The Guardian

The forgotten vaccine

UK has 60m doses on order – will Novavax make a difference?

- Linda Geddes Mark Brown

Pfizer, AstraZenec­a, Moderna. Britons have become so accustomed to these Covid vaccines in the UK most have forgotten about another jab, Novavax, even though the government has ordered 60m doses and hundreds of British jobs depend on it. But last month the US company, with a factory on Teesside primed to manufactur­e doses, submitted its final data to UK regulators and a positive decision is anticipate­d within days or weeks.

So what difference would this additional weapon make to the UK’s vaccinatio­n armoury? Novavax’s offering is a proteinbas­ed jab – similar to those used to protect against flu and for routine childhood vaccinatio­n against pertussis (whooping cough) and meningococ­cal infection.

Other protein-based Covid vaccines are also in late-stage clinical trials, including one being developed by Sanofi and GSK, again with 60m orders from the UK.

Whereas existing UK Covid-19 vaccines instruct cells to create the coronaviru­s spike protein, protein-based vaccines deliver premade fragments of it alongside an immune-stimulatin­g adjuvant. The clinical trials suggest two doses of Novavax have an efficacy of about 90% against symptomati­c Covid – similar to the other approved UK vaccines. The vaccine is also being “mix and match” tested with the Oxford/AstraZenec­a or Pfizer/ BioNTech jabs, and preliminar­y data suggest it generates a robust immune response when given as the second dose. But it is the signs of reduced side-effects that could make Novavax attractive. Trial data appear to show potential for lower “reactogeni­city” compared with existing jabs – meaning side-effects such as fatigue, headaches and muscle pain occur less frequently.

Prof Paul Heath, director of the vaccine institute at St George’s, University of London, and chief investigat­or of the Novavax UK trial, said: “Lower reactogeni­city becomes particular­ly important in groups such as children, where the balance between vaccinatio­n and not vaccinatio­n becomes a little less clear, because, for example, young children’s likelihood of having severe Covid-19 is so small.”

A caveat with any new vaccine is that rarer side effects might not be apparent at first, said Azeem Majeed, professor of primary care and public health at Imperial College London. However, the Novavax vaccine uses more establishe­d vaccine technology, which could make it more appealing to some people. Heath said: “Those people who have been hesitant about receiving other Covid vaccines may be more open to receiving a vaccine that uses this protein adjuvant technology.”

Other benefits with such proteinbas­ed vaccines is the storage, which can be in a standard vaccine fridge at 2C to 8C. A broader range of vaccines would also help if regular booster shots are needed. Easier transport and storage is even more important in developing countries, where low temperatur­econtrolle­d supply is less usual.

Brendan Wren, professor of microbial pathogenes­is at the London School of Hygiene and Tropical Medicine, said: “Worldwide, the more vaccines the better, particular­ly if they are low cost and don’t require freezing.”

In March, Boris Johnson said that 60m doses of Novavax were to be made in north-east England; Fujifilm Diosynth would make them in its Billingham plant, and GSK finish them at Barnard Castle.

The Novavax jab has been approved for use in the Philippine­s and Indonesia. The firm has submitted an emergency use applicatio­n to the World Health Organizati­on, and the Serum Institute of India is also making doses, 20m of which have been approved for export to Indonesia.

Silvia Taylor, senior vicepresid­ent of corporate affairs at Novavax, said: “Now the submission [to the UK] is complete, the timeline is in the hands of the regulatory agencies.”

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