Dr. Kariko and Dr. Weissman were vaccinated on Dec. 18 at the University of Pennsylvania. Their inoculations turned into a press event, and as the cameras flashed, she began to feel uncharacteristically overwhelmed.

A senior administrator told the doctors and nurses rolling up their sleeves for shots that the scientists whose research made the vaccine possible were present, and they all clapped. Dr. Kariko wept.

Things could have gone so differently, for the scientists and for the world, Dr. Langer said. “There are probably many people like her who failed,” he said.

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Moderna and Pfizer-BioNTech Vaccines Are Very Effective, Report Says

The coronavirus vaccines made by Moderna and Pfizer-BioNTech are proving highly effective at preventing symptomatic and asymptomatic infections under real-world conditions, federal health researchers reported on Monday.

Consistent with clinical trial data, a two-dose regimen prevented 90 percent of infections by two weeks after the second shot. One dose prevented 80 percent of infections by two weeks after vaccination.

There has been debate over whether vaccinated people can still get asymptomatic infections and transmit the virus to others. The study, by researchers at the Centers for Disease Control and Prevention, suggested that transmission may be extremely unlikely, as infections were so rare.

There also has been concern that variants may render the vaccines less effective. The study’s results do not confirm that fear. Troubling variants were circulating during the time of the study — from December 14, 2020 to March 13, 2021 — yet the vaccines still provided powerful protection.

The C.D.C. enrolled 3,950 people at high risk of being exposed to the virus because they were health care workers, first responders, or others on the front lines. None had previously been infected with the coronavirus.

Most — 62.8 percent — received both shots of the vaccine during the study period, and 12.1 percent had one shot. The participants had no previous infections with the coronavirus.

Participants collected their own nasal swabs each week, which were sent to a central location for P.C.R. testing, the most accurate type of test. The weekly swabs allowed the researchers to detect asymptomatic infections as well as symptomatic ones.

The investigators also asked participants about symptoms associated with infection, including fever, chills, cough, shortness of breath, sore throat, diarrhea, muscle aches, or loss of smell or taste. The researchers also analyzed patients’ medical records to detect illnesses.

Fifty-eight percent of the infections were detected before people had symptoms. Just 10.2 percent of infected people never developed symptoms.

Among those who were fully vaccinated, there were .04 infections per 1,000 person-days, meaning that among 1,000 persons there would be .04 infections in a day.

There were 0.19 infections per 1,000 person-days among those who had had one dose of the vaccine. In contrast, there were 1.38 infections per 1,000 person-days in unvaccinated people.

“This study shows that our national vaccination efforts are working.,” said Dr. Rochelle P. Walensky, the C.D.C. director, in a news release.

The C.D.C. said this is the first of many vaccine effectiveness studies it will be conducting.

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Howa Covid-19 Vaccine That Caught Trump’s EyeLost Its Way—And Found It Back

BERLIN—Early last year, Ingmar Hörr was at the forefront of the world’s race to make the first Covid-19 vaccine. The company he had founded and was leading, CureVac NV, had developed a promising candidate using largely untested technology he pioneered.

Then, he suffered a crippling stroke that left him in a coma for weeks. Even as he regained consciousness, he couldn’t remember his name and briefly feared he had been abducted by Russian spies.

While he recovered in the hospital under a fake identity, a rival German biotech company, Pfizer Inc. partner BioNTech SE , went on to develop the West’s first vaccine using the same mRNA technology.

Now back on his feet, Mr. Hörr has re-entered the race. This is the story of the blow that almost ended his life and of how he recovered as CureVac’s vaccine effort got back on track.

Compared with many rivals, CureVac was late in submitting its vaccine for review in Europe—and it now expects approval there by June. But the shot could be a godsend for Europe in particular, which has been trailing the U.S. and the U.K. in vaccinations.

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Pfizer-BioNTech Vaccine Package Defects Prompt Hong Kong Halt

Hong Kong on Wednesday suspended use of the Pfizer-BioNTech vaccine after packaging defects ranging from cracked containers to loose caps were discovered in one batch of doses, in a major blow to a city already struggling in its campaign to inoculate its seven million residents against Covid-19.

Health officials called the halt a precaution, saying that none of the defective vials had been administered to patients and that they had found no health risks. But if the suspension persists, the Chinese territory may not have enough shots to protect its population while the coronavirus continues to spread. Hong Kong officials were counting on 7.5 million doses of the vaccine, developed by Pfizer of the United States and BioNTech of Germany, to help fill their needs.

The discovery has also unleashed a hunt for the origin of the defects, as well as questions about whether more might be out there. The doses were manufactured at BioNTech’s facilities in Germany, while a Chinese company called Fosun Pharma was in charge of transporting, storing and distributing the shots in Hong Kong.

“I’m confused as to why this is being reported for the first time in Hong Kong and we haven’t heard about it elsewhere,” said Benjamin Cowling, the division head of epidemiology and biostatistics at the University of Hong Kong.

poll of 2,733 residents showed that only 39 percent of Hong Kong residents were willing to take a Covid-19 vaccine.

