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Which Vaccine Maker Will Win the Fight Against COVID-19?

Kinjel Shah
·5 min read
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Four drug companies have launched their COVID-19 vaccines. While Pfizer PFE-BioNTech’s BNTX BNT162b2/Comirnaty, Moderna’s MRNA mRNA-1273 and J&J’s JNJ single-shot COVID-19 vaccines are available on an emergency basis in the United States, AstraZeneca’s AZN COVID-19 vaccine is not yet approved in the country. Pfizer, Moderna and AstraZeneca’s vaccines are available in several other countries.

A comparison between the vaccines is inevitable even though all four products are required to inoculate the world’s population.

Pfizer/BioNTech and Moderna had a competitive advantage as their two-shot mRNA-based vaccines were launched toward the end of 2020, much earlier than AstraZeneca and J&J’s jabs. Pfizer/BioNTech and Moderna’s vaccines were about 95% effective in clinical trials. AstraZeneca’s vaccine was, on average, about 76% effective in preventing COVID-19. J&J’s single shot vaccine was about 66% effective in preventing COVID-19.

Initially there were concerns about allergic reactions occurring in people who received Pfizer’s shots. Also, their products, especially Pfizer’s vaccine, required ultra-cold storage equipment to be preserved properly. Eventually the issues got sorted. Regulatory authorities approved storage of Pfizer’s vaccine at refrigerator/freezer temperatures of -25°C to -15°C (-13°F to 5°F) for a total of two weeks as an alternative or complement to storage in an ultra-low temperature freezer. Pfizer/BioNTech and Moderna’s vaccines now make up the majority of shots administered in the United States.

AstraZeneca’s vaccine is the cheapest and most widely available. Meanwhile, J&J has the competitive advantage that its vaccine is the only COVID-19 vaccine to be approved for single administration. A single dose requires lesser vaccine production and also ensures patient convenience.

However, J&J and AstraZeneca’s vaccines are now under scrutiny for possible links to very rare cases of blood clots in the brain. On Tuesday, the FDA and U.S. Centers for Disease Control and Prevention (CDC) jointly issued a statement to recommend a temporary pause in the use of J&J’s vaccine in the United States as they review six reports of “rare and severe” blood clots in a few individuals who had taken the J&J one-shot COVID-19 vaccine. The European Medicines Agency (“EMA”) safety committee, Pharmacovigilance Risk Assessment Committee (“PRAC”) is also reviewing similar reports of blood clots.

Meanwhile, The UK’s Medicines and Healthcare products Regulatory Agency and EMAfound a “possible link” between AstraZeneca’s COVID-19 vaccine and extremely rare blood clot events. The World Health Organization also said that a “causal relationship” between the vaccine and blood clot risk factors events is probable. However, all these regulatory bodies maintained that that the vaccine’s benefits outweigh the risks.

Some European countries temporarily suspended the use of AstraZeneca’s vaccine after reports of blood clots emerged while many restricted its use in younger people. Dr Anthony Fauci, the chief medical advisor to the President, said that the U.S. market may not need AstraZeneca’s vaccine at all, even if it wins regulatory approval as the country has enough contracts with other vaccine makers to vaccinate its entire population. This was another blow to AstraZeneca’s prospects.

There were also supply shortages of AstraZeneca’s vaccine to different member countries of the European Union due to difficulties with international supply chains.

Please note that J&J and AstraZeneca’s vaccines have been developed using adenovirus technologies while Pfizer and Moderna’s vaccines are mRNA-based vaccines. Scientists are now thinking whether the adenovirus technology may be contributing to the risk.

Some investors are of the opinion that Moderna and Pfizer/BioNTech may gain additional market share from safety issues related with J&J and AstraZeneca’s COVID-19 vaccines. No clot cases have been reported in people who have received either the Pfizer or Moderna vaccine.

Moderna and Pfizer are expected to help make up for a potential shortfall in J&J's vaccine supply if the pause in its rollout is extended. However, Pfizer and Moderna will likely take some time to ramp up production.

Putting the latest situation into perspective, it seems Pfizer and Moderna are way ahead in the fight against the global pandemic. However, the blood clot issues plaguing AstraZeneca and J&J are exceptionally rare occurrences as only a few cases have been identified out of several million people vaccinated with J&J’s and AstraZeneca’s vaccines in the United States and Europe/United Kingdom, respectively. The regulatory authorities are taking steps to ensure that healthcare providers are prepared to treat blood clots if they occur.

There are high chances that vaccinations may resume in all groups (with a proper plan for blood clot treatments) or with restrictions in use in the vulnerable population. J&J’s single-dose shot and AstraZeneca vaccine’s low-cost are seen as vital attributes in the fight against a pandemic. However, the blood clot issues could increase hesitancy of people to get vaccinated with J&J’s and AstraZeneca’s vaccines.

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