FHI is now considering whether you can choose which vaccine you want.
This case contains:
- How the different types of vaccines work
- Review of vaccines approved in Norway
- Side effects of approved vaccines
- Other vaccines that may come
- When does FHI expect to receive the various vaccines?
- What about children?
The uncertainty that has arisen as a result of the problems with the AstraZeneca vaccine means that FHI is now, for the first time, considering whether it will be possible for Norwegians to choose which vaccine against covid-19 they want.
Also read: Puts 200,000 vaccine doses in stock: NIPH is considering three different options
So far, four vaccines against covid-19 have been approved in Europe. In addition, FHI hopes that two other vaccines will be available by the summer.
All the approved vaccines try to do the same thing: To get the body to produce the spike on the outside of the coronavirus, called the spike protein.
The way they do this, however, is very different.
The goal of a vaccine
The goal of a vaccine is always the same: to train your body to recognize and fight a virus, without you having to go through the disease that could otherwise give you immunity.
There are many different ways to do this, and the different techniques have different advantages and disadvantages. Traditionally, it has involved supplying the body with a weakened or dead variant of the virus one wants to protect against.
Read also: The world has managed to eradicate only one virus: the deadly disease ravaged for thousands of years
The vaccines that have so far been approved against covid-19 in Norway, on the other hand, use a more advanced approach.
Virus vector vaccine exploits that viruses are experts at getting your body to produce things it is not really supposed to produce.
A virus is a small organism that attaches itself to other cells and uses these cells to produce copies of itself.
This virus vector vaccine uses a completely different virus than the one you want to protect against (the vector), often a harmless cold virus like adenovirus.
The virus is genetically modified in two ways: It does not multiply, but instead informs the cell it has attached to that it will produce the spiked protein of the coronavirus.
Your immune system then recognizes that that protein has nothing to do with the body. Thus begins the process of analyzing and combating the spike protein.
This starts the production of antibodies and other immune responses that fight the spike.
Should the body later become infected with the real coronavirus, the body immediately recognizes the spikes of the virus and starts fighting immediately.
Your body is a machine that is constantly producing new cells, whether it is skin cells, blood cells or hair.
The way your body knows what it is going to produce is that the cells receive the recipe for what it is going to produce through what is called “messenger RNA” – or mRNA. This is a simplified form of your DNA, and acts as a baking recipe for cell production.
An mRNA vaccine consists only of this recipe that the cells use to produce. And in the crown vaccines, the recipe is to make the spiked protein for the coronavirus.
This means that the vaccine does not contain any parts of the virus at all.
After this spike is produced, your immune system recognizes that this has nothing to do with your body, and starts the job of fighting it.
mRNA vaccines are considered a revolution for vaccines, and had never been approved for human use before the coronary pandemic.
Read also: If Pfizer’s mRNA vaccine against corona is approved, there could be a revolution
The principle behind the vaccines has been known for decades, but the challenge has been to make vaccines with a long enough shelf life. mRNA breaks down naturally very quickly.
The breakthrough was when one managed to pack the right amounts of mRNA into protective “soap bubbles” (fat particles called lipids).
Pfizer / BioNTech: Comirnaty (mRNA)
- Doses: 2, 21 days apart (FHI has extended to 6 weeks)
- Efficiency: 95 percent
- Delivery: The EU has entered into several and expanded agreements with Pfizer. Norway must be guaranteed around 7 million doses
Pfizer is the world’s largest pharmaceutical company. In collaboration with the German company BioNTech, they developed what became the first mRNA vaccine ever approved for use in humans.
The goal of health authorities worldwide was to get a vaccine that was more than 50 percent effective, and Pfizer’s clinical studies showed that their vaccine was 95 percent effective.
The vaccine has been the most logistically challenging, and requires storage at very low temperatures (-70 degrees) from the time it is produced until it is set. These requirements have now been adjusted downwards.
Should new mutations prove to be vaccine resistant, Pfizer claims they can develop a vaccine in just six weeks.
- Doses: 2 doses, 28 days apart (FHI has extended to 6 weeks)
- Efficiency: 94 percent against symptoms, 100 percent against serious illness
- Delivery: The EU has entered into several agreements with Moderna, and has the total opportunity to purchase 460 million doses. It secures Norway about 4.6 million doses.
- swelling of the forearm
- muscle pain, joint pain and stiffness
- pain or swelling at the injection site
- feel very tired (fatigue)
- rash, redness or hives at the injection site
- itching at the injection site
- Temporary paralysis on one side of the face (Bell’s palsy)
- Swelling of the face (swelling of the face may occur in patients who have had cosmetic facial injections).
- Severe allergic reactions (anaphylaxis)
Moderna is a small American pharmaceutical company that has worked actively with mRNA vaccines for a long time. Until their covid vaccine was approved, they had never before received a vaccine approved for use in humans.
The vaccine works very similar to the vaccine from Pfizer, and the results from the clinical studies are very impressive with a very high efficiency.
