United Kingdom

Matt Hancock says pharmacists will be able to give any Covid jab to speed

Pharmacists will be able to give out Covid-19 jabs to speed up a nation-wide roll out, Matt Hancock has revealed. 

The Health Secretary claimed pharmacists in Britain would play a 'massive role' when Number 10 has a coronavirus vaccination programme.

High street pharmacies are already able to give out jabs for the flu, chickenpox, HPV, and meningitis, as well as injections needed for overseas travel.  

It comes amid hopes a vaccine will be ready by autumn, with two separate trials of experimental jabs in the UK and US announcing positive results yesterday.

Teams from Oxford University and the American pharmaceutical company Moderna both say injected volunteers are showing signs of immunity.

Each group has been working on separate jabs for months to try to protect millions of people from catching the coronavirus in future.

Mr Hancock claimed a 'best case scenario' would be a vaccine being made available later this year, although conceded one was more likely to be ready until 2021.

Matt Hancock has said pharmacists will be able to give out Covid-19 jabs to speed up a nationwide roll out, amid hopes a vaccine will soon be ready

Speaking on ITV's Peston last night, Mr Hancock said the government was working closely with teams across the world to drive the search for a vaccine.

He said: 'We're all working towards the best case scenario, we're all giving AstraZeneca and the team at Oxford, and the Imperial vaccine, every possible support.

'We're working with the other potential vaccines around the world, in America, and Germany, and the Netherlands.

'We're working with them to ensure that if they come off first, that we'll get access to them here.

'But this is an inexact science and it's at risk.' 

WHAT ARE THE LEADING COVID-19 VACCINE CANDIDATES? 

University of Oxford

Clinical teams at the Oxford University's Jenner Institute and Oxford Vaccine Group began developing the ChAdOx1 nCoV-19 vaccine in January, now named AZD1222, after a manufacturing partnership with pharmaceutical giant AstraZeneca was secured.

Human trials started on April 23 and they are now in the final phase. 

Lead of the project Professor Sarah Gilbert told The Times she is '80 per cent' confident of its success.

Imperial College London

Professor Robin Shattock is leading a team working to produce a vaccine at Imperial College. 

Fifteen volunteers have already been given the trial vaccines and testing is expected to ramp up to include as many as 200-300 new participants in the coming weeks.  

A second trial, involving 6,000 people, will come later. 

But Professor Shattock said the vaccine won't be available until at least 2021, even if everything goes according to plan. 

If the jab works, the team want to make it as cheap as possible so the entire British population could be vaccinated for the 'really good value' of just under £200million.

Moderna 

Massachusetts-based Moderna was the first US company to start human trials of its potential Covid-19 vaccine, known as mRNA-1273, on March 16.

Moderna's shot showed early promise in its phase 2 human tests last month. The company reported that it triggered antibody production on par with that seen in recovered coronavirus patients. 

CanSino 

Chinese vaccine Ad5-nCoV, made by CanSino, was the very first shot to enter clinical trials earlier this year and is a leading candidate.

A trial of 108 healthy volunteers in China showed it safely triggered an immune response in participants.

Results published May 22 in The Lancet showed most of the people dosed with the vaccine had immune responses, although their levels of antibodies thought to neutralize the virus were relatively low. Researchers saw a stronger ramp-up of other immune compounds, called T-cells, that might also help fight the infection off.   

Pfizer

Pfizer and BioNTech have been working on a number of potential Covid-19 vaccines under the 'BNT162 program'. 

It reported positive preliminary results from the ongoing Phase I/II clinical trial of one called BNT162b1 on July 1.

Data is available for the trial of BNT162b1 on 24 volunteers. The results showed that it was well tolerated and produced dose dependent immunity.

Dr Kathrin Jansen, Pfizer's head of vaccine research and development, said the vaccine 'is able to produce neutralizing antibody responses in humans at or above the levels observed' in Covid-19 survivors.

Pfizer received fast track designation from the US Food and Drug Administration (FDA) for two of their four potential Covid-19 vaccines this month.   

Johnson & Johnson 

The drug giant started work on the vaccine in January, two months before Covid-19 was labelled a global pandemic. 

