COVID-19 research: Vaccine development – Where are we and where are we heading?

Key takeaways

Today, the University of Oxford/AstraZeneca published interim late stage Phase 3 results showing efficacy of 70% on average. The devil is in the detail, as the efficacy was 90% when the vaccine was given as a half dose followed by a full dos e (one month apart). The efficacy was 62% for two full doses one month apart. We have got used to very high efficacies but remember that the US Food & Drug Administration's (FDA) lower bound is 50% and the efficacy of a normal flu shot is 40 60%. In other words, Pfizer's, Moderna's and AstraZeneca's vaccines all seem to us very promising. Two major advantages of the AstraZeneca vaccine is that it can be stored at 2 8 C for at least six months and that it can produce up to 3bn doses in 2021 (versus 1.3bn for Pfizer and 0.5 1.0bn for Moderna, i.e. a total of c.5bn doses in 2021).

On Friday, Pfizer submitted a Emergency Use Authorisation (EUA) request to the US FDA (see press release). The external advisory committee meeting is set to take place on 10 December, so we believe approval in the US is likely in mid December (see FDA We expect Moderna and AstraZeneca to follow suit as soon as their Phase 3 studies are complete, which may be only a matter of time. It took nine days from Pfizer's interim results to its final results (and two more days for the EUA request).

In the UK, the approval process may be faster, with The Telegraph writing yesterday that the approval for using Pfizer's vaccine may arrive in less than a week, according to government sources.

It seems to us that we are on track to start a vaccination process for risk groups and healthcare workers in mid December, with this continuing in Q1 21 . In our view, mass vaccination is likely to start in late Q1 21 or early Q2 21 . Supporting this view, Spain's Prime Minister Pedro Sanchez said the vaccination process is likely to begin in January (and he expects a ‘very substantial part of the population will be able to be vaccinated, with all guarantees, in the first half of the year' (see Reuters

On treatment, the US FDA issued an EUA for Regeneron's antibody treatment for mild to moderate cases on Saturday.

Conclusion: While the near term situation and economic outlook for countries in the northern hemisphere still looks fragile, the continued good news on vaccines and treatments suggests we may be able to put the worst of the COVID 19 crisis behind us in 2021, as governments may not have to impose restrictions next autumn. We expect a more significant easing of restrictions in spring when it gets warmer.

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