 Hello and welcome to NewsClick. Today we are going to discuss on the COVID-19 vaccine issue, particularly as we have again another vaccine which has seemed to have done reasonably well, the Dovervax vaccine. We have been tracking that from the beginning as one of the possible vaccines which could make a difference because it seems to be able to scale up well and if it works then it seems to be something which it does not require the kind of temperature ultra cold chain that the mRNA vaccines require and therefore could be of wider use. Satyajit, press releases of course only that's available but what do you think of the preliminary results? So Dovervax has announced that its preliminary results from their phase 3 clinical trial are very promising, they've got a very substantial degree of protection and as you will note I am reluctant to actually cite the percentage numbers not simply for Dovervax but for absolutely anybody because as we never tire of pointing out these are all preliminary numbers and therefore the actual precise value of the percentage of protection is likely to change. We will have to wait until the end of each of these clinical trials in order to come to a definitive number but the preliminary data for the Dovervax vaccine exactly like all the other vaccines that have been tested and provisionally approved as emergency usage so far show very respectable protection against COVID-19 particularly even though the numbers are really small particularly against severe illness in depth of which there were more than a dozen cases in their unvaccinated group and not a single case in the vaccinated group. So therefore there is another vaccine on the horizon and unlike some of the others so I remind ourselves the Oxford AstraZeneca serum Institute of India vaccine the Gamalaya Institute vaccines some of the Chinese vaccines the Johnson and Johnson vaccine all of these are adenoviral vector vaccines so the fact that one after another in fairly rapid succession many months ago they all came up with these preliminary protection data was simply confirmation that one adenoviral platform works as well as another adenoviral platform. This is the first so-called protein sub-unit vaccine platform that's come up to my knowledge at least that's come up with preliminary protection data and that's important from a variety of points of view let's keep in mind I'm getting into the science at just a little bit let's keep in mind that the two major modes of this kind of vaccine delivery are the inactivated virus vaccines which Chinese companies as well as ICMR Bharat biotech have come up with which is really just growing the whole virus in activating it and injecting it or taking the specific target in the virus which is the spike protein expressing it in the fermentation tanks via bacterial or yeast fermentation cultures purifying the protein ensuring this is the tricky part ensuring that the protein folds just right so that it looks like it looked looks on the original virus and then vaccinating with that exactly like the familiar tetanus vaccine that we all know and take periodically and because of that tricky bit there have been delays with this vaccine development pipeline but Novavaxis vaccine has now come through these phase 3 clinical trials and therefore over the next couple of months their numbers will firm up they will prepare their dossiers submit it and my guess is that somewhere by September everything moving smoothly they will also get emergency usage approval in some countries because it has implications for India because Serum Institute has an agreement with Novavax and they are saying they will also produce 1 billion doses over a 12 month period of course all these figures are easy to put before you start production and we know that scaling up is not a trivial task in any of the vaccines you've seen that with Serum Institute itself or even the AstraZeneca vaccine so given that at least the fact that it is a new vaccine it is available in India likely to be available in India as well and it seems to be that Novavax is considering it to be used or to be licensed to a number of places so the scaling up of the Novavax vaccine may be also significant is it also that this if you'd hid the right biology so to say is it also scaling up becomes a little easier so I'm sort of into the science today so let me make two separate points that are both science related one about your question of scale up the scale up for live virus growing and then in activating it and using it is of course biosafety as a as a scale up related problem the problem for the adenoviral vaccines including Covishield for example is that you essentially have to make large-scale tissue culture of actual human cells being culture and their the stringency of their needs is so much that scale up is something of a problem it's not impossible it's not it's not innovative it's just that it has to be done just so on the other hand if recombinant proteins such as Novavax's vaccine design needs either bacterial or yeast fermentation cultures which is a much older manufacturing technology much more robust to scale up so there's an advantage on the other hand once you scale up the production of an adenoviral vaccine all you then have to do is to pull out the adenoviruses and package them more or less on the other hand with the Novavax technology you have to purify the protein and worry about its folding so that on a larger scale can introduce batch to batch variation and and becomes a potential bottleneck for the scale up so this is this is one issue of the science of scale up but let me also say something taking the opportunity about the science of the vaccination itself so let's keep in mind that the whole virus vaccine inactivated vaccine and the Novavax vaccine both generate two specific kinds of immune responses they generate so-called CD4 T-cell responses which are inflammatory responses that also help B cells make antibody responses antibody responses on the other hand the mRNA vaccines and the adenoviral vaccines do this they generate B-cell responses they generate CD4 T-cell responses but in addition to that they also generate CD8 killer T-cell responses that might be useful for antiviral immunity it's not even clear that the CD4 T-cell responses and the antibody responses between these two platforms are identical and what this is doing is enhancing our diverse portfolio of generating immune responses by vaccination and I am I am aware that our audience might say something is going on pedantically about his his immunology but I would urge everybody to keep in mind that the more diverse our immune response basis the harder we make it for the virus population to throw up vaccine escape variants if we use a single vaccine globally then that's the that's that's a singular target that will press