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On Monday the news came that the pharmaceutical company Pfizer, which together with the German BioNTech is developing a vaccine for the coronavirus, had obtained very good results.
The Oxford University vaccine candidate and AstraZeneca have also announced that they can give results in the last phase of testing before Christmas. If approved, Norway will, at best, be able to access it through the EU Commission and the Covax Alliance from next year.
Meanwhile, large-scale work is going on here at home to find out which groups should receive a potential vaccine, and if so, which ones should be prioritized first.
Vaccine pairs give hope
This determines the priority of the vaccine.
The National Institute of Public Health, like the Norwegian Vaccine Institute, has been commissioned to prepare for coronary vaccination in Norway. The deadline for this plan is set for December 1, after which the government will determine the order of priority based on the advice of NIPH.
– The preparations and planning with us involve around a hundred employees under the direction of Geir Bukholm, FHI chief physician Preben Aavitsland tells Dagbladet.
FHI’s vaccination work is developed in five themes.
The first is the adaptation and implementation of a vaccination plan. The last three tasks are follow-up and follow-up, communication, and finally analysis and research.
The second, and one that worries many Norwegians now, is, however, the recommendations and priorities for an upcoming vaccine.
– We will propose to which groups vaccination should be recommended and in what order of priority, if there is a shortage of vaccines at first, Aavitsland tells Dagbladet.
There are five types of knowledge that form the basis of NIPH’s input to government on prioritization, Aavitsland explains.
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These are as follows:
Ethical evaluations: A group of medical ethics professors from various universities advise on which ethical principles should be used as the basis for recommendations and priorities.
Risk groups: An internal group investigates which diseases increase the risk of severe coronary disease.
Knowledge about vaccines: An internal group collects information on the properties of individual vaccines, for example, whether they protect equally well in all age groups. NIPH is also based on independent evaluation by the Norwegian Medicines Agency.
Epidemiological scenarios: One group describes the epidemic and models epidemic scenarios with different vaccination strategies.
Socio-economic assessments: A collaboration with an external company that evaluates the socioeconomic results of various vaccination strategies.
– More extensive
Aavitsland also claims that FHI, in addition to this group, has information meetings with various agencies and associations to hear their views.
“Overall, this will provide a basis for our contribution to the government,” Aavitsland told Dagbladet.
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Gunnveig Grødeland, Principal Investigator and Research Group Leader in the Department of Clinical Medicine at the University of Oslo, is an expert in immune systems, viruses and vaccine development.
She tells Dagbladet that this job is probably a bit longer than usual.
– The work is probably more extensive and includes much more than usual. Also, these are completely common knowledge aspects and criteria in vaccine planning, says Dagbladet.
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Since the NIPH has a deadline to complete this work before December 1, they are reluctant to provide clear answers on an order of priority at this time.
The department’s head, Line Vold, had made it clear to Dagbladet that this work has not yet been completed at FHI, but that it is typically healthcare workers and risk groups that top this list.
When asked if this is the case at the moment, Aavitsland responds the following to Dagbladet:
– This is normal with the annual flu vaccination and can also be normal with the corona vaccination.
– 2.6 million ‘priority’ in Sweden
Yesterday, the head of vaccine coordination in Sweden, Richard Bergström, came up with the following answer to Aftonbladet to the question of who will get vaccinated first there.
Therefore, vaccine candidates are discontinued.
– It is the Public Health Authority that decides. But what is suggested is that the elderly have the highest priority. The same applies to those who work in the care of the elderly, hospital staff, as well as certain specific risk groups. In total, 2.6 million people are prioritized.
When Dagbladet asked Aavitsland if there is reason to believe that Norway will prioritize differently, he had the following to say:
– We will return to this in our contribution to the government.
He adds that the deciding factor in how NIPH will prioritize vaccination is that the vaccination program will save lives and health.
– What factors in planning the vaccine work you are involved in is the biggest challenge?
– The biggest challenge is that we do not know what properties vaccines will have, for example, if they protect equally well in all age groups, and if they protect only against serious diseases or also against infections and contagions. This means that the recommendations may need to be changed when we know what vaccines we receive in Norway, says Aavitsland.
Difficult after vaccine shock
– The effect may change
Currently, there are several candidate vaccines that are in the final stages of phase three testing.
Although Pfizer’s preliminary conclusion is that the vaccine provides up to 90 percent protection, Grødeland does not rule out that this number could be reduced.
– Pfizer’s preliminary studies are excellent. The 90 percent efficiency is a very high figure in this context, but of course it can change.
The reason for this is how the studios are organized, explains Grødeland.
– People are vaccinated in different parts of the world and expect them to become naturally infected. What can vary is what other measures have been implemented in these geographic locations, he says.
In this way, the results can also change when the final conclusion is reached.
– Now we also see that there are mutations, without having seen that mortality has changed, but this could have an impact on how the effect will look in the end.
Also, Pfizer’s preliminary results did not include information on which age groups this vaccine is effective in, Grødeland emphasizes.
– We still don’t know anything about that. I know they have included the elderly, but I am assuming they included the elderly later in the study, and the effect will be less here. There are still a lot of things we don’t know yet, concludes Grødeland.
