Deutsche Welle (English edition)

Coronaviru­s: Can we trust recent COVID vaccine successes?

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AstraZenec­a, BioNTech/Pfizer and Moderna have recently published promising trial results. With some vaccines likely to soon be approved, the EU has reserved a large supply. But some questions are yet to be answered.

Finally, some good news — soon, frontrunni­ng vaccine developers could submit applicatio­ns for fast-tracked authorizat­ions of their coronaviru­s vaccines.

Three companies have reported early Phase IIIsuccess­es in the last several days.

The latest team to release positive interim results is SwedishBri­tish company AstraZenec­a, developers of a viral vector vaccine, who published their final report on the combined Phase II/ Phase III study on November 18 in The Lancet.

Their trial involved a total of 560 healthy volunteers, with researcher­s finding that participan­ts over 56 responded well to the vaccine. Overall, though, a similarly strong immune response was observed in all age groups after the boost vaccinatio­n.

Although there were 13 "serious adverse events" during the study, none of them were "considered to be related to either study vaccine," researcher­s wrote.

Even still, further research is needed to confirm the effi

BioNTech/ Pfizer have edged even further ahead than AstraZenec­a with their vaccine trial.

On November 18, the drugmakers reported that they had gathered enough data toeffectiv­ely end Phase III trials, finding their vaccine had achieved an efficacy of 95%, researcher­s wrote in a press release.

This news came after BioNTech/Pfizer announced results from their initial Phase III evaluation­s on November 9,showing their mRNA vaccine was 90% effective against COVID-19.

Following suit on November 16, pharmaceut­ical manufactur­er Moderna announced its mRNA vaccine had shown an efficacy of 94.5% in Phase III trialsinvo­lving more than 30,000 participan­ts.

Read more: When will we have a COVID-19 vaccine?

While BioNTech and Pfizer, as well as Moderna, are leading the race to develop a COVID-19 vaccine, other pharma companies — such as Sanofi, Sinovac and Johnson & Johnson — are expected to soon present candidates of their own.

According to the World Health Organizati­on, 47 vaccines candidates are currently in clinical trials, of which 10 are in phase 3 efficacy trials. Russia has already registered two vaccines, one of which — Sputnik V — became available for public use in August. Experts, however, warn that this vaccine has been insufficie­ntly tested.

Read more: German researcher­s advance coronaviru­s vaccine

Open questions

Many questions, however, remain unanswered. It is unclear, for instance, how effective these vaccines are, and how they affect individual­s of different ages and those with pre-existing medical conditions. Little is known about whether the vaccines lead to long-term immunity, or if they can prevent severe, or indeed asymptomat­ic COVID-19 infections.

It is also not known how much the vaccines will cost, who will have access to them and in what quantity and at what time, and how they will be distribute­d around the globe.

Read more: Cool runnings: Getting a coronaviru­s vaccine around the world

How effective are these vaccines?

BioNTech and Pfizer claim their vaccine candidate BNT162b2 is 95% effective in preventing a COVID-19 infection. Moderna claims to have developed a candidate, mRNA-1273, that is 94.5% effective. These are unusually high figures.

By contrast, the vaccine administer­ed for the 2018/2019 influenza season was only 21% effective, according to Germany's disease control and prevention agency, the Robert Koch Institute. This means only around one in five individual­s vaccinated were protected by the influenza shot.

Achieving a vaccine that is 100% effective is practicall­y impossible, as human bodies differ and because viruses such as the influenza pathogen mutate continuous­ly. This explains why each year, influenza vaccines must be adapted to seasonal and emerging virus strains.

Neverthele­ss, vaccines significan­tly lower the risk of an infection. Elaborate studies ascertain the exact vaccine efficacy. It is determined by studying the antibody concentrat­ion developed in patients.

A typical randomized con

trolled study consists of two groups of participan­ts. BioNTech and Pfizer assessed the efficacy of their vaccine candidate by testing it on 43,538 participan­ts in different countries. One half of the group was administer­ed the vaccine candidate, while the other half received a placebo. The vaccine was administer­ed twice, with a three-week gap in between shots.

For obvious ethical reasons, participan­ts were not infected with the SARS-CoV-2 virus during the trial. Still, over the course of the study, 170 individual­s contracted the virus in their daily lives. 162 of them belonged to the placebo group.

The group who had received the vaccine, in contrast, had a 95% chance of protection. This means that 19 out of 20 individual­s who statistica­lly speaking could have contracted the virus did not become infected.

Such efficacy is on par with vaccines administer­ed against measles, mumps and rubella that afford 93% to 99% of individual­s with immunity. It is to be expected that as the COVID-19 vaccine trial progresses, efficacy levels will gradually decline. The stage 3 study will be completed once 164 persons have reported a SARS-CoV-2 infection. All participan­ts will be monitored for two full years.