Read also: The modern vaccine is 94.1 percent effective – here are three graphs that explain what it means
Experience so far suggests that the vaccine produces somewhat more potent non-hazardous side effects than Pfizer’s vaccine, especially after the second dose. A few days with flu-like symptoms is not uncommon.
The company has little existing infrastructure, and therefore has significantly lower production than Pfizer.
Moderna also says that they can easily make changes to the vaccine if resistant mutations occur. This is part of the company’s agreement with the EU.
AstraZeneca / Oxford: Vaxzevria (virus vector)
- Doses: 2 doses, 4-12 week intervals
- Efficiency: 66-81 percent against symptomatic, 100 percent against serious disease, uncertain on South African mutation
- Delivery: The EU has an agreement of 300 + 100 million doses, which secures Norway 3 + 1 million doses.
The so-called Oxford vaccine, developed by researchers at the University of Oxford, started very early because they were working on a possible vaccine for a closely related coronavirus. It was a long time ago that this would be the first approved vaccine, and the one that would “save the world” because it is very easy to mass-produce. In the beginning, it was also hoped that one dose would be enough.
The vaccine is based on a genetically modified adenovirus from chimpanzees.
The development of the vaccine has since been surrounded by controversy, not least because it turned out that the best results the company had arrived at were due to a mistake in the way the study was handled. The company also published very poor results against the South African variant, which caused South Africa to drop the roll-out of the vaccine.
Also read: Mistake committed by former vaccine favorite: – Surprising, disappointing and confusing
After several serious incidents in Norway and Europe, which among other things ended in several deaths in otherwise healthy patients, FHI decided to put the use of the vaccine on hold until the causal connection was clarified.
Read also: Chief physician is crystal clear: – Definitely a connection with the vaccine
Janssen / Johnson & Johnson (virus vector)
- Doses: 1 dose
- Efficiency: 66.3 percent against symptoms, 100 percent against serious illness
- Delivery: The EU has an agreement of 200 + 200 million doses, which secures Norway up to 4 million doses
This is the only vaccine that has so far been approved for use with only one dose, but is also the vaccine that has the lowest effectiveness on paper.
The fact that you only need one dose is an advantage in almost every way: It makes the vaccine production reach more people, it makes it easier to organize the organization itself and it becomes easier for those who are to be vaccinated.
Three other vaccines can be approved
In addition to these four approved vaccines, the EU Medicines Agency (EMA) is working on the approval of three other vaccines:
CureVac: CVnCoV (mRNA)
The German company CureVac makes an mRNA-based vaccine in line with the vaccines from Pfizer and Moderna. They have entered into agreements with several other vaccine manufacturers to scale up production.
NIPH reports that they hope to receive vaccines from the company in week 27 (from 5 July)
The EU has an agreement for over 400 million doses from the company.
The company uses a completely different vaccine technology than the others on this list, a so-called subunit vaccine. This is a vaccine solution where you supply the body with parts of the virus you want to get protection against.
In the case of Novavax, the body supplies the spike protein itself from the coronavirus, rather than having the body produce it itself.
Clinical trials have shown that the vaccine is 49-96 percent effective, depending on the mutation.
NIPH reports that they hope to receive vaccines from week 23 (from 7 June).
The EU has an agreement with the company, but it is assumed that the vaccine will be particularly important in the rest of the world.
Gamaleya: Sputnik V (virusvektor)
The Russian-developed vaccine was the first to be officially approved, and has now applied for approval in the EU.
The vaccine is a two-dose vaccine that in principle works in the same way as the Astra Zeneca vaccine, but uses two different adenoviruses in the first and second dose. According to clinical studies, the vaccine has been shown to be over 90 percent effective.
The EU and Norway have no agreement to buy the vaccine, but several European countries have bought it on their own.
When will the different vaccines arrive?
NIPH presented new estimates of progress for vaccination in Norway on 30 March.
They now believe that everyone over the age of 18 in Norway will be offered vaccination by mid-July, and that it will be the large deliveries of the Janssen vaccine that only need one dose that will be decisive for when everyone will be fully vaccinated.
In these calculations, FHI has taken into account that the AstraZeneca vaccine will be used, but according to FHI, the use of the vaccine will have little effect on the time when all adults will be vaccinated.
Read also: Here is Norway’s new vaccine plan
What about everyone under 18?
Although all adults will be offered a vaccine before the summer is over, there will still be around 1.1 million children who will not have received an offer.
So far, no vaccine has been approved for use in people under 18 years of age.
Read also: 1.1 million children will not get vaccinated in Norway – what happens then?
The reason is that the vaccines have so far not been tested on children. It is only now very recently that the job of testing children has started.
On Wednesday before Easter, Pfizer announced that they have promising results for children up to the age of 12, and that they hope to be able to offer vaccines to children this autumn.
Read also: Pfizer applies to give the coronal vaccine to children up to twelve years after promising findings
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