Nuvaxovid nearing approval The vaccine some unvaccinated people are waiting for

Berlin · Some unvaccinated people are still waiting for an alternative to the currently available Coronavirus vaccines. The wait could soon be over. Here are the answers to the most important questions about the vaccine.

 In a Novavax pivotal trial, efficacy against disease was 90 per cent. Photo: Lars Hagberg/The Canadian Press/ZUMA/dpa/symbol

In a Novavax pivotal trial, efficacy against disease was 90 per cent. Photo: Lars Hagberg/The Canadian Press/ZUMA/dpa/symbol

Foto: dpa/Lars Hagberg

A number of people have put off being vaccinated against COVID until new vaccines have been developed using technologies different to the ones used for the currently available alternatives. One such vaccine, Nuvaxovid, is now nearing approval, with the EU medicines agency EMA due to consider the application from the manufacturer Novavax on Monday. Other alternatives to the four vaccines so far approved could follow next year. It is hoped that sceptics will then decide to be vaccinated after all.

How does the Novavax vaccine work?

According to the Paul Ehrlich Institute (PEI), Nuvaxovid consists of virus-like particles that contain the spike protein of the coronavirus. The proteins are recognised by the body as foreign, and the immune system is ramped up - specific antibodies and T-cells are produced. This means we are better equipped to fight a real infection. This is different from the way mRNA vaccines work. Here, snippets of genetic material are introduced into the body and they produce the spike protein to trigger an immune response.

How effective is the new Novavax vaccine?

According to data in the pivotal Phase III study by Novavax, the overall vaccine efficacy was 90 per cent. This means that there was 90 per cent less disease in the vaccinated group than in the control group. In the study, two doses were administered three weeks apart. However, the results mainly refer to the alpha variant, which has been almost completely replaced by delta in Germany. According to experts, the new Omicron variant is likely to have a strong influence on the infection rate. "This vaccine will also have to be adapted to Omicron," Carsten Watzl, Secretary General of the German Society for Immunology, recently wrote on Twitter, talking about the Novavax vaccine.

Why wait for certain vaccines?

Some individuals seem to have more confidence in vaccines produced by classical methods. For example, some people mistrust the new mRNA technology that is behind the Moderna and Biontech/Pfizer vaccines. There are fears that these could cause as yet unknown long-term damage. National football player Joshua Kimmich (FC Bayern), for example, had initially explained his hesitation to get vaccinated with "a few concerns, especially regarding the lack of long-term studies". After emotional debates and a Coronavirus infection, he recently announced that he would now be vaccinated after all. Experts believe that it is virtually impossible for the approved vaccines to have any unknown long-term effects.

Inactivated vaccine - what's behind it?

According to the Federal Ministry of Education and Research, inactivated vaccines contain dead pathogens, i.e. pathogens that can no longer replicate. They can also contain only components or individual molecules of these pathogens. Examples are vaccines against hepatitis A and influenza. The body is unable to distinguish the dead vaccine from the pathogen and ramps up a targeted immune defence that protects against a real infection. For some people who have so far refused to be vaccinated, this approach sounds more "natural" than that of, for example, mRNA vaccines.

Is there already a clearly defined classification of inactivated vaccines?

No. There is no uniform use of the term. If the definition is that the vaccine must contain the real virus or at least parts of it, Novavax would not be a dead vaccine in the strict sense at all. This is because the crucial component that is supposed to trigger the immune response was not taken from a real virus but instead is a genetically engineered viral protein. On the other hand, it could also be argued that all vaccines without living - i.e. replicable - pathogens are dead vaccines. "The name is wrong," says Watzl. "All Covid-19 vaccines approved so far are inactivated vaccines." What many meant when they referred to dead vaccines, he says, are "vaccines based on principles that are used for other vaccines."

What other vaccines could be coming soon?

Several products are already under review in the EMA's so-called rolling review process, although not all parts of the authorisation application have been submitted yet. The vaccines developed by the manufacturers Sinovac and Valneva (France), for example, contain dead coronaviruses.

Is it worth waiting for other vaccines?

"If someone insists that they only want this kind of vaccine, then that is still better than being completely unvaccinated," says immunologist Watzl. But he thinks it would be unwise to wait - Novavax will not be available until next year, Valneva not until the second quarter of 2022 at the earliest. "Anyone who waits for these vaccines will still be unprotected for a long time. Therefore: it’s better to vaccinate now than wait." Even the head of the manufacturer Valneva does not think we should wait. "I’m not advising anyone to wait for our vaccine," Thomas Lingelbach, CEO of the French biotechnology company, told Der Spiegel. "That would be ethically unacceptable." He currently recommends friends and relatives to get their jabs with vaccines from other manufacturers, and he himself has recently had his booster shot with Biontech's mRNA product.

Are there also live vaccines?

Yes, for example against mumps, measles and rubella. They contain real pathogens that can still replicate, but whose pathogenic properties have been bred out.

Original text: Sandra Trauner, dpa

Translation: Jean Lennox

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