Reasons for optimism over Covid-19 vaccine rollout

Ireland is set to receive nearly 100,000 more vaccines from Oxford AstraZeneca following a new agreement between the manufacturer and the European Union.
Ireland, and the world, may be facing a challenging road ahead to bring the pandemic under control given recent vaccine supply issues but there are reasons to remain optimistic.
The rapid development of vaccines against Covid-19 in less than a year brought great hope that an end in sight to the pandemic was near.
In reality, it will take time to manufacture and distribute these vaccines as they are approved, as evidenced by Pfizer and AstraZeneca supply issues in recent weeks.
The good news is that more vaccines are being approved and more are in the pipeline.
Ireland has pre-purchased more than 14m doses of six different Covid-19 vaccines under the EU advance purchase agreement, three of which have been approved by the European Medicines Agency (EMA) so far.
The pace of the rollout, however, has and will continue to be determined by supply.
To date, almost 148,000 healthcare staff and long-term care residents have received the Pfizer and Moderna vaccines, the equivalent of around 3% of the population.
The approval of the AstraZeneca vaccine on Friday will ramp up the rollout from mid-February onwards although recent supply issues triggered a major diplomatic row with the European Commission.
Tonight, the pharma company agreed to supply the EU with a further 9m doses in the first quarter, softening the supply setback.
The move will also mean an extra 100,000 vaccines for Ireland, reducing the expected supply shortfall from 300,000 doses to 200,000 in the first quarter but could still dent ambitions to vaccinate 700,000 people by the end of March.
On Sunday, Taoiseach Micheál Martin said he could not be precise about targets but that a significant increase in supplies is expected in the second quarter and “significant numbers” would be vaccinated by autumn.
“The vaccines do offer us great hope," said Mr Martin. "I understand the impatience that is out there but I do believe that the rollout so far has been in line with commitments made.”
He added that the manufacture and supply of vaccines was outside of the Government’s control.
Despite the supply setbacks, there are reasons to be optimistic. Other vaccines in development have shown promising clinical trial results — the Janssen vaccine is 66% effective while the Novavax vaccine is 89% effective.
The Janssen vaccine could also prove to be the real gamechanger in the fight against Covid-19 as it is one of the few single-dose vaccines being developed and the company intends to seek approval in the US this week, with hopes for EU approval shortly afterward.
On Friday, Professor Brian MacCraith, who chairs the high-level vaccine taskforce, said the single-dose vaccine was “very attractive” and, once approved, Ireland could expect to see “hundreds of thousands” of the 2.2m pre-ordered doses being delivered from the second quarter onwards.
Ireland has also pre-purchased more than 5.5m doses of vaccines in development by Curevac and Sanofi/GSK, although how close they are to approval is a little less certain.
The EU has not yet agreed a contract for the Novavax vaccine.
- Pfizer/BioNTech: This was the first Covid-19 vaccine to be rolled out in Ireland following approval by the EMA on December 21 last. Ireland has pre-ordered 2.2m of the Comirnaty mRNA vaccine as part of the EU advance purchase agreement. The two-dose vaccine is 95% effective and requires storage at ultra-low temperatures. Pfizer and BioNTech have committed to supplying 1.3bn doses globally and other pharma companies, such as Novartis and Sanofi, have agreed to help manufacture supplies.
- Moderna: This is the second Covid-19 vaccine to be rolled out in Ireland following approval by the EMA on January 6. Ireland has pre-ordered 880,000 doses separate to the EU advance purchase agreement. The two-dose mRNA vaccine has been shown to be 94% effective and must be stored at -20ºC.
- AstraZeneca/Oxford University: This two-dose vaccine has been shown to be 60% effective against Covid-19 and was the third vaccine to secure EU approval. Ireland has pre-ordered 3.3m doses, although scheduled deliveries to Ireland in the first quarter have been revised downwards. The vaccine is easier to handle and administer as it does not require deepfreeze storage.
- Janssen (Johnson & Johnson): Still in phase three clinical trials, early results suggest the Janssen vaccine is 66% effective against Covid-19. This vaccine requires just one dose and can be refrigerated, making it easier to handle and administer. Ireland has pre-ordered 2.2m doses as part of the EU advance purchase agreement. Janssen intends to seek approval in the US this week, with EU approval likely soon after.
- Curevac: This mRNA vaccine is still in phase three clinical trials but holds promise given that two other mRNA vaccines have been shown to work and are already approved for use. Ireland has pre-ordered almost 2.5m doses under the EU advance purchase agreement. The two-dose vaccine does not require deepfreeze storage making it easier to handle and administer.
- Sanofi/GSK: This protein-based two-dose vaccine is still in phase two clinical trials and is further away from the approval process. Ireland has pre-ordered 3.3m doses of this vaccine under the EU advance purchase agreement.