Following on from the BioNTech and Pfizer vaccine announcement earlier this month, where we expressed cautious optimism, but also the need to ensure equitable access, three more vaccines (to date) have been announced.
- We outline our current position which calls for transparency from all companies and across the board – from making peer-reviewed research data available as quickly as possible and without a paywall, to publishing clear and fair pricing.
Firstly, on the face of it, it’s the brilliant news that everyone has been hoping for.
November has seen the announcement of not one, but four potential vaccines – all reaching late-stage development much faster than anything before, and all announcing effectiveness that reach 90% or above.
The potential of having multiple vaccine options is good news. However, despite the reaction of the media and the stock markets, none of these results are conclusive as of yet.
Data must be peer reviewed
Drugs and vaccines do not make it to the market, or into our bodies, on the basis of self-published, science-by-press-release, from companies with vested interests. Checks and balances are in place to ensure we get a fuller picture, such as side-effects.
The wider scientific community and the public have many questions that will only be answered once peer-reviewed data is shared for review. Questions such as, whether it’s safe and effective for everyone; whether it will prevent asymptomatic infections (thought to be what is driving the pandemic ); and questions that can’t yet be answered until more data is available over a longer period of time, including how long the vaccine protects people.
All companies that have announced preliminary results claim that the vaccine they have worked on is affordable or not-for-profit. Although what is deemed to be affordable, and for how long, varies:
- Pfizer says it “collaborates with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world”.
The pricing of the BioNTech / Pfizer vaccine is unclear, but based on negotiations with the US government it’s expected to be around $20 per dose. Two doses are required, so around $40 per person.
- Moderna has said it will not enforce patents on its vaccine for the duration of the pandemic.
There’s a wide range in the estimate of $10-$50 per dose. The US has negotiated $15 per dose; the EU is working on getting it for less for than $25. Again, two doses are required per person.
- The Oxford University AstraZeneca partnership has said: “A key element of Oxford’s partnership with AstraZeneca is the joint commitment to provide the vaccine on a not-for-profit basis for the duration of the pandemic across the world, and in perpetuity to low- and middle-income countries.”
- This vaccine would initially be priced around $3-$4 per dose, with 1.5 or 2 doses required per person.
- Russian officials have announced that the Sputnik vaccine is over 90% effective and that it will be “cheaper than rivals” and more doses will be produced.
- The initial data, released yesterday, is open to criticism due to lack of data from a phase III trial – another reminder of the importance of scientific peer review.
Profit-led corporations cannot solely and independently proclaim effectiveness without peer review, nor can they define ‘affordability’. With prices varying from $3 – $50 per dose, not all vaccines can or will be affordable.
To determine whether any of the vaccines are affordable or not-for-profit, all development costs need to be transparent, and reflect public investment with taxpayer funds, as well as additional financial support and the involvement of volunteers in trials.
The inference that costs might be inflated is based on the fact that this has been common practice among pharmaceutical corporations, which have routinely refused to disclose the true cost of research and development, and profiteered from many essential medicines for decades, including for HIV, cancer, drugs for rare diseases and treatments for children – overpricing is common practice.
When does the pandemic end?
It’s a question we’d all like to know the answer to.
AstraZeneca apparently knew the answer back in August when it was revealed in a document that it was declaring the end of the pandemic to be July 2021, essentially putting an expiration date on its no-profit pledge.
Moderna has replicated the same language, promising a non-enforcement of patents, but only while the pandemic is considered to be ongoing.
This deliberately nuanced language matters. It provides a ‘get out’ clause, allowing these corporations to initially benefit from good public relations, while also helping to curb the pandemic, but then, as soon as July 2021, being able to profit from high prices for a vaccine that will continue to be necessary.
Furthermore, since we don’t know how long the vaccine will protect people, developing yearly variations may be a gold mine for the pharmaceutical industry yielding endless profit while holding global public health to ransom.
Access must be equitable
We support the ask of the People’s Vaccine campaign, which calls for the first priority in terms of roll-out to be that all countries receive enough doses for 20% of their population. This would allow those most at risk of infection and serious illness, such as frontline workers and people with pre-existing conditions to be vaccinated first. As Winnie Byanyima, Executive Director of UNAIDS, has stressed, it wouldn’t be fair “for everyone in a rich country to receive the vaccine, while health workers die in another”.
Talk of worldwide access to a vaccine is grabbing headlines, but in contrast so are stories of ‘vaccine nationalism’ in rich countries, which are buying up the bulk of these vaccines. Equitable access is not a philanthropic gesture. A pandemic requires a global response. It’s not just a moral response but a logical one. As the World Health Organization (WHO) director general Dr Tedros Adhanom Ghebreyesusv has said, “it’s not over until it’s over everywhere”.