“There are some important risks here that this will further undermine confidence in the vaccines that are available,” said Karen Grépin, an associate professor at the School of Public Health at the University of Hong Kong, who got the BioNTech shot on March 12.

Professor Grépin said that many Hong Kong residents had been waiting to see what the early stages of the rollout would look like before deciding on taking a vaccine.

The suspension sent a ripple of uncertainty through the city’s clinics and medical offices, as vaccinations shuddered to a halt.

rounded up for quarantine.

It is unclear how soon concerns about the Pfizer-BioNTech vaccine will be cleared up or how quickly Hong Kong can make up for the shortfall. The city has also ordered 7.5 million vaccine doses from the British-Swedish company AstraZeneca, which are set to arrive in the second quarter. The company has not yet applied for approval of its vaccine in Hong Kong.

However quickly the problem is resolved, confusion has been sown.

Ruby Callaghan Brown, 32, and her husband arrived at a vaccination center on the eastern side of Hong Kong Island at 7:45 a.m. on Wednesday, 15 minutes before it opened. A staff member shooed them away, saying all vaccinations had been stopped and that an announcement was coming.

Then they read online that the center had reopened, so they returned. They were about to submit their paperwork when they were told once again that vaccinations were suspended.

They waited 45 minutes before leaving. “I thought, ‘I’m just going to sit here until they change their mind,’” she said.

Elsie Chen contributed research.

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Rich Countries Signed Away a Chance to Vaccinate the World

In the coming days, a patent will finally be issued on a five-year-old invention, a feat of molecular engineering that is at the heart of at least five major Covid-19 vaccines. And the United States government will control that patent.

The new patent presents an opportunity — and some argue the last best chance — to exact leverage over the drug companies producing the vaccines and pressure them to expand access to less affluent countries.

The question is whether the government will do anything at all.

The rapid development of Covid-19 vaccines, achieved at record speed and financed by massive public funding in the United States, the European Union and Britain, represents a great triumph of the pandemic. Governments partnered with drugmakers, pouring in billions of dollars to procure raw materials, finance clinical trials and retrofit factories. Billions more were committed to buy the finished product.

But this Western success has created stark inequity. Residents of wealthy and middle-income countries have received about 90 percent of the nearly 400 million vaccines delivered so far. Under current projections, many of the rest will have to wait years.

to help an Indian company produce about 1 billion doses by the end of 2022 and his administration has donated doses to Mexico and Canada. But he has made it clear that his focus is at home.

“We’re going to start off making sure Americans are taken care of first,” Mr. Biden said recently. “But we’re then going to try and help the rest of the world.”

Pressuring companies to share patents could be seen as undermining innovation, sabotaging drugmakers or picking drawn-out and expensive fights with the very companies digging a way out of the pandemic.

As rich countries fight to keep things as they are, others like South Africa and India have taken the battle to the World Trade Organization, seeking a waiver on patent restrictions for Covid-19 vaccines.

as part of their vaccine diplomacy. The Gamaleya Institute in Moscow, for example, has entered into partnerships with producers from Kazakhstan to South Korea, according to data from Airfinity, a science analytics company, and UNICEF. Chinese vaccine makers have reached similar deals in the United Arab Emirates, Brazil and Indonesia.

Canada to Bangladesh say they can make vaccines — they just lack patent licensing deals. When the price is right, companies have shared secrets with new manufacturers in just months, ramping up production and retrofitting factories.

pressured Johnson & Johnson to accept the help and is using wartime procurement powers to secure supplies for the company. It will also pay to retrofit Merck’s production line, with an eye toward making vaccines available to every adult in the United States by May.

Despite the hefty government funding, drug companies control nearly all of the intellectual property and stand to make fortunes off the vaccines. A critical exception is the patent expected to be approved soon — a government-led discovery for manipulating a key coronavirus protein.

This breakthrough, at the center of the 2020 race for a vaccine, actually came years earlier in a National Institutes of Health lab, where an American scientist named Dr. Barney Graham was in pursuit of a medical moonshot.

For years, Dr. Graham specialized in the kind of long, expensive research that only governments bankroll. He searched for a key to unlock universal vaccines — genetic blueprints to be used against any of the roughly two dozen viral families that infect humans. When a new virus emerged, scientists could simply tweak the code and quickly make a vaccine.

In 2016, while working on Middle East Respiratory Syndrome, another coronavirus known as MERS, he and his colleagues developed a way to swap a pair of amino acids in the coronavirus spike protein. That bit of molecular engineering, they realized, could be used to develop effective vaccines against any coronavirus. The government, along with its partners at Dartmouth College and the Scripps Research Institute, filed for a patent, which will be issued this month.

another virus when the outbreak in China inspired his team to change focus. “We just flipped it to coronavirus and said, ‘How fast can we go?’” Dr. Graham recalled.

filed such a lawsuit in 2019 against the drugmaker Gilead over H.I.V. medication.

being lured to the United States.

