Oxford Covid-19 vaccine Q&A: How effective is it, and how is it different to the Pfizer vaccine?

The Oxford/AstraZeneca vaccine is currently being administered in the UK, after the first jab was given on Jan 4.

Brian Pinker, 82, was the first person to be vaccinated with the Oxford/AstraZeneca Covid-19 vaccine at Oxford University Hospitals NHS Foundation Trust’s Churchill Hospital.

The dialysis patient stated that "I am so pleased to be getting the Covid vaccine today and really proud that it is one that was invented in Oxford. The nurses, doctors and staff today have all been brilliant and I can now really look forward to celebrating my 48th wedding anniversary with my wife Shirley later this year."

Tens of millions of people will be vaccinated by the spring as the Government rapidly scales up its Covid-19 vaccination delivery plan. 

The Department for Health and Social Care announced there will be capacity to deliver at least two million vaccinations in England per week by the end of January, with over 2,700 vaccination sites opened across the UK.

On Jan 4, the Health Secretary, Matt Hancock, described the roll out of the vaccine as a "vital step" in the fight against coronavirus, following a dramatic rise in the number of cases in the UK following news of a new strain.

Boris Johnson has pledged that the NHS is committed to offering a vaccination to everyone in the top four priority groups by Feb 15.

Delighted that today we roll out the @UniofOxford / @AstraZeneca vaccine across the whole UK 🇬🇧

It’s a vital step in our fight against this pandemic

This is a national mission. Thank you to everyone involved. pic.twitter.com/EU3R0AJoCx

— Matt Hancock (@MattHancock) January 4, 2021

A Department of Health and Social Care spokesman said in December: "The Government has today accepted the recommendation from MHRA to authorise Oxford University/AstraZeneca’s Covid-19 vaccine for use.

"This follows rigorous clinical trials and a thorough analysis of the data by experts at the MHRA, which has concluded that the vaccine has met its strict standards of safety, quality and effectiveness."

Overall results from phase three of the Oxford/AstraZeneca trial, which had more than 11,500 volunteers from the UK and Brazil, show the vaccine is 70.4 per cent effective on average. However, when administered at a half dose and then a full dose the vaccine can be up to 90 per cent effective.

At an MHRA briefing, regulators said the data points to the vaccine being 70 per cent effective 22 days after the first dose is given. 

Professor Stephen Powis, national medical director of NHS England, told BBC Breakfast on Jan 4: "It’s a remarkable scientific achievement. Who would have thought that, within a year of this virus first becoming apparent, that we would have not just one vaccine but two vaccines that we are able to use?"

Following the approval of the Moderna vaccine on Jan 8, there are now three vaccines available for use in the UK.

Matt Hancock has revealed the NHS has administered 2.6 million doses of the vaccine to 2.3 million people, as of Jan 11, and said the UK has "protected more people through vaccinations than all the other countries in Europe put together."

Mr Hancock has insisted that the Government is on course to reach its target and also pledged that every adult in Britain will have been offered a coronavirus vaccination by the autumn, in the UK’s biggest ever inoculation campaign.

He told Sky News’ Sophy Ridge on Jan 10: "The rate limiting factor at the moment is supply but that’s increasing. I’m very glad to say that at the moment we’re running at over 200,000 people being vaccinated every day."

The Queen and Prince Phillip have been vaccinated, Buckingham Palace announced on Jan 9.

How does the AstraZeneca/Oxford vaccine work?

The vaccine – called ChAdOx1 nCoV-19 – uses a harmless, weakened version of a common virus which causes colds in chimpanzees.

Researchers have already used this technology to produce vaccines against a number of pathogens including flu, Zika and Middle East Respiratory Syndrome (Mers).

The virus is genetically modified so it is impossible for it to grow in humans.

Scientists have transferred the genetic instructions for coronavirus’s specific ‘spike protein’ – which it needs to invade cells – to the vaccine.

When the vaccine enters cells inside the body, it uses this genetic code to produce the surface spike protein of the coronavirus.

This induces an immune response, priming the immune system to attack coronavirus if it infects the body.

How does the Oxford vaccine work?

How effective is it?

AstraZeneca – a British-Swedish multinational pharmaceutical and biopharmaceutical company with its headquarters in Cambridge – and Oxford University announced that their jab was effective in preventing many people getting ill and it has been shown to work in different age groups, including the elderly.

Partial immunity against Sars-Cov-2 is then detected approximately 22 days after administration of the first dose, the MHRA reported.

Data published in The Lancet in early December showed the vaccine was 62 per cent effective in preventing Covid-19 among a group of 4,440 people given two standard doses of the vaccine, when compared with 4,455 people given a placebo drug.

Of 1,367 people given a half first dose of the vaccine followed by a full second dose, there was 90 per cent protection against Covid-19 when compared with a control group of 1,374 people. Again, this dosing regime was not approved on Wednesday. 