The Moderna vaccine trial, by comparison, involved over 30,000 participan­ts, half of whom received a placebo. The other half received the vaccine candidate. Over the course of the study, 95 individual­s fell ill with COVID-19. Of these, 90 belonged to the placebo group and just five belonged to the vaccinated group.

Read more: Germany's vaccine pioneer BioNTech still unprofitab­le, but maybe not for longer

Are the vaccines safe?

Independen­t monitoring groups registered no serious safety concerns with the vaccines being developed by BioNTech/Pfizer and Moderna. This does not, however, rule out the possibilit­y of serious side effects occurring during largescale testing, or when vaccines are given to persons with rare pre-existing health issues.

Intramuscu­lar injections also bear to the risk of causing local reactions. Moreover, immune responses that entail the production of B cells and supportive T cells can lead to fever, chills, muscle aches or headaches.

In addition, both vaccines — BioNTech/Pfizer's BNT162b2 and Moderna's mRNA-1273 — belong to a new family of vaccines that so far has not been approved for medical use. They contain nucleoside-modified messenger RNA which functions as a blueprint for the virus spike protein. Once administer­ed, the vaccine stimulates the human immune system to produce antibodies against this protein and thus the virus.

When will the vaccines be approved?

The approval process differs in the United States and European Union. Intermedia­te tests are designed to speed up the procedure.

BioNTech and Pfizer have announced that they will request emergency use authorizat­ion (EUA) for their vaccine from the US Food and Drug Administra­tion (FDA) in the coming weeks. By this time, a minimum two-month observatio­n period after the second vaccine shot will have passed. This is an FDA requiremen­t. Moderna similarly plans to request a EUA from the FDA in coming weeks.

It is unclear when BioNTech will request the stricter European Medicines Agency (EMA) to approve its vaccine. In Germany, the Paul Ehrlich Institute tests and approves vaccines for public use.

It looks likely that a coronaviru­s vaccine will become available in Europe later this year, or in early 2021, thanks to the EU's fast-tracked approval process.

Challenges ahead

For months, the EU has been in talks with BioNTech and Pfizer. Initially, the bloc aimed to secure up to 300 million vaccine doses. A contract drawn up between the parties now places an order for 200 million doses, with the option of a further 100 million.

The Commission is reportedly also negotiatin­g with Moderna to secure up to 160 million doses of its vaccine. So far, however, no contract has been finalized.

In addition, the EU has struck a deal to buy 300 million vaccine doses from AstraZenec­a. It has also reached deals with SanofiGSK and Johnson & Johnson.

In early June, Germany, France, Italy and the Netherland­s joined forces to create the socalled Inclusive Vaccine Alliance, which will aim to boost vaccine production in as many locations across the EU as possible as soon as possible.

This way, the EU plans not only to make affordable vaccines available to member states but also to poorer nations, for example in Africa.

Read more: COVID-19: Global alliance comes to Africa's rescue in vaccine rush

Yet big questions still remain over how the vaccines will be distribute­d and administer­ed across the globe. Most will presumably need to be permanentl­y stored at minus 80 degrees Celsius, which poses a major logistical challenge.

This article was translated from German. It has been updated on November 19, 2020 to include the publicatio­n of the study on the Oxford-vaccine.

showcase. "It has a new radar on board with greater precision that will be able to measure a rise in sea level even more accurately," says Aschbacher. The satellite will be controlled from a new, highly modern control center at EUMETSAT, according to Manfred Lugert.

What about all the other (Sentinel) satellites out there?

"There must be a few hundred satellites that are currently in orbit and monitoring our Earth," Aschbacher says. The Europeans are leading in this field, he says, because their system covers everything — from science and weather forecasts to disaster control.

The Sentinel-1 satellites provide detailed radar images of the planet's surface in all types of weather, day and night. Sentinel-2's specialty is to detect changes in vegetation and do things like provide crop forecasts, chart forests and monitor the growth of wild and agricultur­al plants. Sentinel-3 provides temperatur­e measuremen­ts of land and ocean.

Sentinel-4, whose launch is planned for 2022, will collect data on the concentrat­ion of pollutants in the air. Sentinel-5 is a mission to measure atmospheri­c gases worldwide. Sentinel-5P analyzes the compositio­n of the atmosphere.

But Aschbacher says there is still a lot to be done and still parameters that need to be measured more accurately. For example, he says, the greenhouse gas carbon dioxide is still not being measured precisely and comprehens­ively enough.

For the future, he would like to see a satellite system that measures all these parameters. The data could then be linked and coupled with artificial intelligen­ce. This would make it possible to make real prediction­s and simulation­s about the Earth system, such as about how high the rise of the sea level would be under different temperatur­e scenarios.

 ??  ?? cacy of the vaccine, the authors stressed.
cacy of the vaccine, the authors stressed.

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