“We funded the research, on both sides of the Atlantic,” said Udo Bullmann, a German member of the European Parliament. “You could have agreed on a paragraph that says ‘You are obliged to give it to poor countries in a way that they can afford it.’ Of course you could have.”

In May, the leaders of Pakistan, Ghana, South Africa and others called for governments to support a “people’s vaccine” that could be quickly manufactured and given for free.

They urged the governing body of the World Health Organization to treat vaccines as “global public goods.”

Though such a declaration would have had no teeth, the Trump administration moved swiftly to block it. Intent on protecting intellectual property, the government said calls for equitable access to vaccines and treatments sent “the wrong message to innovators.”

World leaders ultimately approved a watered-down declaration that recognized extensive immunization — not the vaccines themselves — as a global public good.

grant language requiring equitable access to vaccines. As leverage, the organization retains some right to the intellectual property.

Dr. Slaoui, who came to Warp Speed after leading research and development at GlaxoSmithKline, is sympathetic to this idea. But it would have been impractical to demand patent concessions and still deliver on the program’s primary goals of speed and volume, he said.

“I can guarantee you that the agreements with the companies would have been much more complex and taken a much longer time,” he said. The European Union, for example, haggled over price and liability provisions, which delayed the rollout.

In some ways, this was a trip down a trodden path. When the H1N1 “swine flu” pandemic broke out in 2009, the wealthiest countries cornered the global vaccine market and all but locked out the rest of the world.

Experts said at the time that this was a chance to rethink the approach. But the swine flu pandemic fizzled and governments ended up destroying the vaccines they had hoarded. They then forgot to prepare for the future.

For months, the United States and European Union have blocked a proposal at the World Trade Organization that would waive intellectual property rights for Covid-19 vaccines and treatments. The application, put forward by South Africa and India with support from most developing nations, has been bogged down in procedural hearings.

“Every minute we are deadlocked in the negotiating room, people are dying,” said Mustaqeem De Gama, a South African diplomat who is involved in the talks.

But in Brussels and Washington, leaders are still worried about undermining innovation.

During the presidential campaign, Mr. Biden’s team gathered top intellectual property lawyers to discuss ways to increase vaccine production.

“They were planning on taking the international view on things,” said Ana Santos Rutschman, a Saint Louis University law professor who participated in the sessions.

Most of the options were politically thorny. Among them was the use of a federal law allowing the government to seize a company’s patent and give it to another in order to increase supply. Former campaign advisers say the Biden camp was lukewarm to this proposal and others that called for a broader exercise of its powers.

The administration has instead promised to give $4 billion to Covax, the global vaccine alliance. The European Union has given nearly $1 billion so far. But Covax aims to vaccinate only 20 percent of people in the world’s poorest countries this year, and faces a $2 billion shortfall even to accomplish that.

Dr. Graham, the N.I.H. scientist whose team cracked the coronavirus vaccine code for Moderna, said that pandemic preparedness and vaccine development should be international collaborations, not competitions.

“A lot of this would not have happened unless there was a big infusion of government money,” he said.

But governments cannot afford to sabotage companies that need profit to survive.

Dr. Graham has largely moved on from studying the coronavirus. He is searching for a universal flu vaccine, a silver bullet that could prevent all strains of the disease without an annual tweak.

Though he was vaccinated through work, he spent the early part of the year trying to get his wife and grown children onto waiting lists — an ordeal that even one of the key inventors had to endure. “You can imagine how aggravating that is,” he said.

Matina Stevis-Gridneff and Monika Pronczuk contributed reporting.

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Hungary Pays $36 Per Dose for Chinese Vaccine

Hungary has agreed to pay about $36 a dose for Covid-19 vaccines made by Sinopharm, a Chinese state-owned vaccine maker, according to contracts made public by a senior Hungarian official on Thursday. That appears to make the Sinopharm shot among the most expensive in the world.

Hungary has agreed to buy five million doses of the Sinopharm vaccine, priced at 30 euros ($36) each, according to contracts that Prime Minister Viktor Orban’s chief of staff, Gergely Gulyas, uploaded to his Facebook page. That price far surpasses what the European Union has agreed to pay for vaccines from Western manufacturers.

The European Union has said it would pay 15.50 per dose for the Pfizer-BioNTech vaccine, according to Reuters, which cited an internal E.U. document. For AstraZeneca, it agreed to pay $2.15 per dose, according to Belgium’s budget secretary.

The contracts that Mr. Gulyas published also show that Hungary, which has recorded nearly half a million cases and more than 16,000 deaths, has agreed to pay $9.95 per dose for the Russian Sputnik-V vaccine.

79 percent, and that the second, made with the Wuhan Institute of Biological Products, is 72.5 percent effective.

Adam Liptak contributed reporting.

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