The overall Lancet data, which was peer-reviewed, set out full results from clinical trials of more than 20,000 people.

Among the people given the placebo drug, 10 were admitted to hospital with coronavirus, including two with severe Covid-19 which resulted in one death.

However, among those receiving the vaccine, there were no hospital admissions or severe cases.

The combined analysis from both dosing regimens resulted in an average efficacy of 70.4 per cent.

However, Deputy Chief Medical Officer Professor Jonathan Van Tam said in a press conference on Dec 30 that although people receiving the vaccine would be protected, he could not provide assurance they would not still "pose a hazard" to others in terms of passing on the virus.

"We will know quite quickly within a couple of months the impact of these vaccines on reducing severe illness in the population," he said.

"We don’t know if the vaccines will reduce transmission but Public Health England have their finger on the pulse."

He would also go on to say that it would take up to two weeks for scientists to confirm the AstraZeneca and Pfizer vaccines were effective against the new strains of Covid-19.

How many doses does the UK have?

The UK has secured 100 million doses of the Oxford/AstraZeneca vaccine, this is the most the Government has ordered out of all of the potential vaccine candidates. 

The order is enough to vaccinate 50 million people.

AstraZeneca said it aimed to supply millions of doses in the first quarter of this year as part of an agreement with the Government.

There will be four million doses available post authorisation and tens of millions of doses in the first quarter of this year.

A specific schedule is difficult to establish as batches need to be quality approved by the MHRA.

Which NHS Trusts are receiving the vaccine first?

On Jan 4, six NHS Trusts in England will begin to roll out the Oxford/AstraZeneca vaccine. This is before inoculations  of the vaccine will be administered by GP-led services later in the week. 

The six NHS Trusts are:

  • Royal Free Hospital London NHS Foundation Trust
  • Brighton and Sussex University Hospitals NHS Trust
  • Guy’s and St Thomas’ NHS Foundation Trust 
  • Oxford University Hospitals NHS Foundation Trust
  • University Hospitals of Morecambe Bay NHS Foundation Trust
  • George Eliot Hospital NHS Trust

Brian Pinker, 82, was the first person to receive the Oxford/AstraZeneca vaccine at Churchill Hospital in Oxford. 

Mr Pinker receiving the first Oxford vaccine on January 4

Credit: PA

Does it differ to Pfizer and Moderna’s vaccines?

Yes. The jabs from Pfizer and Moderna are messenger RNA (mRNA) vaccines.

Conventional vaccines are produced using weakened forms of the virus, but mRNAs use only the virus’s genetic code.

An mRNA vaccine is injected into the body where it enters cells and tells them to create antigens.

These antigens are recognised by the immune system and prepare it to fight coronavirus.

No virus is needed to create an mRNA vaccine. This means the rate at which the vaccine can be produced is accelerated. 

The Pfizer and Moderna vaccines have both been approved in the US.

The UK Government began the roll-out of the Pfizer vaccine on Dec 8.

Unlike the Pfizer vaccine, the Oxford jab does not require ultra-low temperatures.

The Oxford jab requires temperatures between 2C and 8C and can be stored for at least six months. 

This is the typical temperature of a domestic refrigerator and this will make deployment of the vaccine much easier and faster.

What about antibodies and T-cells?

The Pfizer, Oxford/AstraZeneca and Moderna vaccines have been shown to provoke both an antibody and T-cell response.

Antibodies are proteins that bind to the body’s foreign invaders and tell the immune system it needs to take action.

T-cells are a type of white blood cell which hunt down infected cells in the body and destroy them.

Nearly all effective vaccines induce both responses.

The Oxford/AstraZeneca vaccine induces robust antibody and T-cell responses across people of all ages, the data indicates.

Vaccine development timeline

Can the Oxford vaccine be manufactured to scale?

Yes. The UK Government has secured 100 million doses as part of its contract, enough for most of the population.

The head of the UK Vaccine Taskforce, venture capitalist Kate Bingham, has said she is confident it can be produced at scale.

Vaccine orders by location

Where is it being manufactured?

While there are some doses coming from Europe in the very first instance, the majority will be provided from the UK supply chain.

Do you need two doses of the Oxford vaccine?

The MHRA has recommended the over 18s should receive two doses to be administered with an interval of between four and 12 weeks.

Will the vaccines be given out 24 hours a day?

Possibly. Government ministers are currently facing pressure to expand the vaccination programme to offer jabs "round the clock", meaning jabs may be administered 24 hours a day. 

Supplying vaccinations overnight will speed up the rollout, and allow the Government to reach their goal of vaccinating 32 million people- 60 per cent of the UK adult population by Spring-which was announced on Jan 11. 

On the same day as the announcement, ministers were asked why jabs are only administered during daytime hours, when other countries, such as Israel, who has already vaccinated one-fifth of its population, continue to offer jabs around the clock. 

Can this vaccine help the elderly?

