Will the poorest and most vulnerable get access to the Covid-19 vaccine?
Penicillin was first discovered by Alexander Fleming in 1928. Fleming’s discovery of penicillin happened, like many other invention or discoveries, fortuitously than by design.
Fleming was a devout researcher, and at the time was working at St Mary’s Hospital in Paddington, London. His research was on the common bacteria called “staphylococcus,” and he was experimenting on discovering its various strains that could be grown naturally. He had left the bacteria to grow in a culture media in his laboratory, accidentally leaving the petri-dish uncovered by mistake and went away for a few days.
On his return, and to his absolute surprise, he noticed that a fungus, penicillium chrysogenum/rubens, had taken the opportunity to contaminate the growth media, consequent of leaving the petri-dish uncovered, and had stopped the growth of the staphylococcus around the mould, completely, closest to the fungus and the inhibition faded in decreasing gradient, as the distance between the fungus and the bacteria extended.
This was due to the production of the antibiotic by the fungus, which Fleming was given the honour to name. That was how penicillin was discovered, the first of the antibiotics to revolutionize humanity’s battle against bacteria. Fleming however, to his bewilderment and annoyance, failed initially to draw any attention from the scientific community, despite presenting his discovery to the most prestigious audiences including the members of the Royal Society.
Not for another 11 years had there been any progress with penicillin, and only when the Oxford scientists Chain, supported and advised by Norman Heatley and his head of department Howard Forley, started experimenting on sizeable production of the chemical, which they successfully achieved in the 1940s.
Fleming was awarded the Nobel Prize and the knighthood, and scientists all over the world appreciated their pioneering and revolutionary work. It is said that without Fleming, no Chain; without Chain, no Flory; without Flory no Heatley; without Heatley, no penicillin.
Companies like Merck and Pfizer had benefitted beyond their dreams and earned billions by commercially producing the drug penicillin, but the University of Oxford -- neither the academics nor the institution -- made not a single farthing from their real drudgery, while making the pharmaceutical companies like Pfizer and Merck wealthy beyond their reverie.
A similar scenario is being played out on the world stage now with the development and manufacturing of vaccines for coronavirus. Pfizer and Moderna have both announced the result of their phase III trial with extremely heartening outcomes. Both have utilized a new technique of adopting Messenger Ribo-Neucleic-Acid (mRNA) of the spike protein component of the coronavirus that allows entrance of the virus into human cells, turning human cells into a production factory for the virus, which then destroys infected cells, tissues, and organs with impunity.
Both the vaccine companies produced vaccines based on the viral mRNA to stimulate the human immune mechanism of combating the virus. Both have successfully demonstrated, in their large-scale phase III Trial, that both the vaccines are effective, approximately in 95% of cases, in preventing the virus taking hold and harming the infected individuals.
The principal difference between the two vaccines relates to the method of preservation after manufacturing. The vaccine produced by Pfizer, the second largest pharmaceutical giant in the world, needs to be preserved in an environment ensuring a -92 degree Fahrenheit temperature in an ultra-low freezer in contrast to that of Moderna, a relatively small biotech company, which can be preserved in normal freezer temperature.
The Oxford University vaccine developed by the university and manufactured by AstraZeneca, “ChAdOx1 nCoV-19” is a recombinant vaccine (the viral anatomy is manipulated, restructured, reconstituted), the inner core or template is a modified adenovirus causing common cold in chimpanzees.
As I have mentioned in the past, it is modified in such a way that even if it enters human cells, it is incapable of replicating and thus rendered harmless. The second component of the vaccine is a genetically modified spike glycoprotein of the SARS-CoV-2 virus, that initiates a human immune response and generate antibody and T-cell-mediated longer standing immunity.
The Oxford vaccine received approval for trial towards the end of March, and phase 1 clinical trials started on April 23 in healthy volunteers aged between 18-55. It had completed its phase I and phase II trial involving, among others, the elderly. The result of the large-scale phase III trial is likely to be published next month. The phase II trial data have shown robust responses in the elderly without any mentionable adversity, and this discovery of the robust response in the elderly has not been demonstrated in other vaccines as yet.
This disclosure is extremely important, as the elderly are unlikely, in normal circumstances, to produce significant immune responses due to their declining ability of their immune mechanism.
The Oxford vaccine is already in production. Given the devastation unleashed by the virus, the immediate start of large-scale manufacturing following rigorous safety standards guarantees availability of the high quality, safe vaccine when approved for use, and the Oxford authority believes that their vaccine would not be much behind the Pfizer or the Moderna vaccine in action, and would play a significant role in ending the pandemic.
And here comes the role of the academics in saving the distressed and suffering humanity. Whereas the cost of the vaccine produced by Pfizer and Moderna would vary between $25 to $45, the cost of the Oxford vaccine produced by AstraZeneca will remain at $3-$4 until the pandemic is ended as agreed in the contract between the university and AstraZeneca, making the vaccine affordable for the economically weak and the most vulnerable of society.
The clause in the contract was incorporated in the insistence of the academics involved in the development research, ensuring the access of the poor and vulnerable in their survival endeavour against the most villainous virus in the vicinage.
Dr Raqibul Mohammad Anwar is Specialist Surgeon, Global Health Policy and Planning Expert, and Retired Colonel, Royal Army Medical Corps, UK Armed Forces.