Since August, Sweden has signed agreements with five vaccine manufacturers through the EU. Provided the vaccine is approved, the doses are sufficient for the entire population.
– There are three candidates for whom you have seen preliminary results. Pfizer and Moderna look very good so far, while Astra Zeneca reports a slightly lower protection effect so far, says Jan Albert, professor of infection control at AI.
Sweden’s contracts with several manufacturers may prove useful in the future, says Johan Brun, physician and senior medical advisor at the pharmaceutical industry association Lif, who has a background at Astra Zeneca and Pfizer.
There are advantages to having different vaccines with slightly different mechanisms, as one vaccine may be better suited for the elderly and the other for younger people. A vaccine may also be better suited if we have to give extra doses in a few years, he says.
“We will be our own vaccine factory”
Sweden has contracts with three manufacturers of so-called RNA vaccines: Pfizer, Moderna and Curevac. It is a completely new type of vaccine that has never been used on a large scale before.
Simply explained, this means that the virus’s genome is injected into the body, where the cells then start to produce vaccines.
– We will be our own vaccine factory. This means you get a really good immune system, and the technology means you can give the vaccine as often as you want. Although you cannot give a vector vaccine more than twice, you have formed an anti-vector immunity, and it works worse and worse each time, says vaccine researcher Matti Sällberg of Karolinska.
Quiet around two manufacturers
Astra Zeneca and Janssen’s vaccine is a viral vector vaccine, which means you modify a cold virus to look like the coronavirus. When injected into the body, an immune response is triggered, which leads to the formation of antibodies.
– The challenge with the RNA vaccine is that they have to be frozen, between minus 20 and minus 80 degrees. In the Western world, we have this kind of cold storage in hospitals, while in long-income countries the vaccine from Astra Zeneca and Janssen may be more useful, says Matti Sällberg.
According to Swedish Public Health Agency Director General Johan Carlson, it is estimated that Janssen and Curevac’s vaccine will be approved in April. But so far, according to Sällberg, things have been relatively quiet with these vaccine manufacturers.
– I haven’t heard from Curevac’s phase 3 studies, and we haven’t heard a beep from Janssen yet, he says.
Here are Sweden’s secure vaccine candidates
The agreement with the Swedish-British Astra Zeneca was already signed on August 20 and includes approximately 6 million doses. It is a vector vaccine that must be taken in two doses, four weeks apart.
The studies show that two high vaccine doses gave 62 percent protection, while a low and one high dose gave 90 percent protection. In the large test group, this meant protection of an average of 70 percent.
However, the study that showed 90 percent protection must be repeated as the subgroup was accidentally given the first lower dose.
“60 percent protection is enough to get the product approved, so there are likely to be intensive negotiations to get approval in the meantime and then supplement with this study”, says Johan Brun.
The Astra Zeneca vaccine has two distinct advantages. It can maintain a temperature between 2-8 degrees in a light-protected environment, and is said to cost on its own “Like a cup of coffee”. Media reports say this is the equivalent of SEK 30.
In terms of price, Astra Zeneca has settled for almost cost, while the others have reported more market prices. According to the company, this is partly because their business is benefiting from a rapid return to normalcy. Of course it is also business thinking ”, says Johan Brun.
The agreement with Janssen Pharmaceutica, part of the American pharmaceutical company Johnson & Johnson, was concluded on October 15 and includes approximately 4.5 million doses.
Like Astra Zeneca, the candidate is a vector vaccine that does not need to be frozen during storage and must be sold at a production cost, but instead in a single dose.
Janssen has not yet shown any results from the phase 3 studies that started in September. The Public Health Agency’s assessment is that the vaccine could be approved in Sweden in April.
PFIZER / BIONTECH
The agreement with the American Pfizer and the German Biontech was concluded on November 17 and includes approximately 4.5 million doses.
The companies’ joint vaccine candidate has already been approved in the UK. Pfizer / Biontech has applied for an emergency permit in the EU and could receive a green light in Sweden on December 29, according to the Swedish Public Health Agency.
It is an RNA vaccine to be taken in two doses at three-week intervals. Studies have shown 95 percent protection.
The price tag per dose will be around 170 SEK. The vaccine must also be stored at minus 70 degrees which can cause problems. The company has developed a dry ice that allows the vaccine to be stored for 10 days without freezing, but doses still need to be shipped by special transports.
The agreement with Curevac, Germany, was signed on November 24 and includes approximately 4.5 million doses.
It’s also an RNA vaccine, but unlike Pfizer and Moderna, Curevac reports that their vaccine has a shelf life of up to three months at refrigerator temperature and a day at room temperature.
The company has not yet shown results from the phase 3 studies. The Swedish Public Health Organization’s assessment is that the vaccine could be approved in Sweden in April.
The agreement with American Moderna was signed on December 4 and includes approximately 1.8 million doses.
The studies have shown nearly 95 percent protection, and the vaccine is expected to be approved in Sweden on January 12.
It is an RNA vaccine that should be taken in two doses four weeks apart. The vaccine must be stored at minus 20 degrees, but can also be kept at refrigerator temperature for several weeks.
Modern vaccines are the most expensive and a dose costs the equivalent of about 330 SEK.
“Both Pfizer and Moderna have an impressive effect. Security appears to be high. The expected side effects are similar to those of covid-19 as they cause controlled infection with the vaccine. “, says Johan Brun.
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