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A Look At COVID-19 Vaccine Development Progress


This week, the nation passed the milestone of 250,000 deaths from COVID-19 - a quarter of a million lives lost to a pandemic that continues to rage from coast to coast across the country. But even amid the warnings of a dark winter ahead and the CDC strongly recommending that Americans stay home for Thanksgiving next week, there is hope. That's because the race to produce a COVID-19 vaccine is moving swiftly, both here in the U.S. and around the world. To learn more about the many different vaccines being developed, we're joined now by NPR correspondents Richard Harris, Lauren Frayer and John Ruwitch. Welcome, everyone.




FADEL: So Richard, I want to start with you. Here in the U.S., we've heard the vaccines being developed by two pharmaceutical companies, Pfizer and Moderna, are both around 95% effective. The next step would be for the federal Food and Drug Administration to review them and grant emergency use authorization. Can you tell us what that review involves? How does the FDA decide whether to grant authorization?

HARRIS: Sure. Well, the FDA's job is to make sure that any new drug is safe and effective. Safety is especially important for a drug that will be distributed to hundreds of millions of Americans. So the FDA has taken pains to say that it is not cutting corners on its usual review.

For example, the FDA insisted on two months of follow-up for half of the volunteers in these original studies to gather the kind of safety data they need. Now that that data is in hand, the FDA can move pretty quickly in its review. They plan to hold a public committee meeting to discuss this on December 10. And health officials expect a decision before the end of the year.

FADEL: Wow. So assuming both vaccines meet the FDA's threshold for emergency use authorization, then what? Who gets access first and when?

HARRIS: Right. Well, who gets the vaccine first will actually be up to a committee at the Centers for Disease Control and Prevention that's responsible for vaccines. And they actually won't make that call until the FDA has made its call. For example, one of those vaccines might be better suited for older people, and that could affect how the first doses get prioritized.

But in general, public health experts expect that vaccines would go first to people who are putting their lives on the line, especially in hospitals and other health care settings. And older people and those with underlying health conditions would also be high on the list, as would frontline workers, like bus drivers and others in the service industry. Americans who are generally healthy and not at super high risk might need to wait maybe 'til late spring or even early summer, depending upon how quickly these vaccines are produced, and, in fact, how many products are available because there are actually others in the pipeline.

FADEL: So as we mentioned earlier, COVID vaccines are being developed elsewhere around the world. China has several, and I understand they're already in use. John Ruwitch, you've been reporting on this. Who in China is getting the vaccines, and how effective are they?

RUWITCH: Yeah, China's got four vaccines that are in Stage 3 clinical trials, the final stage. But in the summer, they approved three of them for emergency use. Inside China since the spring, pretty much, there have been very few COVID cases. The pandemic is mostly under control. And so initially, these vaccines were going to people who work overseas - so, for instance, state-owned enterprise construction workers or office workers. It was broadened out to students going abroad. And then now, some of these vaccines are being offered to the general public, the general fee-paying public.

Sinopharm, which is the biggest state-owned pharma group in China, has two vaccine candidates. Their chairman the other day said that they've inoculated nearly 1 million people already. And that is outside of clinical trials - right? - which include tens of thousands of other people. In terms of effectiveness, you know, again, there's not a lot of coronavirus in China now. But the Sinopharm chairman says there have been no major adverse reactions. They've had nearly 60,000 people go abroad and haven't reported any infections yet.

FADEL: Wow. There's been a lot of concern that rich and powerful countries, like the U.S., would snap up all COVID vaccines first and leave poorer, smaller countries potentially exposed. Does China have a position on this?

RUWITCH: Yeah, China is conscious of this. Xi Jinping, the leader, has been saying for months that a Chinese vaccine will be a public good. And the authorities in China have promised preferential access to developing countries across the world - Asia, Latin America, Africa. China's pharmaceutical companies have entered into a bunch of agreements, bilateral agreements, with countries around the world to supply the vaccines. And there have been promises made of loans to actually help them pay for it.

