Even more good news came last week with respect to the BioNTech/Pfizer vaccine. First, multiple studies showed that a single dose is highly effective (more than 80 percent) in preventing symptomatic disease a few weeks after it’s administered. Second, following successful internal testing, Pfizer and BioNTech asked U.S. regulators to allow their vaccine to be stored and transported at standard freezing temperatures (-4 F / -20 C) instead of the super cold temps that are currently required. This would greatly expand the number of places in the United States and elsewhere that could store and administer the vaccine, and it comes at the perfect time for the many states that have teamed up with local pharmacies (including Walmart) to ramp up vaccine distribution in the coming weeks.
As George Mason University’s Alex Tabarrok (who’s been a true champ on vaccine issues) adds, the single dose data might unfortunately be wasted on the United States, which appears wedded to the original two‐dose approach, but it and the storage development could be a very big deal for developing countries that are just getting started. They also show why we shouldn’t blindly and permanently adhere to the companies’ initial clinical trial data, which were “designed at speed with the sole purpose of getting the vaccines approved” not “to discover the optimal regimen for public health.” We can, and should, keep adapting as the evidence warrants.
Oh but what about those variants?! Again, there’s (mostly) good news and a lot of misguided pessimism (or outright fear mongering). First, both mRNA vaccines and the AstraZeneca vaccine have been shown to be effective against the highly transmissible U.K. variant (B.1.1.7), and its becoming the “dominant strain” in the United States will not necessarily lead to a “fourth wave.” With respect to the other key variant, from South Africa, AstraZeneca struggles to produce sufficient neutralizing antibodies, but Pfizer still works (and Moderna probably does), as does the Johnson & Johnson single‐shot vaccine. For people who have had COVID-19, a single shot of the mRNA vaccines also provides protection against the South African variant, which has fizzled out in South Africa and is still pretty limited here.
Variants will remain a cat‐and‐mouse game between the virus and the vaccines, likely requiring a subsequent booster shot at some point down the road, but (1) declining cases worldwide will decrease the chance for mutation (and thus the number of variants); and (2) the amazing mRNA technology provides a crucial advantage in fighting new variants, in that the vaccines can be rapidly updated (in only 60 days, per Pfizer) and manufactured (in around 110 days, versus “much longer” for traditional vaccines). Even the slow‐moving FDA has promised it will fast‐track future vaccine booster shots against COVID-19 variants, instead of requiring large clinical trials (wonders never cease). Thus, as the New York Times’ Ross Douthat noted yesterday, the variants will remain a concern for a long while but do not justify a permanent extension of our current bunker mentality.
Of course, all of this good news might be wasted if vaccine supply and distribution lagged. But here again there’s reason for optimism. First, after six weeks of chaos, the United States’ vaccination drive has improved significantly, as many states prioritized speed by, for example, loosening prioritization guidelines, holding mass vaccination events, and expanding the number of distribution sites. As a result, most states have administered 80 percent or more of the doses they’ve received, and the United States has repeatedly exceeded 2 million doses per day—trends that should continue now that the winter storm mayhem is behind us.