Pfizer, Moderna Results Leave Many Important Questions Unanswered

“The light at the end of the tunnel.” It’s a phrase we’ve heard a lot this week, since Pfizer confirmed that its experimental mRNA COVID-19 vaccine is 92% effective: “The light at the end of the tunnel”.

That is, the notion that a the emergence of an effective vaccine means we’re reached the beginning of the end of the global COVID-19 pandemic, which has come roaring back in the US and Europe as the fall weather arrives, Bloomberg reports.

In recent days, we’ve discussed the myriad obstacles to widespread vaccination that still remain, and warned that much testing and research remains to be done before humanity can start to feel like it’s finally getting its arms around the coronavirus. Aside from that, there are logistical and public-relations hurdles as well, as a team of DB analysts explained in a recent report for clients.

Other major obstacles facing vaccines in development by both Pfizer and Moderna, which is also working on an mRNA-based vaccine, as we’ve noted before, are the low temperatures required to store them, making distribution in the developing world virtually unworkable without serious infrastructure investment.

Moreover, the Pfizer vaccine has a notable practical limitation: It must be kept frozen at an ultralow –94F until a few days before it is used. That requires special freezers or dry ice packs, complicating distribution. Moderna is thought to be just a few weeks behind Pfizer in the testing process. It’s working with the same messenger RNA technology, which uses the body to produce a key coronavirus protein, stimulating the immune system to make antibodies to fight the virus. Moderna says its vaccine can be kept in regular freezers; some other vaccines don’t need to be frozen at all.

Pfizer’s vaccine also requires two shots to be given three weeks apart before significant protection kicks in. While most other vaccines in late-stage testing also require multiple shots, Johnson & Johnson’s may work after just one, which would enable more people to get protection faster. Results of a 60,000-participant J&J trial may come by year-end.

Though the Gates Foundation, the WHO and Beijing are all working together on the “Covax” international vaccination effort, attempting to raise $18 billion to vaccinate the world, the odds that the necessary infrastructure will actually be built in the coming months and years is slim. Rather, while the “rich” world gets the early, experimental mRNA vaccine, the “poor” world might need to wait for a more familiar “protein-based” option.

“If there is a protein-based vaccine that could achieve the same effect as an mRNA vaccine does and there’s the need to vaccinate billions of people every year, I’d go for the protein-based shots in the long run,” says Ding Sheng, director of the Beijing-based Global Health Drug Discovery Institute, which has received funding from the Bill & Melinda Gates Foundation.

Even if everything goes swimmingly with both the Pfizer and Moderna vaccination effort, the US still needs all of the six or so leading western projects to be approved without any issues if the goal is to reach herd immunity levels by June.

At least, that’s what the scientists said.

Even the US, which has lined up hundreds of millions of doses through the Warp Speed program, would need all six of its suppliers to be successful for the country to reach herd immunity by June, according to researcher Airfinity.

Because the rollout of any shots will not happen overnight, masks, distancing, testing, and contact tracing will still be vital, says Ohid Yaqub, a senior lecturer at the University of Sussex’s Science Policy Research Unit.

And since the mRNA technology used in the Pfizer/BioNTech vaccine has never been deployed in humans before, people who get the vaccine will need to be monitored. “It will be crucial to track the safety and efficacy over the coming weeks and months,” says Kinch, the Washington University expert. “If nothing else, we have learned that we need to look to the long term.”

And with Pfizer now striking more deals promising vaccine supplies to the EU, it’s a good reminder that it’s not just the US.