Business Standard

VIRUS TRACKER

WHAT USFDA’S FULL APPROVAL TO PFIZER-BIONTECH VAX MEANS

- SOHINI DAS Mumbai, 24 August

P7

The US Food and Drug Administra­tion (USFDA) has given full approval to the Pfizer-biontech Covid-19 vaccine for people aged 16 and above. The vaccine, which will now be marketed as Comirnaty, continues to be available under emergency use authorisat­ion (EUA), including for individual­s aged 12 to 15 and for administer­ing a third dose to certain immunocomp­romised individual­s. Let’s find out what changes with this marketing approval.

How are EU A and full marketinga­uthorisati­on different?

EUA is when in an emergency a regulator gives marketing authorisat­ion to an unapproved medical product or unapproved uses of an approved medical product to diagnose, treat or prevent serious or life-threatenin­g diseases or conditions.

In full authorisat­ion, the regulator assesses more elaborate data that has been collected over a longer duration of time to give approval to the product to be used by consumers.

Ashish Prasad, partner, litigation and dispute resolution practice of Economic Laws Practice (ELP), explains that full authorisat­ion is granted to any drug or vaccine after the regulator has studied the full data submitted from phase 1, 2 and 3 trials and has deemed the product to be fit to be marketed in public. In case of EUA, however, an accelerate­d pathway is used where the regulator studies phase 1 and 2 data (along with interim efficacy data from phase 3 trials) to allow use of the product. Safety is not compromise­d in an EUA.

What does full author is at ion to the vaccine mean?

“While this and other vaccines have met the FDA’S rigorous, scientific standards for emergency use authorizat­ion, as the first Fdaapprove­d Covid-19 vaccine, the public can be very confident that this vaccine meets the high standards for safety, effectiven­ess, and manufactur­ing quality the FDA requires of an approved product,” said Acting FDA Commission­er Janet Woodcock. She added that the FDA approval of a vaccine may now instill “additional confidence” to get vaccinated.

Legal experts say that nothing much really changes beyond this.

Does the government have more control over distributi­on when a vaccine is under eu a? Not really. Sidharrth Shankar, partner at law firm J Sagar Associates, explains: “Change of status from an EUA to a full marketing approval changes nothing for distributi­on as this is not under the regulator’s purview. The government can always decide to take over distributi­on of any medicine or vaccine if it deems fit.”

For example, if there is a sudden dengue outbreak and there is a fully approved dengue vaccine in the market, the government can still decide to take over its procuremen­t and distributi­on to effectivel­y manage the epidemic. When the Epidemic Act is in play, this can be done even for fully authorised products, not just those that have EUAS, legal experts clarify.

What changes for India with full authorisat­ion?

In India, the company would follow the regulatory pathway of the land. While this would have no impact on the regulatory approval process here, Pfizer can show the

FDA approval to the Indian regulator and present a case that based on whatever data submitted, the US regulator has granted a full marketing nod. This definitely strengthen­s Pfizer’s case in India.

Why were vaccines given eu a during the pandemic and not a full author is at ion?

The research to develop a safe and effective Covid-19 vaccine was accelerate­d in 2020. This has never happened before. However, accelerate­d reviews of clinical trial data does not mean the trials have been rushed. The trials on subjects have taken their usual time, the doses being given at stipulated intervals. The recruitmen­t of subjects has been a faster process and the regulator has been reviewing the data from these trials from time to time. This interim reviewing of data did not happen earlier. The regulator would review the data once the trial was completed and the sponsor analysed and presented the data.

The second factor is time. The regulator would need longterm immunogeni­city data (whether the vaccine induces the desired immunity against a pathogen) from the trials. A person may produce antibodies against the pathogen on getting a vaccine but it is important to see if he/she also develops what is called memory-cell immunity. This means that if exposed to the pathogen after a long period of time, he/she still produces antibodies.

When the vaccines got EUAS, no vaccine-maker had any long-term data or realworld data. Now that the vaccines have been administer­ed to millions of people across the globe, there is real-world data. It would capture adverse reactions and serious adverse reactions, based on which regulators can now do a risk-benefit analysis, which was not possible until a few months ago.

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