Industry Updates - Volume 4

With January nearing a close, Volume 4 looks at how the pandemic is progressing and whether vaccinations are starting to roll out.
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Global Pandemic

• More than 2 million COVID-19 deaths passed globally last week; More than 400K deaths in the U.S.
• Latest 100K deaths in the U.S. took just 36 days from December 2020 to January 2021.
• Total infections surged past 96 million, accompanied by new mutated virus strains.
• CDC predicts that ⅓ of all new USA infections would be new B117 strain by March.
• Ireland saw a 30X increase in infections in 2 weeks, after a 3-Day pre-Christmas loosening of restrictions.

Industry News

• "U.S. Vaccination Rollout Turns to Chaos" - Latest headline story in Bloomberg 'Coronavirus Prognosis', cites last mile logistics issues with mRNA vaccines, confusion re eligibility, and not enough supply.
• To address the U.S. shortage, the Federal government announced that the reserve stocks held back for second shots would be released early.
  • Health Secretary Azar subsequently disclosed that no such reserve vaccine inventory actually existed.
• Pfizer informed 6 EU member countries that it wouldn’t meet promised delivery dates this month and Canada has also experienced a similar delay.
• Russian hackers released on the dark web negotiations between Pfizer and the EMA in December; EMA leaned against approval of the Pfizer vaccine due to quality control problems, where the minimum threshold of 55% of vaccine doses meeting the quality standard was missed, falling below 50%.
• In California, the state epidemiologist called for a recall of one batch of Moderna vaccines due to a high number of adverse allergic reactions.
• Deaths following vaccination are being reported worldwide. A study of 77 cases in Norway attributed it to the comorbidities of elderly nursing home population. There have been similar reports of a small number of elderly patients who died shortly post Pfizer vaccination, in both Germany and Israel.
• The first death occurred in India following vaccination with The Serum Institute of India (SII) produced AstraZeneca-licensed vaccine, and is being investigated.
• In the 'data wars' Sinovac’s vaccine came under fire for varying estimates of efficacy from 51% to 78%, based on different trials and measurement methods. 
  • The lowest figure occurred when Sinovac was required by Brazilian authorities to count vaccinated parties with no symptoms of Covid but some evidence of presence on a clinical test.
  • Company officials claim this measurement is inconsistent with the method used in other companies, trials, and that their vaccine was 100% effective against serious disease. 
  • Nevertheless, Brazil has since confirmed its authorisation and purchase of the Sinovac vaccine.
• The Times of London lent credence to this criticism by claiming that the 95% efficacy quoted for Pfizer had ignored cases with only mild symptoms.
  • The same article also suggested that Pfizer might be 50% effective after one only dose.
  • Pfizer did not PCR-Test those with mild symptoms, and cannot say that they were not infected. 
• However in Israel the largest HMO, Clalit, released a study comparing 200,000 each of vaccinated and unvaccinated parties (10 times the size of the Pfizer Stage 3 trial) after one dose of Pfizer, and concluded that one Pfizer shot was only 33% effective.
• In view of the shortage of vaccines and logistical challenges, regulators in both the United States and Europe are rushing through the approval process for the AstraZeneca and Johnson and Johnson vaccines in the coming weeks.
• Rajeev Venkayya - A leading industry figure - Global Head of Vaccines at Takeda; former Head of Global Healthy delivery at Gates’ Foundation; and previously Senior Director for BioDefense at the White House - Called for an end to the 'data wars’, saying all approved vaccines so far appear equally effective in providing close to 100% protection against severe Covid.
  • The relevant, but currently unknown, differences between vaccines were length of protection afforded and effect on transmissibility.

Financial News

• A leak by a Belgian government Minister disclosed the prices negotiated for vaccines in the EU:​

Value	Price to EU
Pfizer/BioNTech	€12 ​
Moderna	​$18
​AstraZeneca/Oxford	​€1.78 (might be at cost)
Bayer/Curevac	€10 ​
GSK/Sanofi	​€7.56
​Johnson & Johnson/Janssen	$8.50

• Israel is paying $47 per two dose regime, and appears to have secured early access to supplies from Pfizer (and soon from Moderna).
  • By combination of paying higher prices, and sharing its comprehensive data capture, from its high speed rollout (80% vaccination of older and high risk groups/25% total population vaccinated).
• WIV vaccines from China are gaining wide acceptability in the Muslim world. Indonesia, Bahrain, Saudi Arabia, Bangladesh, Malaysia, UAE and Pakistan have all approved WIV vaccines.
  • The highest religious authorities in Indonesia (the world's largest Muslim population, and 4th most populous country overall) have declared Sinovac to be Halal.
  • A Halal issue may arise with the AstraZeneca vaccine - a stabilizer component was originally derived from Pig gelatin, commonly used as a vaccine feedstock component.
• The Chinese vaccines are also moving into eastern and central Europe.  Following previous deals in Turkey and the Ukraine, Sinovac has now been ordered by Hungary and Sinopharm by Serbia.

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