Watch | What Does the Pfizer COVID Vaccine Update Mean for India? 

Pfizer says its COVID-19 vaccine is more than 90% effective. What comes next? Will it be available in India?

Treatment & Vaccine
4 min read

In big news on the vaccine front, Pfizer and BioNTech announced on Monday, 9 November that their coronavirus vaccine was more than 90% effective in preventing COVID-19.

With the flurry of excitement surrounding the preliminary results, a lot of key questions were left unanswered. For instance, while the results may as well be promising, do we know enough about the vaccine’s safety and efficiency yet? What’s left to be done? Will the candidate vaccine be reaching India anytime soon?

FIT speaks to Dr Shahid Jameel, Virologist and Director, Trivedi School of Biosciences at Ashoka University, who breaks it down for us.

How do we make sense of these results? Is this good news?

Dr Jameel: Although these are interim phase three results, they are very encouraging from a few different perspectives.

These are the first initial results from a late-stage human trial of any COVID vaccine which have been shared. Secondly, this is the first mRNA vaccine platform that has shown to be efficacious. Till date, there has been no RNA based vaccines that have been licensed for use. This bodes really well for the future because it’s fairly simple to make RNA vaccines once you have the platform available. This also proves that you can take a small part of the virus structure, immunise with it and get protection. In this case, they didn’t even have to use the entire spike protein, but only a part of the spike protein.

So yes, it is optimistic from many different angles. We can hope that by the end of this year, we would know for sure whether this vaccine receives emergency use authorisation from the Food and Drug Association or not.

What do we not know about the Pfizer vaccine yet?

Dr Jameel: Out of the 94 people who got infected with COVID-19 in these results, we can estimate that nine were in the vaccine group and 85 were in the placebo group. That is how 90 percent efficacy has been calculated.

It remains to be seen whether there is any difference in the level of disease between people who got infected in the vaccine group versus those who got infected in the placebo group. We are yet to see whether the vaccine is able to attenuate disease or not, which many vaccines normally do. Most vaccines don’t actually protect against infection, but instead, they protect against disease.

This will only been known once the vaccine is rolled out into a much larger population, and that is something to be done post approval.

The FDA’s threshold for emergency use authorisation is 50% efficacy. Is 90% a realistic number? Did we expect it?

Dr Jameel: No, nobody was expecting that. In fact, I don’t think even the company was expecting it.

They were expecting the vaccine to be about 70 percent efficacious. It turned out to be more than 90 percent. For now, you have to go by the data. Its possible that when the analysis is done at a later time point, the efficacy may drop from 90 percent to, maybe, 85 or 80 percent. It would still be a good vaccine.

These early results are extremely encouraging and positive, but let’s wait for the final data to come out.

Will India be getting it anytime soon?

Dr Jameel: A word of caution here. This vaccine requires ultra-cold temperatures to be stored in - near -94 degree F in supercooled containers. This creates immense challenges as far as the distribution and cold chain for the vaccine is concerned.

Therefore, it is certainly not a vaccine with which you can think of immunising a lot of people in India, because India just doesn’t have the infrastructure for this kind of a cold chain. Perhaps, some very rich people who can afford to pay a lot of money may be able to afford it, that too if the vaccine finally becomes available in India.

But the fact of the matter is, don’t get too happy that this vaccine will reach us In India in the near future. It won’t.

The development is, nevertheless, good from the point of view that it has proven a concept. India is in a fairly good position. In the coming months, we are likely to have at least 3 or 4 candidates that are working on the same principle essentially - not mRNA, but the same part of the virus, and hopefully, they will also show efficacy.

How is India’s COVAXIN different from Pfizer’s vaccine?

They are very different. COVAXIN is the whole virus. The procedure for such inactivated vaccines is that you grow a lot of the virus, purify it and then kill it with a chemical. This killed virus is then injected.

On the other hand, the mRNA vaccine and even the Oxford-Astrazeneca vaccine are based on a single component from the virus- the spike protein. COVAXIN contains all the proteins that are present in the virus.

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