There have been concerns that a Covid-19 vaccine will not work as well on elderly people, much like the annual flu jab.

However, data from the Oxford/AstraZeneca trial suggests there have been "similar" immune responses among younger and older adults.

The results show that the vaccine is better tolerated in older people compared with younger adults, and produces a similar immune response in old and young adults.

Brian Pinker was the first person to be administered with the vaccine. The 82 year old dialysis patient from Oxford stated that he is "so pleased to be getting the Covid vaccine today and really proud that it is one that was invented in Oxford." 

Can pregnant women have the vaccine?

Pregnant women and breastfeeding mothers have now been given the green light to take either the Oxford and Pfizer coronavirus vaccines following an appropriate case-by-case risk evaluation with their healthcare practitioner.

This is a reversal of previous advice which was put in place as precautionary measure.

Traditionally pregnant women are not included in clinical trials, but following a review the MHRA are recommending pregnant women be given the opportunity to receive the vaccine as as there is no evidence they would be at risk.

Dr June Raine, chief executive of the MHRA, said: "Our advice to date has been that given that in initial lack of evidence on a precautionary basis, use of a vaccine wasn’t recommended in pregnancy and women with breastfeeding should not be given the vaccine.

"But now that we have reviewed further data that has become available, the Commission on Human medicines has advised that the vaccine can be considered for use in pregnancy when the potential benefits outweigh the risks following an individual discussion with every woman."

Can people with allergies have the vaccine?

The roll-out of the Pfizer vaccine was halted for those who are known to suffer from severe allergic reactions following a handful of adverse events in the initial distribution of the vaccine. 

There were some concerns that this would also apply to the Oxford jab. 

However, following a review, the UK regulatory body has recommended both the Pfizer and Oxford vaccine are safe to administer to those with food or medicine allergies. 

Only those who have a known history of reacting to vaccines in the past should proceed with caution.

Sir Munir Pirmohamed, clinical pharmacologist and geneticist, and chairman of Commission on Human Medicine Expert Working Group, said. "We’ve come to the recommendation people with a known history of reacting to any specific ingredients of vaccine should not have it. But people with allergies to other medicines or food can have the vaccine."

Dr June Raine added that "at least 800,000 in the UK, probably a million and a half in the US" have already received the Pfizer vaccine. 

There has been "no additional concerns and this gives us further assurance that the risk of anaphylaxis can be managed through standard clinical guidance and an observation period following vaccination of at least 15 minutes."

When will roll-out of the Oxford vaccine start?

The Oxford vaccine started to be rolled out across the country on Jan 4.

The Government is aiming for two million people to receive their first dose of either the Oxford vaccine or the Pfizer jab within a fortnight as part of a major ramping up of the inoculation programme.

The Oxford jab will be administered at six hospitals for the first few days for surveillance purposes before the bulk of supplies are sent to hundreds of GP-led services to be rolled out.

Hundreds of new vaccination sites are due to be up and running in the first week of January as the NHS ramps up its coronavirus immunisation programme with the newly-approved jab.

As many as one million doses of the vaccine will be available for roll out across the UK from Jan 4, with vulnerable groups already identified as the priority for immunisation.

An army of more than 10,000 medics and volunteers has been recruited by the NHS to help deliver the Oxford Covid-19 vaccine. 

Mr Johnson has pledged that the NHS is committed to offering a vaccination to everyone in the top four priority groups by Feb 15.

To help with meeting this target there are already 595 GP-led sites providing vaccines with a further 180 coming on stream later this week, he said. There are also 107 hospital sites with a further 100 later this week. 

Furthermore, on Jan 7, The Ministry of Defence revealed it has prepared a "reserve" taskforce of 1,500 members of the Armed Forces who are ready to work at jab centres, should the vaccinators fall ill, and extra staff are required. 

The plan comes after the NHS made a formal request to the Civil Authority (Maca) convention via the Military Aid, for 133 members army personnel to take part in the vaccination programme. The workers began their training on Jan 4, and will start administering vaccines from Jan 11. 

Seven vaccination centres will also be opening in places such as sports stadiums and exhibition centres, including Derby Arena, which opened as a vaccination centre on Jan 7. 

On Jan 8, NHS England said letters inviting the over-80s to attend mass vaccination centres were starting to land on doormats.

The first 130,000 invitations asking the elderly to sign up for a jab at the centres, which open this week, were due to arrive over this weekend, with more than 500,000 to follow over the next seven days.

The letters have been sent to people aged 80 or older who live between a 30 to 45-minute drive from one of the new regional centres, with information about how they can book a slot either over the phone or via an online national booking service.

The Telegraph also understands the Prime Minister wants to have established 50 mass vaccination centres across England by mid-February to help drive the mass vaccination programme.

Ministers hope that the rapid expansion of these regional centres will deliver two million jabs a week by the beginning of next month.

Read more: The priority list for the Oxford and Pfizer vaccines – and how they will be rolled out

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