The corona vaccine is on the way. Minister Hugo de Jonge (Public Health) hopes that the first vaccinations can start in early January. Not every Dutch person can get a vaccination right away. In addition, more factors can interfere with the vaccination process. These bumps can still be overcome.
Approval
Vaccine developers AstraZeneca, Pfizer and Moderna are the furthest at the moment. Their vaccines are in the third and final stage of development. That means that the makers are testing the vaccines on large groups of thousands to tens of thousands of people.
When that process is completed, the pharmaceutical companies submit their data to the European Medicines Agency (EMA) for approval. That ultimately decides whether the vaccine works and is safe enough to market.
It is also important that the efficacy of the vaccine is in balance with any side effects, explains a spokesperson for the Medicines Evaluation Board (MEB).
The EMA is already evaluating the vaccines through an accelerated procedure, also known as a rolling review mentioned. According to the MEB, this accelerated state of affairs does not lead to uncertainties or risks. “We are not skipping important control steps,” the spokeswoman assures.
production
At best, the first vaccines will roll off the production line in early 2021. However, it is uncertain how many doses will be available for the Netherlands in what time frame. The cabinet hopes that 3.5 million Dutch people will be able to get vaccinated in the first quarter of 2021.
“Much depends on the production capacity of the various producers”, explains Ben van der Zeijst, former scientific director of the Netherlands Vaccine Institute and emeritus professor of vaccination at the LUMC.
“You see, for example, that Pfizer and Moderna are now showing good results, but they only have a few tens of millions of doses available by the end of this year. They have to be distributed all over the world. AstraZeneca has produced over a billion vaccines. vaccine has been approved, there is a chance that it will come to the Netherlands in February, but that is still very uncertain, “he says.
Transportation and storage
The distribution and storage of the vaccines is a complicated process that, according to Rogier Sanders, professor of virology at the University of Amsterdam (UvA), will need to be monitored very closely. This is especially true for the RNA vaccines. For example, the Pfizer vaccine must remain at a temperature between -70 and -80 degrees Celsius, even on the road in planes and trucks. A temperature of -20 seems sufficient for the Moderna vaccine.
Those freezing temperatures are necessary because “RNA is by definition a very unstable substance that is easily degradable”, says Sanders. “Although the RNA is well encapsulated in the vaccines, it is not as stable as the AstraZeneca and Johnson & Johnson vaccines, which can be kept in refrigerators,” said the virologist.
Effectiveness
Although the safety of the vaccines has not yet been optimally tested, they seem to work well. For example, Pfizer announced this week that the vaccine developed by the company has an effectiveness of 95 percent.
Sanders is cautious: “We know from other vaccines that they may be less effective in older people. They are participating in the trials, but in too small numbers to be able to say anything about it now.”
In addition, it is still unclear how long the vaccines actually retain their effectiveness, which is essential for building up herd immunity. Will it still work in six months? In a year? Do we have to get another vaccination in a while? Time will tell.
“You see with this coronavirus that antibodies decrease and people can become infected again. That can also happen after vaccination. It’s about how well the immune system’s memory will work,” says Sanders.
It kabinet also keep in mind that the corona vaccine should be given every year, just like the flu shot.
Willingness to vaccinate
Research by I&O Research shows that the number of people who are willing to vaccinate has decreased from 73 percent in June to 60 percent at the moment.
We do not know exactly what percentage of the Dutch population must be vaccinated with a corona vaccine to create group immunity, according to Sanders. This coverage can differ per disease and vaccine. For example, measles is very high, at about 95 percent.
Moreover, if the willingness to vaccinate remains too low, the vulnerable can suffer if the vaccine proves to be less effective for them.
Van der Zeijst thinks that the willingness to vaccinate will be fine. “Those tests are a daily course. You will see that if a few people are vaccinated they will go up.”
According to him, another factor is that only a limited number of people will belong to the first vaccination group. “So people can choose: either you go now or you end up at the end of the queue.”
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