Demand for COVID-19 vaccines is outstripping global supply, and frustrated populations and governments alike want to know how to get more. Much more. Straight away.
The problem, said vaccine specialist Maria Elena Bottazzi, of the Baylor School of Medicine, is that “it’s not like adding more water to the soup.”
COVID-19 vaccine manufacturers must thrive by scaling up production to hundreds of millions of doses, and any minor setback could lead to a delay. Some ingredients have never been produced to the sheer volume required now.
And the seemingly simple proposals that other factories change their production to make the new vaccines cannot be implemented overnight. That same week, French pharmaceutical Sanofi announced the unusual decision to help package and package a number of vaccines from competitor Pfizer and German partner BioNTech. But those doses won’t come in until the summer, and Sanofi only has the space available at its German plant because its own vaccine has been delayed, which is bad news for overall global supplies.
‘We thought, okay, aren’t they just men’s shirts? I just have another place to do it, ”said Dr. Paul Offit of Children’s Hospital in Philadelphia, a US government adviser on vaccines. “It’s just not that easy.”
DIFFERENT VACCINES, DIFFERENT RECIPES
The different classes of vaccines used in different countries train the body to recognize the new coronavirus, mainly the glycoprotein that covers it. But they require different technologies, raw materials, equipment and knowledge.
The two vaccines that have been tentatively approved in the United States, from Pfizer and Moderna, are made by placing a piece of genetic code called mRNA – the instructions for that glycoprotein – in a small ball of fat.
Making small amounts of mRNA in a research lab is easy, but “before that, nobody had taken a billion doses, not 100 million, not even a million doses of mRNA,” said Dr. Drew Weissman of the University of Pennsylvania, who helped develop mRNA technology.
Scaling up doesn’t just mean multiplying the ingredients to get more. Making mRNA involves a chemical reaction between enzymes and genetic elements, and Weissman noted that enzymes don’t work as efficiently in large quantities.
The AstraZeneca vaccine, already in use in Britain and other countries, and the vaccine expected to be released shortly by Johnson & Johnson, are made from a cold virus that carries the gene for glycoprotein in the body. Its fabrication is very different: living cells of this virus are grown in huge bioreactors before they are extracted and purified.
“When cells get old or tired or start to change, you can get less,” Weissman said. “There are a lot more variables and a lot more things to check.”
A more classic variety, “inactivated” virus vaccines such as those made by Sinovac of China, require even more steps and improved biosecurity because they are made from killed coronaviruses.
There is one thing all vaccines have in common: they must be manufactured under strict regulations that require facilities that pass specific inspections and controls at every step, which is time consuming but necessary to have confidence in the quality of all shipments.
WHAT ABOUT THE SUPPLY CHAIN?
Production depends on obtaining sufficient raw materials. Pfizer and Moderna insist that they have reliable suppliers.
Still, a US government spokesperson said logistics experts were working directly with vaccine manufacturers to anticipate and resolve any delivery issues.
Moderna CEO Stephane Bancel recognizes that challenges remain.
The company maintains production 24 hours a day, so that if one day “a material is missing, we cannot start making products, and that capacity will be lost forever because we cannot make up for it,” he recently explained to investors. .
Pfizer temporarily reduced deliveries in Europe for several weeks to make improvements to its Belgian plant and increase production.
And sometimes remittances fall short. AstraZeneca told an outraged European Union that her company would also initially deliver fewer doses than promised. The stated reason: lower production than expected in some production centers in Europe.
More than in other industries, when you work with organic ingredients, “there are things that can go wrong and will also go wrong,” said Norman Baylor, former director of vaccines at the US Food and Drug Administration (FDA for the acronym in the US). English ). and that he described production variations as general.
HOW MUCH IS MADE?
That differs per country. Moderna and Pfizer expect to deliver 100 million doses to the United States by the end of March and an additional 100 million in the second quarter of the year. President Joe Biden has announced plans to buy more in the summer to vaccinate a total of 300 million Americans.
Pfizer CEO Albert Bourla said at a Bloomberg conference this week that his company will deliver 120 million doses by the end of March, not because production is accelerated, but because medical staff are now allowed to scoop an extra dose from each vial.
But getting six doses instead of five requires special syringes, and there are questions about worldwide delivery. The United States ships batches of the specialty syringes with every shipment from Pfizer, a spokesman for the Department of Health and Human Services said.
Pfizer also said upgrades at its factory in Belgium are now causing problems and longer-term benefits, as the changes will help increase global production to 2 billion doses this year from the 1.3 billion originally planned.
Moderna also recently announced that it will be able to deliver 600 million doses of vaccines by 2021, up from the 500 million originally planned, and that it is expanding its capacity to reach 1 billion.
But possibly the easiest way to get more doses is to see that other vaccines in development have been proven to work. US data on the effectiveness of Johnson & Johnson’s one-time drug is expected soon, and another company, Novavax, is in the final stages of trials.
OTHER OPTIONS
For months, major vaccine companies in the United States and Europe have signed “manufacturer contracts” to help them produce the doses and complete the packaging. Moderna, for example, works together with the Swiss Lonza.
Outside of rich countries, the Serum Institute of India has a contract to manufacture 1 billion doses of the AstraZeneca vaccine. It is the largest vaccine manufacturer in the world and is expected to be a major supplier to developing countries.
But some local efforts to increase stocks seem to be having problems. Two Brazilian research institutes expect to make millions of doses of AstraZeneca and Sinovac vaccines, but have experienced unexplained delays in supplying ingredients from China.
In addition, Bottazzi noted, the world must also continue to produce vaccines against polio, measles, meningitis and other diseases lurking during the pandemic.
Weissman, the University of Pennsylvania expert, called for patience.
“I think we’re going to be doing more vaccines every month than the month before,” he said.