SARS-CoV-2 Vaccines

This wiki is intended for healthcare professionals and should not be considered medical advice.

General


WHO/COVID-NMA consortium vaccine research living map

RAPS - COVID-19 Vaccine Tracker

Nigel Watson. Recorded 11 Dec 2020. COVID vaccines for Wessex clinical teams (Video)

Medcram.com. Published 17 Dec 2020. COVID 19 Vaccine Deep Dive: Safety, Immunity, RNA Production, with Shane Crotty PhD (Video)

UK Vaccinations Greenbook: Chapter 14a on the vaccination program for COVID-19 and SARS-CoV-2 - covers Pfizer and AstraZeneca at time of writing (02/02/2021 17:25). The chapter includes information on the disease, priority risk groups, dose scheduling, adminstration, storage and disposal.

Florian Krammer's vaccine "tweetorial" about vaccines and variants.

First dose prioritisation, dose delay or single dose strategies
Voysey M et al (1 Feb 2021) Single Dose Administration, And The Influence Of The Timing Of The Booster Dose On Immunogenicity and Efficacy Of ChAdOx1 nCoV-19 (AZD1222) Vaccine. The Lancet Pre-print.(accessed 2.8.21). This paper concerns the Oxford-AstraZeneca vaccine.

UK Joint Committee on Vaccination and Immunisation. (31 Dec 2020) Optimising the COVID-19 vaccination programme for maximum short-term impact (short statement).  This statement was referenced in the CMO letter (31 Dec 2020)  "A letter to the profession from the UK Chief Medical Officers, regarding the UK COVID-19 vaccination programmes". [Note: The link to the JCVI minutes available here on GOV.UK was broken at time of writing 02/01/2021 17:00]

Department of Health and Social Care (30 Dec 2020) Statement from the UK Chief Medical Officers on the prioritisation of first doses of COVID-19 vaccines

Polack et al (December 31, 2020) Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med 2020; 383:2603-2615 DOI: 10.1056/NEJMoa2034577 -See Figure 3 for one dose evidence. Numbers are small.

WHO (8 January 2021) [https://apps.who.int/iris/rest/bitstreams/1326072/retrieve. Interim recommendations for use of the Pfizer BioNTech covid-19 vaccine, BNT162b2, under emergency use listing.] WHO’s recommendation at present is that the interval between doses may be extended up to 42 days (6 weeks), on the basis of currently available clinical trial data.

Jurgens, GT Modelling Decay of Population Immunity With Proposed Second Dose Deferral Strategy 6 January 2021. medRxiv 2021.01.05.21249293; doi: https://doi.org/10.1101/2021.01.05.21249293

Abstract

A second dose deferred strategy has been proposed to increase initial population immunity as an alternative to the default two dose vaccine regimen with spacing of 21 or 28 days between vaccine doses for the mRNA vaccines from Pfizer and Moderna. This increased initial population immunity is only of value if one dose immunity does not decay so fast as to nullify the benefit. Because decay rates of one dose and two dose efficacy are currently unknown, a model to project population immunity between the two strategies was created. By evaluating the decay rate of one dose efficacy, two dose efficacy, and time until the second dose is given, the model shows that if there is an increased decay rate of one dose efficacy relative to two dose decay rates, it is highly unlikely to nullify the benefit of increased population immunity seen in a second dose deferral strategy. Rather, all reasonable scenarios strongly favour a second dose deferral strategy with much higher projected population immunity in comparison to the default regimen.

Robertson JFR, Sewell HF, Stewart M, Kendrick D, Agius RM Covid-19 vaccines: to delay or not to delay second doses BMJ Opinion, 5 January 2021

Twitter discussions on delaying second dose of Pfizer vaccine approach in the UK:
 * Doctors' Association UK Letter to Matt Hancock
 * Prof Akiko Iwasaki
 * Sandy Douglas

Mixing between different types and brands of vaccinations
University of Oxford (4 Feb 2021). Oxford leads first trial investigating dosing with alternating vaccines | University of Oxford [Internet].

AstraZeneca/Oxford
Hilda Bastian. The AstraZeneca Covid Vaccine Data Isn't Up to Snuff. WIRED: 25 Nov 2020.

Pfizer/Biontech
Pfizer (27 Jan 2021). "In vitro studies demonstrate Pfizer and Biontech covid-19 vaccine elicits antibodies that neutralize SARS-CoV-2 with key mutations present in U.K. And South African variants"

Novavax
Novavax, Inc. (28 Jan 2021) Novavax Press Release: Novavax COVID-19 Vaccine Demonstrates 89.3% Efficacy in UK Phase 3 Trial "First to Demonstrate Clinical Efficacy Against COVID-19 and Both UK and South Africa Variants"