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6 Oct, 9 tweets, 3 min read
In 2022, protein-based COVID-19 vaccines could be what mRNA vaccines have not been for many lower-income countries: accessible and relatively easy to manage. Slower out of the gate than other vaccines, there are now several candidates on the near horizon. 1/
They are refrigerator stable, have promising safety profiles, and efficacy that in many cases rivals mRNA vaccines. Protein vaccines are also readily scalable, with good prospects for technology transfer 2/
nature.com/articles/d4158…
Novavax, delayed for months with manufacturing and supply woes, recently filed for authorization in several countries and WHO for its protein-based vaccine. COVAX has already purchased more Novavax doses (900 M) than any other vaccine in its portfolio 3/
launchandscalefaster.org/covid-19/vacci…
Novavax says it will produce 100 to 150 million doses/month by year’s end, and 2 billion doses in 2022. 1.1 billion of those doses, primarily from Serum Institute in India, are designated for COVAX 4/
devex.com/news/novavax-e…
Chinese pharma company Clover’s protein-based vaccine released efficacy and safety results from a late-stage trial recently, and expects to pursue WHO emergency use authorization soon 5/
cloverbiopharma.com/news/83.html
The efficacy of Clover’s vaccine appears superior to that of the inactivated vaccines (Sinopharm, Sinovac), which have been dogged by questions and “controversy on their performance”; this might shift global perceptions about Chinese vaccines 6/
science.org/content/articl…
COVAX signed a purchase agreement with Clover in June to buy 414 million doses of their protein-based vaccine. That is four times as many doses as COVAX has purchased from Sinovac and Sinopharm 7/
gavi.org/news/media-roo…
The protein-based candidate from Biological E (India)/Baylor/Texas Children’s could release Phase 3 results soon and expects to have 300 million doses ready by Dec and produce 1.2 billion doses in 2022 8/
hindustantimes.com/india-news/bio…
There are yet others from Russia, Cuba, Taiwan, and elsewhere. In all, at least 11 protein-based vaccine candidates are in late-stage trials, so the expectation is we will see a number of them debut this year and early next 9/
nytimes.com/interactive/20…

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More from @joshmich

Josh Michaud Profile picture
6 Oct
Wonderful: a malaria vaccine is now recommended for use in high burden areas, and could save tens of thousands of lives a year
who.int/news/item/06-1…

(For sense of the timing: initial Phase 3 trial results for this vaccine were published a decade ago!)
nejm.org/doi/10.1056/NE…
WHO and others careful to note the vaccine is best positioned as one component of a comprehensive public health approach to malaria prevention. It is burdensome (4 shots over 18 months) and perhaps 50% effective in preventing severe malaria in kids.
Unclear how quickly it can be rolled out in African countries given the resources focused on Covid-19 vaccine distribution.

“We’re really going to have to see how the pandemic unfolds next year in terms of when countries will be ready"
nytimes.com/2021/10/06/hea…
Read 6 tweets
Josh Michaud Profile picture
4 Oct
Over 7 billion Covid-19 vaccine doses have been produced globally to date, with >1.35 billion more doses produced each month now.

Sinovac and Sinopharm produce the greatest number of vaccines monthly, with Pfizer and AstraZeneca not far behind. 1/
By the end of this year the world is likely to produce over 12 billion vaccine doses of all vaccine types.

By June 2022 the number produced could reach double that – 24 billion doses (assuming all goes well, and it usually doesn’t) 2/
Even after reserving doses for boosters, Western countries are likely to accumulate large stockpiles of vaccines over the coming months, perhaps as many as 1.2 billion doses by the end of this year.

These “surplus” doses could be redistributed to lower income countries. 3/
Read 7 tweets
Josh Michaud Profile picture
25 Aug
Keeping a wary eye on Covid trends in South America. The good: cases/deaths there have come down from devastating peaks a few months back, and there’s progress on vaccinations. The bad: Delta may have only begun to circulate, and questions about vaccine efficacy
Most countries in the region have fully vaccinated between 20 and 40% of their populations; Chile and Uruguay stand out, with >70% fully vaccinated. Countries use a mix of vaccines, mostly Chinese inactivated vaccines (Sinovac and Sinopharm), plus some Pfizer & AstraZeneca
Chinese vaccines have lower effectiveness vs symptomatic disease but protect vs hospitalizations and death.
Chile estimated the Sinovac VE vs. symptomatic Covid at 58%, and 86% vs hospitalization. For Pfizer: 88% and 97%, AZ: 68% and 100%, respectively
minsal.cl/wp-content/upl…
Read 11 tweets
Josh Michaud Profile picture
23 Aug
Some initial thoughts on full FDA approval of the Pfizer vaccine and what it might mean for vaccine acceptance in the US, based on @KFF polling and policy work
A commonly referenced finding from KFF's vaccine monitor is that 3 in 10 unvaccinated people reported they'd be more likely to get the vaccine upon full FDA approval
kff.org/coronavirus-co…
Still, I don't think it means that if unvaccinated people hear the news about full FDA approval 3 in 10 of will all of a sudden decide to get the shot based on that alone.
Read 8 tweets
Josh Michaud Profile picture
21 May
G20 summit today featured many pledges, promises and proposals to address global gaps in COVID19 vaccine access. We'll have to see how many of these become concrete actions in the weeks and months ahead.
reuters.com/world/g20-heal…
Pfizer promised to provide 2 billion doses "at cost" for lower income countries over the next 18 months: 1 billion by the end of this year and another billion by the middle of 2022.
reuters.com/business/healt…
.@gavi and J&J announced a purchase agreement of 200 million doses of the J&J vaccine for distribution through COVAX this year
gavi.org/news/media-roo…
Read 6 tweets
Josh Michaud Profile picture
15 Apr
Important data on "breakthrough" infections: CDC says 5,800 infections documented so far in the US, of which 396 (7%) needed to be hospitalized. About 77 million people have been fully vaccinated in the US.
cnn.com/2021/04/14/hea…
CDC says a "little over 40% of the infections were in people 60 or more years of age" but hard to draw too many conclusions from that given that the preponderance of the vaccinated are in that age group, too.
We knew these infections would occur, and that some could lead to severe disease and even death. In this article alone, three different experts used the phrase "not surprising" to describe the phenomenon. Vaccines are not 100% protective.
washingtonpost.com/health/2021/04…
Read 8 tweets

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