My sincere gratitude to Pfizer
Preliminary data from pharmaceutical giant Pfizer and German biotechnology firm BioNTech show that their COVID-19 vaccine is more than 90 percent effective at protecting people from the infection, compared to patients who received a placebo saline shot, according to a Pfizer statement on the 9th of November. While it’s unclear exactly how many of the trial’s 43,000 participants, who received either two doses of the vaccine or the placebo, have contracted COVID-19, the interim analysis includes 94 confirmed cases. Among these 94, roughly 10 percent had been given the vaccine, while the other 90 percent had been given a placebo. The sky suddenly seems bluer, the sun a little brighter, the chirping of the birds outside my window a little more joyous.
These results are indeed preliminary — all we, the public, have so far is a news release. The data will need to be scrutinized by the Food and Drug Administration in the U.S., and more data collected, before we know for sure how good this is. Even if this vaccine confers strong immunity, we can’t yet know how long it will last. Nor are any clinical trials ever big enough to detect really rare, one-in-a-million, side effects. All that said, if the early data pans out, this is very, very good news. The side effect profile looks pretty minimal, and its efficacy is fantastic. The FDA’s minimum target for a covid-19 vaccine was 50 percent efficacy at preventing infection — about what you get from a decent flu vaccine. At 90 percent, you’re closer to the measles vaccine: something that can, with mass inoculation, effectively eliminate the disease in the population. Keep in mind, however, that mass inoculation will be a massive headache. Earlier vaccination programs against childhood illnesses could rely on widespread immunity among adults and focus somewhat narrowly on kids, or adults who hadn’t had the disease. Once we have an effective vaccine, we’d ideally want to inoculate most of the population in short order. That will be particularly challenging with this vaccine, which needs to be stored at minus 70 degrees Celsius. You can’t just pop this one in the fridge.
Those cold storage requirements are raising serious questions about who could get the Pfizer vaccine if it’s approved, and when. The reality, experts say, is that the Pfizer vaccine probably won’t be available to everyone, at least not right away. Large medical centers and urban centers are the most likely to have the resources necessary for ultra-cold storage. People without access to these facilities, such as those living in rural areas, nursing homes and developing nations, may have to wait for other vaccines working their way through the development pipeline. Even if we solve the storage and trust problems, it will take a while to reach mass inoculation. Pfizer estimates it can produce 50 million doses globally in 2020 and up to 1.3 billion in 2021, which isn’t enough for everyone who will want it, so let’s hope there are more, and equally effective, vaccines in the works from other manufacturers. In the meantime, we’ll probably start by targeting health-care workers and the elderly.
Luckily, this is not just good news for Pfizer, but for the other vaccine makers and candidates as well, since all of them are targeting the same viral spike protein that helps it enter your cells. This suggests that approach can work — if we give it time to bear fruit. The delay between announcement, approval and wide vaccine availability will be hard to wait out. Should a vaccine be approved, but remain in limited supply, it will taunt us as we settle into the darkest days of winter with our masks, our hand sanitizer and what’s left of our sanity. People will be tempted to return to normal early. Don’t give in to that temptation. If you take only one thing away from this piece, I want you to remember this: The expected value of covid-19 prevention has never been higher. The argument that all the precautions were unsustainable, so we might as well just all get it now, were unfortunately persuasive if a vaccine was five years away. If it’s five or six months away, however, it’s worth staying the course, or maybe even increasing your vigilance a little, to avoid a substantial risk of death or lifetime disability.
All hail to science
Which brings me to my final thought: Whatever we have suffered in the past eight months, and whatever we are suffering now, we have been witnesses to a miracle. At no time before in human history would it have been possible to slow the spread of a novel disease collectively, much less to hope for a vaccine so shortly after the emergence of the virus. Our ancestors could never have afforded to focus so much of humanity’s efforts on the same problem and at the same time. Nor would they have had the scientific expertise they needed to manage it. However miserable this pandemic has been, those of us who are still surviving it should remember that we are damned lucky to be alive right now, in every sense of those words. Thank you Pfizer!
See you next week,
PS: Thank you for the 1.200 unique reads so far!
PSS: On advice of one of the readers, I will be posting a monthly compilation of the best stories on Substack so you can get them directly in your mailbox. Have a look at https://laurentdossche.substack.com/