Pfizer, AstraZeneca, Moderna. Britons have change into so accustomed to the three Covid vaccines obtainable within the UK that almost all have forgotten about one other jab, Novavax – despite the fact that the federal government has ordered 60m doses and a whole lot of British jobs depend upon it.
Late final month the US firm, with a manufacturing unit on Teesside primed to fabricate doses, submitted closing knowledge to UK regulators and a constructive determination is anticipated inside days or even weeks. It’ll deliver to an finish what appears like a protracted wait in contrast with the speedy growth and approval of the opposite jabs, together with for individuals who took half in trials.
So what distinction would this extra weapon make to the UK’s vaccination armoury? Novavax’s providing is a protein-based jab – just like these used to guard towards flu, and for routine childhood vaccination towards pertussis (whooping cough) or meningococcal an infection.
Different protein-based Covid vaccines are additionally in late-stage medical trials, together with one being developed by Sanofi and GSK, once more with 60m orders from the UK. Last knowledge from its part 3 trial is predicted any day now, paving the way in which for the businesses to hunt regulatory approval.
Whereas current UK Covid-19 jabs instruct our cells to fabricate the coronavirus spike protein, protein-based vaccines ship pre-made fragments of it alongside an immune-stimulating adjuvant.
Medical trials recommend that two doses of the Novavax jab have an efficacy of about 90% towards symptomatic Covid – just like the opposite permitted UK vaccines. It’s also present process “combine and match” testing with the Oxford/AstraZeneca or Pfizer/BioNTech jabs and preliminary data recommend it generates a strong immune response when given because the second dose.
However it’s the rising indicators of diminished side-effects that might make Novavax significantly engaging.
Trial knowledge seem to point out the potential for decrease “reactogenicity” in contrast with current jabs, which means side-effects corresponding to injection-site swelling, fatigue, complications and muscle ache happen much less ceaselessly. No direct head-to-head comparisons have but been executed, nonetheless, and additional research are wanted.
“Decrease reactogenicity turns into significantly necessary in teams corresponding to kids, the place the stability between vaccination and never vaccination turns into rather less clear, just because, for instance, in younger kids the chance of them having extreme Covid-19 is so small,” mentioned Prof Paul Heath, the director of the Vaccine Institute at St George’s, College of London, and chief investigator of Novavax’s UK trial.
Nevertheless, a caveat with any new vaccine is that rarer side-effects could not change into obvious till a vaccine is used extensively, mentioned Azeem Majeed, professor of main care and public well being at Imperial School London. “Submit-marketing surveillance can be wanted to determine any beforehand unknown side-effects,” he mentioned.
The truth that it makes use of a extra established vaccine know-how might additionally make it extra interesting. Heath mentioned: “It could be that these individuals who have been hesitant about receiving different Covid vaccines could also be extra open to receiving a vaccine that makes use of this protein adjuvant know-how; it could be one thing that’s extra acquainted to them, and due to this fact shall be joyful to obtain.”
Majeed is much less satisfied Novavax will make a lot distinction to uptake however can see different advantages to such protein-based vaccines. It may be saved in a regular vaccine fridge at 2C to 8C, making it simpler to move and retailer than mRNA-based vaccines. He mentioned: “The AstraZeneca vaccine has related storage necessities to Novavax however the UK authorities appears to have largely stopped utilizing it.”
Entry to a broader vary of vaccines would even be useful if common booster photographs are wanted sooner or later. “Due to Novavax’s easier storage necessities, it could be simpler to make use of in GP surgical procedures and pharmacies,” mentioned Majeed.
This mix of simpler transport and storage is much more necessary in creating international locations, the place low temperature-controlled provide chains are much less effectively established. “Worldwide, the extra vaccines the higher, significantly if they’re low price and don’t require freezing for storage and supply,” mentioned Brendan Wren, professor of microbial pathogenesis on the London Faculty of Hygiene and Tropical Medication.
Jobs might come alongside the brand new jab, too: in March, Boris Johnson introduced that 60m doses can be made in north-east England. Fujifilm Diosynth would manufacture them at its plant in Billingham, whereas GSK would fill and end them – bundle them up in vials – at its operation in Barnard Castle.
About 300 individuals at FujiFilm are mentioned to have been engaged on the vaccine, although delays had prompted considerations that jobs can be hit. Fujifilm final month mentioned manufacturing was unaffected by the delay, and it deliberate to increase its workforce within the years to return.
The native Labour MP, Alex Cunningham, who represents Stockton North, met with a consultant of Novavax and mentioned he felt reassured. “I don’t know the way lengthy the approvals course of will take however hope manufacturing will rise up and working quickly,” he mentioned.
The Novavax jab has already been permitted to be used within the Philippines and Indonesia. On 4 November, the corporate submitted an emergency use utility to the World Health Group. If permitted, it could be the primary protein-based vaccine to be beneficial by the WHO.
Novavax informed the Guardian that it was now routinely producing high-quality product at industrial scale at a number of websites internationally. The Serum Institute of India can be manufacturing doses, 20m of which have been approved for export to Indonesia.
Silvia Taylor, the senior vice-president of worldwide company communications and investor relations at Novavax, mentioned: “Now that the submission [to the UK Medicine and Healthcare products Regulatory Authority] is full, the timeline is within the fingers of the regulatory businesses.”