A vaccine trial spearheaded by Johnson and Johnson will start recruiting people in September, with clinical data available by the end of the year.

An 'emergency use' batch of the vaccine is anticipated to be authorised as early as 2021, which would likely be prioritised for vulnerable people.

He said the most clinically vulnerable, the oldest, and healthcare workers would be the first to get the vaccine — which in a 'best case scenario would be sometime this year' but 'more likely next year'.

He said: 'We'll use all the assets we've got available to get it into people. In fact, I am expanding who can legally vaccinate to make sure not just GPs, but also technicians, nurses and pharmacists. 

'Pharmacists have got a massive role to play in this.' 

Nurses and pharmacists can already administer certain vaccinations without a prescription from a doctor.

They are accessible to lots of people, both because of their location and opening hours, which helps with the challenge of getting the vaccine rolled out quickly.  

Pharmacists are actively involved in the supply chain of vaccines, so that they can work out the right distribution to areas where they are needed most.

Their involvement with vaccination programmes also help to free up time for GPs and nurses at surgeries. 

But the potential arrival of vaccine in September could clash with the flu vaccination programme — which is expected to be ramped up this autumn. 

The Government is currently considering expanding the free flu jab list to include those in their 50s to avoid a severe flu season together with a second Covid-19 wave.

There have already been concerns about the logistics of getting potentially 10million extra doses out. 

With optimum flu vaccination dosing time between October and November, it is not clear how services would operate if a Covid-19 vaccine is proven to work this autumn.

Oxford scientists have already said they are '80 per cent' confident they can have their jab — called AZD1222 — available by September. 

And drug giant AstraZeneca has said it is on track to produce millions of the AZD1222 jab by September if it is proven to work.

Some of the first results were revealed yesterday, after Phase 1 trials started in April, and gave promising signs a vaccine is on the horizon.

People being given the Oxford vaccine have been developing antibodies and white blood cells called T cells which will help their bodies fight off the virus if they get infected, it is reported. 

While early research focused on antibodies, scientists are increasingly turning to a type of immunity called T cell immunity — which is controlled by white blood cells — which has shown signs of promise.

One source on the Oxford project told ITV News: 'An important point to keep in mind is that there are two dimensions to the immune response: antibodies and T-cells.

'Everybody is focused on antibodies but there is a growing body of evidence suggesting that the T-cells response is important in the defence against coronavirus.'    

The combination of the two responses is 'double protection' which 'will hopefully keep people safe', a researcher told the Daily Telegraph.

David Carpenter, chairman of the Berkshire Research Ethics Committee, which approved the Oxford trial and continues to work with scientists on amendments, told the paper that the team were 'absolutely on track'.

He added: 'Nobody can put final dates ... things might go wrong but the reality is that by working with a big pharma company, that vaccine could be fairly widely available around September and that is the sort of target they are working on.'

It came as Moderna, based in Cambridge, Massachusetts, said reported its own vaccine has passed these early milestones and now plans to move on to bigger trials.

In the first phase of its trials, 45 participants all successfully developed antibodies. 

Scientists said the apparent side effects were a 'small price to pay' for protection against Covid-19.

Dr Anthony Fauci, the US government's top infectious disease expert, said: 'No matter how you slice this, this is good news.'

The vaccines work by tricking the body into thinking it's infected with Covid-19 and causing it to produce immune substances that have the ability to destroy it.

It comes as a group of 100 leading experts urge for healthy people to be purposely infected with the coronavirus to speed up the development of a vaccine. 

Controversial 'challenge trials' could rapidly accelerate studies on experimental jabs which are struggling to recruit volunteers because of falling Covid-19 infection rates, the group, that includes Nobel Prize-winning scientists, says. 

They have written an open letter to the US National Institutes of Health saying the benefits of bringing a vaccine to the masses outweighs the risk to trialists' health.

Challenge trials are commonly deployed by scientists trying to develop a vaccine and have been used in malaria, typhoid and flu.

But, unlike those illnesses, there is only one scientifically proven treatment for Covid-19, so there is little to stop the participants falling seriously ill.  

There are 23 experimental vaccines in clinical trials around the world.