the virus in us in a in a certain direction evolutionarily to emerge with variant but if we have multiple vaccines multiple vaccine platforms multiple vaccine designs and that are generating even nuancedly variable immune responses I'm arguing that it adds to our portfolio of diversity and robustness in slowing down the likelihood of immune escape variant generation and that's a point that doesn't get easily made and therefore I'm taking time to make it yes let me sort of put it in slightly more English words what Satyajit is basically saying is that since the vaccine is very clear the virus is mutating therefore if we have more vaccines our ability to find a vaccine that will be able to act against a particular variant is more and secondly virus also will then have different ways of mutating and then that makes its task of a single successful mutant which overcomes the vaccines or the vaccine immunity that we have developed much easier so variety of attacks is actually better in this case that fact being of the immune system on the virus and therefore different kinds of vaccines being in our kitty being used simultaneously is also an advantage so these are the two arguments in why we we should look at more vaccines the better we are particularly already we have four variants of concern and that's including the variant Delta now including the Delta variant which as we know started in India though now of course we don't refer to them geographically and quite correctly so and Satyajit is one of the people who's been pointing it out all the time when you were talking about the UK variant the South Africa variant and the Brazilian variant that this is not the way to identify viruses but it is also the interesting that each of these vaccines seem to also have different levels of protection against different kinds of new variants of concern variants of concern but it is also interesting each of the vaccines to have seem to have different figures of success against each of the variants of concern well that's a little less clear than what some media reports would have us believe it's so far not happened that any two vaccines have been actually formally compared against a given variant of concern these are all independent reports emerging so for example some results come from looking at very mild infections by variants of concern some come from hospitalization and death related protection against variants of concern so I wouldn't put at this point too much weight and credence in the great variability but what you're making is a version of the point that I was making earlier that because each individual vaccine platform at the least generates a somewhat different landscape of immune responses the likelihood is that then there would be some differences in how each of them protects to what degree against a given variant of concern and all of that helps us in the sense that it helps prevent a sort of overwhelming takeover by a completely new resistant variant of concern and it would also seem to indicate that if we did boost the doses we could also mix by a vaccine so the first of course is as you pointed out the fact that none of these unlike the mRNA vaccines require ultra cold storage and therefore are very friendly to vaccination campaigns in the global south but secondly let's keep in mind that it increasingly becomes possible to now imagine test and begin to make evidence based policies on vaccine mix and match strategies that will give us better responses that will give us even more diverse responses and as far as the adenoviral vector platforms are concerned that allow us to sidestep one of the oft sighted limitations of the adenoviral platform which is that if you keep boosting with the adenoviral platform again and again you generate antibodies to the adenovirus itself which reduce the effectiveness of boosted doses and in all of these crossing different vaccine platforms into immunization vaccination protocols becomes an extremely attractive strategy and once again I come back to my point of science and technology politics all of this is something that we should have begun formally testing as soon as we began to approve vaccine platforms for usage knowing that these mix and match are going to be of significance and relevance for the common good and the fact that all of that has gotten so delayed into these now recent months I tend to relate it to the fact that it's all pharma companies competing for profits holding the pipelines of these vaccines. Yes enlarging their markets not wanting competition creating a monopoly before others would come in and of course deriding if it is a Chinese vaccine or a Russian vaccine basically claiming they're not as good as the American ones are. A lot of the vaccine issues are also to do with market monopolies and once you have a way you want to create market monopolies you don't really want any competition and secondly which is the other problem that you also want a longer term market so in fact in the back if the virus becomes endemic that might provide you a perennial market for your vaccines the risk that you carry is what you said that if you have only a few vaccines in our kitty then we have a chance of vaccine escape virus escape and then we have also our ability to counter the pandemic then reduces so in this sense the pharma company's goals and what societal goals should be are at loggerheads and that I think is one of the issues this is bringing up that while we have tried to saturate the market with just a few vaccines initially now we are slowly beginning to find that that is not a very good strategy A because then choke the pipeline and the availability of vaccines which is what we are seeing today and secondly you have vaccines which are not suitable to large parts of the world in terms of the supply chain and therefore more robust vaccines is what you require at the moment of course there is a whole bunch of issues with emergency use authorization should be the US may not go in for emergency use authorization already they have told Bharat biotech to make full submissions will they do the same with their home grown Novavax vaccine we don't know but all of this is up for grabs at the moment because it's not simply the question of public health it's also a question of pharma interested now coming and as we know big pharma has always had an outsized influence on policies and that's why instead of public health we have pharma policies driven by big pharma thank you Saty for being with us explaining to us the science which we have tended to reduce a bit because it's not so easy for people to grasp but being with us today and explaining some of the scientific issues which should inform our public health policies as well this all the time we have for news click today do keep watching news click and do visit our website