Then, in October, the government joined COVAX, which is this World Health Organization-supported effort that involves dozens of countries around the world to try to get the coronavirus vaccine to developing countries equitably. You know, China really wants to look responsible here, right? So the virus emerged in China first. That's where it blew up. The Chinese government's initial response was to cover it up. And they've gotten major flak for that. So it appears to be trying to put all that behind it and build goodwill. Some are calling it vaccine diplomacy.

FADEL: Wow. So I want to bring in Lauren Frayer now. Lauren, you cover India for NPR, and India's the largest drug manufacturer in the world. What's happening there in terms of COVID vaccines?

FRAYER: Yeah, so there are several different vaccines being tested and being produced in India. The biggest vaccine maker in the world is actually an Indian company. It's called the Serum Institute. And I spoke with the CEO there this summer when he was already mass-producing vaccines even before clinical trials finished. So the idea is that when they do finish, he's got hundreds of millions of doses ready to hand out.

The Serum Institute's a family business. It's this guy and his dad who took a gamble. I mean, they could potentially lose millions of dollars on vaccines that might not work, or they could help save humanity. And they're hedging their bets. They're making a handful of vaccines, including this Oxford University AstraZeneca formula. There are other Indian companies doing the same. The Russian Sputnik vaccine is being manufactured in India. So all of this is sort of keeping with India's nickname of the pharmacy to the world.

FADEL: Are the vaccines that will be manufactured in India for both domestic and international use?

FRAYER: They are. So Serum Institute is earmarking half of its vaccines for the domestic population. India has the second-highest caseload of COVID-19 the world, so it's definitely needed in India. The Serum Institute has also signed agreements with the Bill and Melinda Gates Foundation, the Gavi Vaccine Alliance, to make 200 million doses available to other countries in need.

You know, incidentally, this Oxford AstraZeneca vaccine needs to be stored at warmer temperatures - 2 to 8 degrees Celsius. That's a lot more manageable than some of the other vaccines. Like, the Pfizer vaccine needs to be in these special refrigerators at negative 80 degrees Celsius. So that's a candidate that could work better in places like India and other developing countries.

FADEL: So India, like China, is home to more than a billion people. Does that present a challenge when it comes to planning for the distribution of vaccines to people?

FRAYER: Yeah, totally. I mean, nearly 1.4 billion people - so think about what it takes to vaccinate, like, a European country. That's, like, my neighborhood in Mumbai. So the scale of anything in India is just immense. As for the timeline, I mean, vaccines are expected to roll out this winter. But the bottom line is, it will probably take two to three years to get all Indians vaccinated. So we're looking really at 2024.

FADEL: So Richard, I want to bring it back to you. Here in the U.S., we have challenges, too, in terms of getting vaccines out to people. President-elect Joe Biden has said that many people may die if the outgoing Trump administration continues its refusal to coordinate with the incoming Biden team on COVID vaccine planning. How big a problem would that create in terms of distribution?

HARRIS: Well, under the best-case scenario, distribution will start in December during the last few weeks of the Trump administration. And you know, there will inevitably be snags along the way. So those are unlikely to be resolved by January 20. So the concern really is officials from the new administration won't have a clear idea of what problems they're inheriting, and it will take them time to figure that out. I've heard this compared to a relay race in which the runners stop before handing over the baton. And that's obviously not how it should be done.

FADEL: Right. That was NPR's science correspondent Richard Harris. We also heard from NPR's Lauren Frayer and John Ruwitch, who cover India and China, respectively. Thank you all for being here today.

HARRIS: Anytime.

FRAYER: Thanks for having us.

RUWITCH: Thank you. Transcript provided by NPR, Copyright NPR.

Award-winning journalist Richard Harris has reported on a wide range of topics in science, medicine and the environment since he joined NPR in 1986. In early 2014, his focus shifted from an emphasis on climate change and the environment to biomedical research.
Lauren Frayer covers India for NPR News. In June 2018, she opened a new NPR bureau in India's biggest city, its financial center, and the heart of Bollywood—Mumbai.
John Ruwitch is a correspondent with NPR's international desk. He covers Chinese affairs.