There’s a tiny spark of optimism in the gloom of this November lockdown. On Monday, Pfizer and BioNTech announced, to everyone’s surprise, interim analysis showing their vaccine candidate for Covid-19 may have up to 90% efficacy in preventing symptomatic cases of Covid-19 in participants who received two doses three weeks apart.
That was based on analysis of 94 confirmed cases of Covid-19 in a trial expected to enrol 44,000 people across the globe.
Experts were cautioning that initial Covid-19 vaccine efficacy could be much lower. The US Food and Drug Association had set its bar for approval at 50% efficacy.
Frustratingly there is little accompanying detail, with the headline data announced by press release, rather than in a peer-reviewed journal, which means less scrutiny than an announcement of this magnitude perhaps needs. The primary goal of the trial, preventing symptomatic Covid-19 infections, will be analysed when cases in the trial reach 164, and it’s unlikely we’ll see a full data release announced before December, never mind widespread vaccination.
Christmas 2020 is still looking like a quiet one for everyone, and there are still a lot of unanswered questions for a vaccine that could be administered to billions of people:
• Does the vaccine protect against infection with the virus, or just render most infections asymptomatic?
• If it doesn’t prevent infections, does it prevent people from being contagious to unvaccinated people?
• Does the vaccine prevent severe cases which result in hospitalisation and death?
• How well does the vaccine work in different populations such as the elderly, the chronically ill, or those with an underlying condition?
• What is the safety profile over the entire trial population?
Even a full peer-reviewed dataset doesn’t end the need for caution. Logistical questions of distribution and administration — people need to receive two doses three weeks apart — will be difficult to set up, even in countries with developed healthcare systems.
The idea that we could have a full global vaccination programme set up by Christmas (as suggested by a member of the UK’s Vaccine Taskforce, Prof. John Bell) is laughable, particularly if the British government attempts to outsource this to Serco or another private company. In such a scenario there’s a very real risk that the perpetual incompetence seen with Test and Trace would mean the vaccination program undermined and worse outcomes, such as continuing uncontrolled outbreaks and increasing vaccine hesitancy. Ensuring an effective route to deliver the vaccine to whole populations (phased by vulnerability and age) is arguably as important as having an effective vaccine in the first instance.
Vaccine roll-outs in the UK should be planned and executed by local public health teams with the support of a national supply and distribution chain, and guarantee that whole populations can access these without any barriers. Anti-migrant policies already prevent some of the most vulnerable in society from accessing basic healthcare, even during non-pandemic times. Preventing anyone from receiving a vaccine stalls the control of the virus and puts everyone at risk from future outbreaks.
Fundamentally, any policies that restrict humans from accessing such basic health services are morally wrong, but even judged solely on the grounds that these are damaging to public health, those anti-migrant policies should be abolished.
Globally, what with distribution difficulties and access, some countries simply might not be able to use this vaccine. This vaccine needs to be kept extremely cold, making it hard to use in areas of the world where health facilities are not set up to store vaccines at minus 20 degrees Celsius. In addition, countries in the Global South are already struggling to guarantee access to vaccines that are readily snapped up by countries such as the UK and US, although the global Covax initiative is working towards manufacturing capacity for two billion plus doses. Those can then be distributed to countries left out of initial orders.
Other vaccines that are more stable at warmer temperatures are also in late-stage development (though these are lagging behind the Pfizer one) and may be better suited to deployment to more remote areas of the globe.
Socialists should be arguing for democratisation of manufacturing facilities for both drugs and vaccines, requisitioning them from private companies. Guarantees of free access to vaccines and healthcare regardless of income, location and immigration.
With the rise of online anti-vax conspiracies, we should also be talking to our colleagues, friends and family who might be hesitant about the vaccine, so that we can proactively debunk conspiracy theories and improve its uptake. The labour movement is far from immune to the virus of conspiracy theories, so we also need to take these arguments to union and Labour branches.
We should be critical of the motives of pharma companies — nobody should be making a profit out of sickness and death — but creating a safe and effective vaccine for Covid-19 is an overriding social benefit that we must support the wide scale implementation of.
Done right, this hopefully means winter 2021 will look very different to winter 2020.