Vaccines update…

Last week, we all had the good news from Pfizer, this week more good news from Moderna both announcing over 90 per cent effectiveness in Phase 3 clinical trials.  These are just two of 12 vaccine undergoing phase 3 trials worldwide, including 3 involving clinical trials here in Scotland.

Pfizer and Moderna will share evidence from clinical trials with the regulatory and advisory bodies to allow clinical and scientific review, with advice then to each UK health department to determine on safety and effectiveness. 

The safety of the COVID-19 vaccine is paramount for the Scottish Government. The global scientific, research and pharmaceutical community has come together and worked as never before. We’ve seen unprecedented investment worldwide in research, development and manufacture; people across the world – including here in Scotland – volunteering to take part in clinical trials; and driven and dedicated research teams. 

That is why we are seeing these front running vaccines delivered in months, rather than the many years that vaccine development can sometimes take.

Each vaccine goes through a rigorous and independent 3 phase testing process, long before it can be licensed as safe and effective for use. 

Regulators (like the European Medicines Agency in Europe or the Medicines and Health products Regulatory Agency in the UK) review the trial results and decide whether to approve the vaccine or not. During a pandemic, this timeframe can be compressed but never at the expense of safety.

Vaccinating the adult population in Scotland – everyone 18 and over – is 4.45 million people. The Scottish Government has, rightly, worked on a four nations basis to secure the vaccines and agreement on the population share of the doses purchased for each of the UK nations. 

From December, the Scottish Government expects to see the first delivery of vaccines to Scotland. The Scottish Government is planning on the basis both that the Joint Committee on Vaccination and Immunisation is able to review the clinical evidence and provide Governments with a recommendation, and that the vaccine receives a license.

The Scottish Government is hopeful that over the coming weeks into 2021, we will have more than one vaccine available so that they can – with minimum delay – vaccinate as many people as possible as quickly as possible. 

However, there are a number of challenges and, at this point, unknowns to the delivery programme which the Scottish Government hopes will, in full, take from December to Spring next year to complete.

The first of those is clearly the start date.  The Scottish Government is ready for December, but the first vaccine available has to be approved and supplies have to arrive.  Thereafter, we need to see more vaccines become available and to understand the delivery schedules for each.

The Pfizer vaccine has specific requirements in terms of transportation, storage and accessibility for use in certain settings. Other vaccines will have their own requirements – they may be similar to Pfizer, they may be different. It will be important to understand those differences to inform clinical advice about deployment. 

A vaccine must be used in a way that ensures those most in need of protection receive that protection first, so the Scottish Government’s planning will be informed by independent scientific and clinical advice from the Joint Committee on Vaccinations and Immunisations. 

In the first wave of the plan – from December through to February, Scotland will vaccinate frontline health and social care staff, older residents in care homes, care home staff; all those aged 80 and over, unpaid carers and personal assistants and those who will be delivering this vaccination programme.

The current – interim – advice from JCVI is that we then work through those aged over 65 and those under 65 who are at additional clinical risk. We then move on to the wider population.

Over the coming weeks and month, the Scottish Government will be sending out information explaining what the vaccine is, how they are prioritising who gets the vaccine, what to expect when you are vaccinated. 

For those in the first wave of the programme –

  • You will be contacted during December and January either by mail or for health and social care workers, by your employer and
  • You will be told where you will receive your vaccine, how to make an appointment and what you need to know.

Scotland has an excellent track record on vaccinations, but this is to be one of the biggest civilian logistical challenges in our lifetime. So, the Scottish Government has strengthened their NHS planning teams, engaging with local authorities, local resilience partnerships and the military.

It is important to be clear about what we don’t yet know.

We don’t know which vaccines will be approved for use, and when doses of those vaccines will reach us. We do not yet have information about all the vaccine characteristics – for instance we don’t yet know whether the Pfizer vaccine will be approved for transportation beyond the Ultra Cold Temperature currently used in order to allow us to vaccinate in multiple smaller locations like GP practices and care homes. 

Although we have some welcome news on the efficacy of the vaccine from the trials we don’t know if this vaccine will stop you getting the virus, stop you passing the virus on or prevent it from causing serious harm. 

While Pfizer and Moderna are reporting up to 95 per cent efficacy, their data has not yet been shared for scrutiny and it may take many months before we fully understand the level of protection on transmission and the impact on reducing the severity of the illness caused by the virus. 

We know that the first vaccines will require 2 doses, 3 to 4 weeks apart.  It is possible that further booster doses, and even an annual programme might be required, given we do not know how long any protection will last.  For now, the important thing is that when we start to deliver these first vaccines, it will be on the basis that it will offer at least some form of protection, even if we don’t at this stage know how much that is. 

A safe and effective vaccine does bring hope. It gives us all encouragement that where we are now will end.  But right now, we have to all keep following the necessary restrictions tough though I know they are, keep washing our hands, wearing face coverings, keeping 2m distance.  That’s how we protect ourselves, our loved ones and our NHS as science itself brings us hope.

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