FDA says it concludes inspection of Emergent plant, issues 483 letter. Production of J&J vaccine remains stopped until issues are remediated. 483 letter here: fda.gov/media/147762/d…
FDA observations re Emergent plant:

1: Failure to conduct thorough investigations into unexplained discrepancies.

Specifically, cross-contamination of two viral vaccines. FDA: “there is no assurance that other batches have not been subject to cross-contamination.”
Note- FDA cites “cross-contamination of client [redacted] viral vaccine drug substance batch... with the virus from client [redacted].”

Emergent’s CEO April 1: “It wasn’t the case where an ingredient from one vaccine contaminated or impacted the other.”

cnbc.com/video/2021/04/…
Observation 2: The building used for manufacture of the client [redacted] viral vaccine drug substance and client [redacted] viral vaccine drug substance is not maintained in a clean and sanitary condition.

Waste not decontaminated, peeling paint on floors & walls, FDA notes
Observation 3: The building used for the manufacture of the client [redacted] viral vaccine drug substance and client [redacted] viral vaccine drug substance is not of suitable size, design, and location to facilitate cleaning, maintenance and proper operations
Observation 4: Written production and process control procedures to prevent cross-contamination are not followed in the execution of production and process control functions and are not documented at the time of performance.
Observation 4 includes reference to a manufacturing worker who didn’t de-gown and shower while moving between different manufacturing areas of the Emergent plant - the reported (by NYT) way contamination of J&J vaccine happened
Observation 5: The components, product containers and/or closures were not handled and/or stored in a manner to prevent contamination.

Security camera footage revealed employees carrying unsealed bags of medical waste, which contacted containers of staged manufacturing materials
Observation 6: Written procedures designed to assure that the drug substances manufactured in the facility have the identity, strength, quality, and purity they purport or are represented to are inadequate.

Mainly, issues with decontamination:
Observation 7: Employees were not trained in the particular operation that they performed and/or in CGMPs (Current Good Manufacturing Practices) related to their job function.

Review of security cam footage observed employees moving btw spaces & moving waste w/o proper controls
Observation 8: Equipment used is not of adequate size to facilitate operations for its intended use or for cleaning and maintenance.
Observation 9: Equipment and/or utensils are not cleaned and maintained at appropriate intervals to prevent contamination that would alter the safety, identity, strength, quality or purity of the drug substance.
In statement on FDA’s inspection, Emergent says “the issuance of findings by the FDA is normal following a facility inspection,” & that issues identified “are correctable and we will take swift action to remedy them.” (H/t @strickdc)
J&J says in statement it “will exercise its oversight authority to ensure that all of FDA’s observations are addressed promptly and comprehensively” at Emergent plant, and notes global vaccine supply network it’s establishing “to meet its commitments.”
FDA’s @DrWoodcockFDA & Peter Marks add in statement that Emergent’s production of J&J vaccine will be paused, no product released until issues at plant are resolved.

This is the only U.S. plant making J&J #covid19 vaccine drug substance at the moment, until Merck comes on board.

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More from @megtirrell

26 Feb
WH #covid19 response briefing:

-@aslavitt46: Nearly 1 in 5 adults and nearly half Americans 65+ have received first shot
.@aslavitt46: Biden Admin asking businesses to:
-require masking & social distancing to protect workers, customers
-reduce barriers to vaccination, provide incentives (paid time off, compensation)
-communicate w customers, educate public about benefits of masking & vaccination
.@aslavitt46 on business contribution:
🔹Ford and the Gap producing & donating millions of masks
🔹Pro sports & live events offered 100+ stadiums, venues for vaccination sites
🔹Retailers like Best Buy, Target, Dollar General gave 500K+ workers PTO or compensation to get vax
Read 11 tweets
25 Feb
Moderna notes in earnings release this AM it's completed enrollment of its #covid19 vaccine study in kids ages 12-17 (study is called TeenCOVE); a phase 2 study in ages 6 months - 11 years (KidCOVE) will start "in the near-term" investors.modernatx.com/news-releases/…
Along w boosters of original vaccine & B.1.351-tailored vaccine, Moderna says it's developing a next-gen vaccine encoding for portions of the spike protein critical for neutralization (RBD & NTD). Shorter antigen & hoped to be fridge-stable. Plans to test as booster and primary.
Moderna details #covid19 vaccine supply deals:
US: 300M (option for 200M more)
EU: 310M (option for 150M in 2022)
Japan: 50M
Canada: 44M
Korea: 40M
UK: 17M
Switzerland: 13.5M
Colombia: 10M
Israel: 6M
Taiwan: 5M
Singapore: undisclosed
Qatar: undisclosed
Read 4 tweets
24 Feb
White House #covid19 briefing now. @JeffZients says in March, govt will delivering millions of masks to food banks and community health centers around the country. In total, 25M masks to more than 1300 health centers and 60k food pantries nationwide. Free, American-made.
.@JeffZients: Masks will be well-fitting cloth masks available in children’s and adult sizes, and can be washed for reuse, all consistent with CDC guidance.
.@JeffZients on #covid19 vaccine allocation this week: 14.5M doses to states, 2.1M doses to federal retail pharmacy program. Notes pharmacy program “has performed well so far.”
Read 7 tweets
22 Feb
In written testimony posted ahead of Congressional hearing tomorrow, Moderna president Stephen Hoge notes the company is in the process of 'onboarding' another fill-finish partner (along w Catalent) for its #covid19 vaccine in the US: docs.house.gov/meetings/IF/IF…
Written testimony also showing how mRNA vaccine supply is ramping up in US:

Moderna says it aims to double output to 40M+ doses per month by April: docs.house.gov/meetings/IF/IF…

Pfizer says it's more than doubling to 13M+ doses per week by mid-March: docs.house.gov/meetings/IF/IF…
J&J updates on expected #covid19 vaccine supply in written congressional testimony for hearing tomorrow: 20M+ doses to US by end of March, assuming necessary regulatory approvals re: manufacturing (100M total by end of June; 1-dose vaccine): docs.house.gov/meetings/IF/IF…
Read 8 tweets
5 Feb
WH #Covid19 briefing:
@aslavitt46 says US govt using Defense Production Act to:
-increase supply of vaccinations
-scale tests
-reduce dependence on foreign supplies
.@aslavitt46: 6 more cos will surge manufacturing of at-home test kits, with goal of by summer millions of Americans being able to access at-home tests
.@aslavitt says Defense Sec ordered first contingent of 1000+ active duty military personnel to support state vaccination sites. Part of group will start to arrive in CA within next 10 days to begin operations around Feb 15, with additional vaccination missions soon to follow
Read 8 tweets
2 Feb
New Oxford/AstraZeneca #covid19 vaccine pre-print. Pooled analysis of their phase 3 efficacy trials in UK & Brazil + phase 1/2 clinical trials in UK and South Africa.

17,177 volunteers overall
UK: 8,948
Brazil: 6,753
South Africa: 1,476

332 infections >14 days post dose 2
Overall vaccine efficacy for Oxford/AZ #covid19 vaccine >14 days after 2nd dose = 66.7%

Complete protection against hospitalization "after 21 day exclusion period." (15 hospitalizations in control group, none in vaccine group.)
Oxford/AZ report #covid19 vaccine efficacy of 76% with just a single shot, between Days 22 and 90.

Say antibody levels are maintained with minimal waning 3 months out.
Read 4 tweets

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