SARS-CoV-2 Vaccines

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

General

Summary of coronavirus vaccine trials November 2020 - screenshot from Nigel Watson's video at 09:00min

WHO/COVID-NMA consortium vaccine research living map

RAPS - COVID-19 Vaccine Tracker

Medical News Today - COVID-19 vaccine: Live updates - MNT news team updates this page regularly

New York Times - Covid World Vaccination Tracker - Global vaccines administered tracker

Public Health England COVID-19 Vaccine Surveillance Reports: Data on the real-world effectiveness and impact of the COVID-19 vaccines

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

Cunningham AM, Flaxman A, Marchevsky N et al. (28 June 2021) Tolerability and immunogenicity after a late second dose or a third dose of ChAdOx1 nCoV-19 (preprint). (AZD1222) Lancet preprint.

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 and looks at evidence for 12 weeks strategy.


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) 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:

Mixing between different types and brands of vaccinations

Liu X, Shaw RH et al. (28 June 2021) Safety and Immunogenicity Report from the Com-COV Study – a Single-Blind Randomised Non-Inferiority Trial Comparing Heterologous And Homologous Prime-Boost Schedules with An Adenoviral Vectored and mRNA COVID-19 Vaccine (preprint). Lancet preprint.

Shaw et al. (12 May 2021) Heterologous prime-boost COVID-19 vaccination: initial reactogenicity data. The Lancet Correspondence. Vol 397, Issue 10289, p.2043-2046. DOI: https://doi.org/10.1016/S0140-6736(21)01115-6

University of Oxford (4 Feb 2021). Oxford leads first trial investigating dosing with alternating vaccines | University of Oxford [Internet].

Long Covid and vaccination

On prevention: Some cases reported. Aria Bendix (18 Jun 2021). A 33-year-old nurse got long COVID despite being fully vaccinated. Doctors think we may see more of these rare cases. Business Insider.

On symptoms: Ondine Sherwood, W David Strain and Jeremy Rossman (May 2021) The impact of COVID vaccination on symptoms of Long Covid. An international survey of 900 people with lived experience [not peer-reviewed/pre-print]. This is a survey that was circulated amongst different Long COVID groups.

When we combined differences in scores across all symptoms, we found 56.7% of people saw an overall improvement and 18.7% a deterioration in their symptoms, with 24.6% remaining unchanged. Once broken down by vaccine, we can see that those who had Moderna were more likely to report improvements and less likely to report deterioration

Measuring antibody levels post vaccination

Thomson H. (12 Mar 2021) Should you measure your antibody levels after a coronavirus vaccine? Commercial tests that promise to measure your immune response aren't very useful, at least for now, finds Helen Thomson. New Sci. 2021 Mar 13;249(3325):10. doi: 10.1016/S0262-4079(21)00397-3. Epub 2021 Mar 12. PMID: 33746327; PMCID: PMC7954518.

AstraZeneca/Oxford

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

Pfizer/Biontech

Amit S, Regev-Yochay G, Afek A, Kreiss Y, Leshem E. Early rate reductions of SARS-CoV-2 infection and COVID-19 in BNT162b2 vaccine recipients (18 Feb 2021). The Lancet - Correspondence. 2;0(0).

Our data show substantial early reductions in SARS-CoV-2 infection and symptomatic COVID-19 rates following first vaccine dose administration. Early reductions of COVID-19 rates provide support of delaying the second dose in countries facing vaccine shortages and scarce resources, so as to allow higher population coverage with a single dose. Longer follow-up to assess long-term effectiveness of a single dose is needed to inform a second dose delay policy.

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"

Hall VJ, Foulkes S, Saei A, Andrews N, Oguti B, Charlett A, et al. (Feb 2021) Effectiveness of BNT162b2 mRNA Vaccine Against Infection and COVID-19 Vaccine Coverage in Healthcare Workers in England, Multicentre Prospective Cohort Study (the SIREN Study) . Rochester, NY: Social Science Research Network; 2021 Feb. Report No.: ID 3790399.

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"