. Gavi’s core partners include the World Health Organisation (WHO), UNICEF, the World Bank and the Bill & Melinda Gates Foundation.
The alliance helps vaccinate almost half the world’s children against deadly and debilitating infectious diseases. It seeks to continue the work of improving access to new and under-used vaccines for millions of the most vulnerable children.
Between 2000-2020, 79% of Gavi’s funding came from governments committed to Gavi’s mission of saving children’s lives while 21% of contributions come from the private sector.
Private donors are also becoming a prominent component of Gavi's financing.
How much did world leaders commit to Gavi so far?
On June 4, 2020, an initial $8 billion funding was pledged by world leaders to Gavi. But against the $20 billion target for a global vaccine, it’s only a down payment.
Who pledged to Gavi?
Pledges were made by the following:
- $1.6 billion – Bill & Melinda Gates Foundation
- $1 billion - Norway (including $400 million for the International Finance Facility for Immunisation (IFFIm)
- $439 million - Canada
- €300 million – European Commission (for the period 2021–2025)
- £150 million - UK (£1.65 billion in 2020 - 2025)
- $150 million - Saudi Arabia
- €120 million – Italy (2021-25)
- $100 million – Japan
- €50 million – Spain
- €18 million – Ireland
- $20 million - China
- $15 million – India
- $10 million - TikTok
- $10 million - Laerdal Global Health and the Laerdal Million Lives Fund
- $5.9 million - Airtel Nigeria
- $5 million - The Rockefeller Foundation
- $4.65 million - New Zealand
- $3.84 million - Unilever
- $3 million - UPS
- $2.9 million – Finland
- $1.5 million - United Bank of Africa Foundation
(We will update this list as information becomes available.)
How will the money be spent?
Gavi stated a tentative vaccine spending plan as follows:
- $4.4 billion – vaccine development
- $2 billion – the search for effective therapeutics
- $1 billion – testing
A number of vaccine candidates are currently in clinical testing. Even with the increased funding, experts have said it will take time to determine which candidates are the most effective.
The $20 per COVID-19 vaccine price set by Pfizer: What does it mean?
It would mean that to cover for the world’s 7.8 billion people, and if Pfizer/BioNTech vaccine is the only approved shot, the world would need $156 billion. If two shots are needed for good (long-term) protection, just double that amount, to $312 billion.
That’s a crude calculation. And it does not take into account the role of market forces, economies of scale and the probability of multiple vaccines getting approval.
It’s just a ballpark figure derived from Pfizer’s deal with the US government, which has secured a $1.95 billion supply agreement to manufacture over 100 million ($19.50 a dose), before 2020, if they meet approvals.
Trump plans to give the vaccine to Americans for free (it being an election year).
Pfizer's $20 (roughly Dh74 or Rs1,496), therefore sets a precedent for competitors, in effect, setting a price cap.
Oxford has also signed a manufacturing deal with Serum Institute of India (SII) to ramp up production. Indian biopharma companies are known for their efficiency and affordability. India’s Cadila and US vaccine maker Novavax plan to use their vaccine manufacturing facility in India, too.
By comparison, the average polio shot today costs $0.50 per vial.
How would the COVID-19 vaccine cost be brought down?
There are a number of ways. Technology and mass production are good ways of cutting per-unit cost using traditional vaccine development platforms.
One Indian pharmaceutical company has already set the price of their COVID-19 vaccine at about Rs1,000 ($13.20) per shot.
There are at least five Chinese biotech firms in advanced stages of vaccine trials too. Sinopharm is undergoing Phase III trials of its vaccine in the UAE for its “inactivated” vaccine, with 10,000 volunteers enrolled in the UAE.
In Brazil, at least 2,000 volunteers have begun taking part in the Sinopharm vaccine trial. In June, Oxford also started Phase III in the Latin American country involving thousands of human volunteers.
So both India and China, alongside Brazil, could hold the key for a good vaccine that is also affordable.
With the new mRNA vaccine development technique (Pfizer, Moderna and CureVac), it’s possible the “micro-factories” this technology will spin off could allow trained medical staff to produce vaccines in remote areas, and potentially disrupt the vaccine industry altogether.
COVAX facility: What is it?
COVAX is a global program that aims to accelerate the development and manufacture of COVID-19 vaccines, and to guarantee fair and equitable access for every country — rich and poor — in the world.
The COVAX Facility forms a key part of the COVAX pillar (COVAX) of the Access to COVID-19 Tools (ACT) Accelerator, that also seeks an equitable access to COVID-19 tests, treatments, and vaccines.
COVAX is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO, working in partnership with vaccine manufacturers in developed and developing countries.
How would it achieve its 'fair and equitable' access to vaccines?
The program has adopted the following strategy:
- Sharing the risks that go with vaccine development;
- Investing in manufacturing upfront so vaccines can be deployed at scale as soon as they are proven successful;
- Pooling procurement and purchasing power to achieve sufficient volumes to end the acute phase of the pandemic by 2021.
What's the latest on COVAX?
As of July 15, 2020, 75 countries have submitted expressions of interest to COVAX Facility, joining up to 90 further countries which could be supported by the COVAX Advance Market Commitment (AMC)
Under the scheme, 75 countries would finance the vaccines from their own public finance budgets, and partner with up to 90 lower-income countries that could be supported through voluntary donations to Gavi’s COVAX Advance Market Commitment (AMC).
Interest from governments representing more than 60% of the world’s population offers ‘tremendous vote of confidence’ in the effort to ensure truly global access to COVID-19 vaccines, once developed.
“COVAX is the only truly global solution to the COVID-19 pandemic,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance said in a statement.
“For the vast majority of countries, whether they can afford to pay for their own doses or require assistance, it means receiving a guaranteed share of doses and avoiding being pushed to the back of the queue, as we saw during the H1N1 pandemic a decade ago.
"Even for those countries that are able to secure their own agreements with vaccine manufacturers, this mechanism represents, through its world-leading portfolio of vaccine candidates, a means of reducing the risks associated with individual candidates failing to show efficacy or gain licensure.”
