STAN GRANT:
Yesterday's announcement that the British drug regulator has given emergency approval to Pfizer's COVID-19 vaccine has been touted as a game-changer with the first doses to be rolled out within days. The United States is also likely to give emergency approval very soon. Australians, however, will have to wait until March. Now, the big hope in the COVID-19 pandemic has been that it can be brought to an end by vaccines, but is that a realistic expectation? Norman Swan reports.
NORMAN SWAN:
The United States, the UK and Europe are going through a second nightmare, as the coronavirus wreaks havoc going into winter. There have been around 270,000 deaths in the US alone, and 60,000 in the UK. And that's made governments desperate for a vaccine.
[EXCERPT]
DONALD TRUMP:
What we'd like to do, if we can, is the vaccine, and I think we're going to be successful in doing it and hopefully by the end of the year.
BORIS JOHNSON:
The vaccine will begin to be made available across the UK from next week.
END OF EXCERPT]
NORMAN SWAN:
The emergency authorisation of the Pfizer vaccine puts pressure on our regulator to give an early approval. But there could be safety risks, which is why Paul Kelly, the Acting Chief Medical Officer thinks there are benefits for us if we go more slowly.
PAUL KELLY:
If those emergency use authorisations happen in those other countries, we could be at a position of having many millions of English and United States citizens having been vaccinated.
SCOTT MORRISON:
We will implement the vaccine here in Australia according to Australian needs and Australian conditions and the challenges and opportunities we have here.
NORMAN SWAN:
And while Australia has managed to largely eliminate spread, it's natural to assume that an effective vaccine will be the ultimate answer to this pandemic. We're in the happy position of having promising vaccines, largely thanks to international donors who foresaw a pandemic like this and invested in rapid vaccine technologies. But that has still meant an almighty rush. Brett Glenn heads R&D for Novavax, a US developed vaccine that Australia has arranged to take.
BRETT GLENN:
It’s really a staggering effort. I mean, it’s never- nothing like this has happened in history, I hope it won’t happen again. It’s the collaborations amongst science, industry, government, public health, you know, global collaboration - it's just incredible.
KANTA SUBBARAO:
Normally it takes years for a vaccine to go from a phase one clinical trial to being on the verge of being licensed and here we are ten months after the virus was first identified, we have a vaccine for which we actually know something about the efficacy and we have options, so it's really very remarkable.
PAUL KELLY:
We have advanced purchasing agreements with four companies - Pfizer, AstraZeneca, the UQ CSL vaccine as well as Novavax.
NORMAN SWAN:
The front running vaccines all do the same thing - they generate an immune response to all or part of the spike on the coronavirus and that’s because the spikes around the coronavirus are the keys that allow the virus to enter our bodies. The COVID vaccines create an immune response to the spikes that stops COVID-19 disease developing. The Pfizer and AstraZeneca vaccines work by carrying genetic messages into our cells, telling them to produce all or part of the COVID spikes, which then go on to train our immune systems to fight the disease. Other vaccines don't rely on genetic messages; they inject the spike protein directly into our bodies. The University of Queensland vaccine does this, as does the vaccine from Novavax.
BRETT GLENN:
We actually put it into a little particle, so it assembles into something that looks like a virus, which is what the immune system is accustomed to seeing, and we add an immune stimulant to it, called Matrix-M that just- all that does is gives it- looks dangerous to the immune system and it gets a very strong response and direct it to the spike protein.
NORMAN SWAN:
It has been a rush and time has had to be compressed. This has created frustration and confusion, as pharmaceutical companies have announced their findings by press release, rather than through scientific papers.
BRETT GLENN:
It literally is building the aeroplane, you know, as we take off on the runway, and it's working, but it's incredibly intense.
NORMAN SWAN:
It's important to be clear that numbers like 95 per cent effectiveness means that 95 per cent of people immunised don't develop COVID-19 disease when infected. The Achilles heel of COVID-19 vaccines is that they may not prevent infection in the first place and that has huge implications for transmission and the pandemic.
COLIN POUTON:
The trials are all a little bit different, but they're all set up with the same principal objective, which is to see whether the vaccine can prevent COVID-19, and by that I mean the disease itself, rather than whether or not the virus is transmitted.
KANTA SUBBARAO:
It's quite challenging with many different viral infections to prevent all infections. In fact, we don't do so well with that with many vaccines.
NORMAN SWAN:
While it would be great to prevent people getting sick with COVID-19, the problem - if the vaccines don't prevent infection and transmission - is that there will be no herd immunity and the pandemic will continue.
PAUL KELLY: Is this going to solve and eradicate this virus by using a vaccine strategy? It's too early to tell in terms of the data that we have so far. In terms of the wider transmission and what that will mean in terms of what we do for this epidemic into the future, that's something we’ll be watching very carefully.
KANTA SUBBARAO:
I think it remains to be seen when we'll be able to relax our social distancing and mask-wearing and opening borders.
NORMAN SWAN:
However, at Novavax, they're pretty confident that transmission will be prevented.
BRETT GLENN:
What I would say, based on what we've seen, our immune response, the hallmark of our technology, is to make a very strong immune response and it's very safe. In animals, we can actually give the vaccine to an animal and then give them the virus and see if it blocks infection. We not only block infection in the lungs, we also block the infection in the nose and what that might mean for the public is not only can we block you from getting sick but we may also be able to block infection, which would mean you wouldn't transmit the virus, either.
NORMAN SWAN:
The rollout of approved vaccines in Australia is planned for March. There's still lots to consider, including keeping the Pfizer vaccine very cold. GPs will be involved and perhaps later on pharmacists, but there is one aspect of the rollout that hasn't had much coverage. COVID immunisation will be recorded electronically.
PAUL KELLY:
We are looking to mandate that in terms of the recording of the vaccine, not the receiving of the vaccine but- that will be voluntary - but the recording of the vaccine on the Australian immunisation register is a fundamental component of our plan going forward.
NORMAN SWAN:
That's going to give Australia a huge advantage to make sure that people get the right second dose and to monitor side effects. It's all really exciting. It’s the end of the beginning. Thank goodness for that.