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In recent weeks, it’s been hard to feel optimistic about the UK’s battle with Covid-19. From the introduction of another lockdown, to talk of trying to “save Christmas”, to test and trace still experiencing difficulties, even the most cheerful among us might have struggled to see a light at the end of the tunnel.

But all of that changed yesterday when it was announced that a vaccine for the virus had proved successful in clinical trials. It has managed to protect over 90 per cent of the participants (43,500 in total) from becoming infected.

Although, as Boris Johnson has warned, it’s “very, very early days” and people cannot “rely on this news as a solution”, it cannot be stated enough what an astonishing achievement this is.

Indeed, when I last wrote about the vaccine in October for ConservativeHome, there were actually a lot of reasons to be doubtful that this would be a viable exit strategy. These reasons are broadly:

  • Other members of the Coronavirus family – SARS and MERS – do not have vaccines.
  • Smallpox is the only disease that has ever been fully eradicated by a vaccine.
  • Kate Bingham, the chairman of the UK Vaccine Taskforce, said that a Covid vaccine would probably have the same success rate as the flu jab (50 per cent). 
  • Patrick Vallance said we would be looking at a vaccine model similar to flu, and that the “notion of eliminating Covid is not right.”

Bingham and Vallance’s estimates were entirely realistic at the time. That’s why the vaccine development is so special; it is groundbreaking territory to create something with 90 per cent efficacy, never mind the fact it was developed in such a short period.

But as I wrote before, there will still be some major challenges ahead. Without further ado, here are some of the main takeaways from the vaccine news – and what the big questions ahead are for the Government and scientists.

How does the vaccine work?

It is a new type of vaccine, called an “RNA” vaccine. Although RNA vaccines have been researched in the past, they have never been approved before. It works by using a small part of the virus’s genetic code, which is then introduced to the body. The immune system then identifies this as foreign and begins to attack the virus.

How is it administered?

The vaccine is given in two doses, which are taken 21 to 28 days apart (the Government has ordered 40 million doses of it, which will give the UK the capacity to vaccinate 20 million people). 

It will be delivered at care homes (by NHS workers), at GP surgeries, pharmacies and “go-to” vaccination centres set up in places like sports halls. The goal is to have the vaccine administered seven days a week, and Matt Hancock has announced £150 million extra funding to help GPs carry out this huge task.

Who will get it first?

As age is the biggest risk factor for severe Covid-19, the first people to receive the vaccine will be care home residents and care home staff. Next down the list are likely to be health workers and hospital staff. From then on, people will be ranked by age; those under 50 will be bottom of the list. Children will not be vaccinated (although expect this to be contested, as some scientists are worried about the long-term effects of Covid).

When could it become available?

There have been conflicting estimates of when the vaccine will arrive, but the overall expected is either by the end of this year or early in 2021. Hancock has said that a mass roll out by Christmas is “absolutely a possibility”, although he expects it to come in the first part of next year. Emergency approval could mean the vaccine is with us as soon as November.

What are the challenges ahead?

There are a number of challenges for the Government, which can broadly be categorised as 1) Regulatory/ medical 2) Logistical and 3) Societal. 

To run through these in more detail:

Regulatory

The vaccine will first need to be considered by agencies around the world, and only with their approval can it be rolled out to the masses. This is why Johnson is trying to manage expectations about the vaccine – as this is quite a big hurdle to get through.

Medical

Then there are more considerations about the vaccine’s effectiveness, which will influence Governmental policy. Here are some questions that will be asked:

  • Does the vaccine stop people from catching and spreading the virus? (As well as stopping someone from getting ill).
  • How protective is the vaccine across different age groups? (There is missing data on this at the moment).
  • Do people need repeated doses of the vaccine? How long does its protective effect last for?
  • What is the potential for the virus to mutate?
  • What are the rare side effects of the vaccine? (We can only see this when much larger numbers of people take it).
  • How many people need to be immunised in order to return life back to normal?
  • How do we protect the 10 per cent, for whom the vaccine does not work? 
Logistical

Rolling the vaccine out is an operation of epic proportions; Jamie Njoku-Goodwin, formerly Hancock’s Special Advisor, said on Twitter that it would “require the biggest logistical effort since WW2”.

Getting two doses out to tens of millions of people is no walk in the park (to put it mildly). There are other logistical challenges, too; for instance, the vaccine needs to be moved from one station to another, without removing it from a temperature of -70C over four times. 

Societal

The last big headache is trying to manage who gets the vaccine. This is perhaps the most complicated aspect of this exit strategy, as the Government will have to deal with two divides in society; people who want the vaccine, but aren’t on the priority list (some teachers, for instance, are reported as wanting to be prioritised), and those who do not want a vaccine at all. And that’s before we get to the global demand for vaccines.

It’s not clear how many people need to be vaccinated in the UK to get us out of more lockdowns, as it’s ultimately contingent on some of the medical considerations mentioned above. But Bingham has previously said that 30 million out of the 67 million people who live in Britain would get it.

The other difficult aspect is managing what happens before we get the vaccine (if it’s approved). The Government is conscious that people can let their guard down with good news, and it remains to be seen how the prospect of a vaccine effects compliance over the next couple of months. The Government knows it must keep expectations low, in case there isn’t regulatory approval for the vaccine – and it needs to focus more on other strategies.

But whatever happens, it’s still an incredibly exciting week, particularly as this is not the only vaccine on the go. There are 11 vaccines currently in the final stages of testing, and Pfizer and BioNtech have the manufacturing capacity for 1.3 billion doses of their vaccine by next year. All in all, “hoping for the best but planning for the worst” is the mantra Johnson cited early on in the crisis, and – through the vaccine news – these words will carry through.

74 comments for: The vaccine. The biggest breakthrough so far in the Covid-19 battle. But a logistical challenge unlike anything else.

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