AstraZeneca’s Vaccine Could Be a Marvel for Lower, Middle-Income Countries

AstraZeneca’s (AZ) and the University of Oxford’s COVID-19 vaccine candidate — which has been shown to be 90 percent effective at a one-and-a-half-dose level — could be a godsend for low- and middle-income nations due to its relative ease of distribution, high manufacturing capacity and the not-for-profit price the drugmaker has vowed to offer developing countries “in perpetuity.”

The world could see supplies of up to 3 billion doses of the promising vaccine, AZD1222, in 2021, AZ said, which would help to cover a significant portion of global population. Further, the vaccine will be provided globally at cost as long as the pandemic lasts, and low and middle-income nations will always be able to get it at the not-for-profit price even after the crisis is determined to be over, Oxford said.

The World Health Organization (WHO) will provide the vaccine at no more than $3 per dose through its COVAX project if the candidate is approved. That price is far cheaper than competitors such as Pfizer and Moderna, which are pricing their vaccines at $19.50 per dose and $32 to $37 per dose, respectively.

“The vaccine’s simple supply chain and our no-profit pledge and commitment to broad, equitable and timely access means it will be affordable and globally available supplying hundreds of millions of doses on approval,” Oxford University said.

A one-and-a-half dosing regimen of the AZ vaccine is looking to be nearly as effective as the competing two-dose candidates from Moderna and Pfizer, which have demonstrated 95 percent efficacy, according to data from AZ’s first interim analysis unveiled yesterday.

 AZD1222’s one- and-a-half dose regimen proved to have a 90 percent efficacy rate, while its double-dose regimen demonstrated a notably lower 62 percent efficacy. The interim analysis looked at 131 confirmed coronavirus cases and found that of the patients treated with the vaccine, none needed hospitalization or developed severe COVID-19. Additionally, no serious safety events related to the vaccine were noted.

Another boon offered by AZ’s vaccine is its storage requirements that will help ease distribution burdens, especially in developing nations. The vaccine may be stored at standard refrigerator temperatures of 35.6 to 46.4 degrees Fahrenheit, meaning already established logistics for vaccine distribution will be able to accommodate shipping of the vaccine without much trouble.

By contrast, Pfizer’s vaccine, which is 95 percent effective and was the first to reach the Emergency Use Authorization (EUA) request milestone in the U.S., could be complicated to ship with its -94F degrees requirement, though its partner BioNTech said it’s working on a formula that will allow room temperature distribution (DID, Nov. 23). Adapting for ultra-cold shipping will be a challenge in developed nations but would likely be significantly more difficult in low- and middle-income countries.

Moncef Slaoui, chief adviser of the government’s Operation Warp Speed project, predicted during an interview Sunday that the first administrations of Pfizer’s vaccine could occur across the U.S. as soon as Dec. 11 or 12. The government stands ready to ship vaccines to immunization sites within 24 hours of an EUA being granted, he said.

“With the level of efficacy we have, 95 percent, 70 percent or so of the population being immunized would allow for true herd immunity to take place. That is likely to happen somewhere in the month of May, or something like that, based on our plan,” he said.

Moderna has not yet made an EUA filing to FDA for its 94.5 percent effective vaccine, as it still needs to conduct a final analysis, though it is expected to do so soon. — James Miessler