Scientists behind the two frontrunners — Oxford University and US pharma company Moderna — have warned they might not have results until next year because not enough people are getting infected in the community. 

HOW MIGHT THE CORONAVIRUS VACCINE WORK? 

Human trials of the coronavirus vaccine candidate being developed at the University of Oxford are reported to be looking promising. 

It is thought that early results indicate the jab could provide double protection - generating an immune response which stimulates the body to produce both antibodies and 'killer T-cells'.

But what does the vaccine do, how does it work, and what happens next? 

What is the vaccine? 

The vaccine - called ChAdOx1 nCoV-19 - uses a weakened version of a common cold virus (adenovirus) which causes infections in chimpanzees. It has been genetically changed so it is impossible for it to grow in humans. 

Researchers hope their version will make the body recognise and develop an immune response to the spike protein - recognisable in images of the virus - that will help stop Covid-19 from entering human cells and therefore prevent infection. 

What do the early results suggest? 

While the researchers are not expected to publish the results of their Phase 1 clinical trials until July 20, reports indicate that the vaccine candidate has triggered two responses in the immune system. 

The first is that it stimulates the immune system to produce antibodies - proteins produced by the blood in response to antigens which are harmful substances that come from outside the body, such as from viruses or bacteria - and that it also causes the body to produce T-cells. 

If the non-specific immune cells which respond to any invader instantly cannot tackle it, the T-cells come into play. They take two forms - helper T-cells and 'killer' T-cells. 

The latter attack the virus directly. With questions remaining about the duration of the antibody response to Covid-19, research suggests T-cells have a more important role in offering protection against the disease. 

It is not yet known whether the Oxford vaccine candidate provides long-term immunity. 

How are the trials progressing? 

More than 4,000 participants are already enrolled in the UK, with enrolment of a further 10,000 people planned as researchers test the ChAdOx1 nCoV-19 vaccine. 

Trials are also taking place in South Africa and Brazil and it is hoped an effective vaccine could be ready later this year. 

This trial aims to assess how well people across a broad range of ages could be protected from Covid-19. 

It will also provide valuable information on safety aspects of the vaccine and its ability to generate good immune responses against the virus. 

Do enough people in the UK have Covid-19 in order for trials to show efficacy? 

Professor Sarah Gilbert, who is leading the Oxford research, has said low transmission rates in the UK mean there is 'little chance' of trials in the country proving the effectiveness of a coronavirus vaccine. 

A sufficient number of volunteers have to be exposed to the virus to see whether a vaccine protects them or not. 

However, if their chances of being in contact with an infected person are low, it will take a long time to demonstrate the efficacy of a vaccine candidate. 

What can be done to combat this? 

Researchers have started trialling the vaccine in countries where there is a higher infection rate. 

But some are calling for challenge trials, which involve deliberately exposing people to the virus after giving them the vaccine. 

A number of prominent scientists, including Nobel laureates, are calling for volunteers to be exposed to coronavirus after receiving a vaccine to see if it offers protection. 

They have signed an open letter to the head of the US National Institutes of Health (NIH), saying these challenge trials could accelerate vaccine development. 

The signatories, who include Adrian Hill, director of the Jenner Institute at Oxford where the vaccine was developed, are calling on the NIH, its allies, international funders, and world bodies like the World Health Organization, to undertake immediate preparations for human challenge trials. 

They suggest this should involve supporting safe and reliable production of the virus and any biocontainment facilities necessary to house participants. 

The authors write: 'If challenge trials can safely and effectively speed the vaccine development process, there is a formidable presumption in favour of their use, which would require a very compelling ethical justification to overcome.' 

In the letter the signatories also set out principles for a challenge trial, including an ethical and scientific review. 

If a successful vaccine is developed, can it be manufactured to scale? 

Production of the vaccine has already been scaled up ahead of the trial to prepare as early as possible for potential future deployment. 

AstraZeneca has reached an agreement with Europe's Inclusive Vaccines Alliance (IVA) to supply up to 400 million doses of the University of Oxford's Covid-19 vaccine at no profit, with deliveries starting by the end of 2020. 

The British Government has agreed to pay for up to 100 million doses, adding that 30 million may be ready for UK citizens by September.

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