A committee of independent, expert advisers for the Meals and Drug Administration voted overwhelmingly to authorize the two-dose Novavax Covid-19 vaccine yesterday, with 21 of twenty-two committee members voting in favor of the vaccine and one member abstaining.
The endorsement is just for a two-dose main collection in adults, not for boosters. The FDA will not be obligated to comply with the recommendation of its committee—the Vaccines and Related Biological Products Advisory Committee (VRBPAC)—however the company sometimes heeds its recommendation. If the FDA authorizes the vaccine, the Facilities for Illness Management and Prevention might want to log off on use earlier than it turns into accessible.
The choice concerning the Novavax vaccine, which is already licensed in dozens of different nations, will not be a simple one within the US. The vaccine has some benefits over presently authorized vaccines however has a number of strikes in opposition to it.
Conventional Design
When it comes to design, the vaccine follows a extra conventional recipe than the 2 mRNA-based Covid-19 vaccines or Johnson & Johnson’s adenovirus vector-based design. Each of these designs are comparatively new and work by delivering genetic code for the SARS-CoV-2 spike protein to our cells, which then translate the code. The Novavax vaccine, alternatively, is a protein subunit-based vaccine that instantly delivers the SARS-CoV-2 spike protein to cells, together with an adjuvant—which is an additive utilized in vaccines to reinforce immune responses to the vaccine. On this case, the adjuvant is derived from saponin compounds discovered within the Chilean soapbark tree, which have been utilized in FDA-approved vaccines beforehand.
Typically, the protein-subunit vaccine design is tried and trusted; it is already utilized in vaccines in opposition to flu, pertussis (whooping cough), and meningococcal an infection, for instance.
Who Would Get It?
Novavax leaned onerous into the normal design in its pitch to the FDA. Now that we’re greater than two years into the pandemic and mRNA vaccines are available within the US, most individuals who need to get vaccinated have already gotten their pictures. This raises a key query of what position Novavax’s vaccine has left to play and the way it warrants “emergency use” authorization given the provision of different vaccines.
The corporate firmly aimed its conventional pictures at vaccine holdouts, which the CDC estimates to quantity round 27 million. They might be cautious of the extra revolutionary mRNA vaccines however may lastly be swayed to get vaccinated if supplied another that’s perceived as extra standard, Novavax argued.
“Tens of millions of Individuals right now are nonetheless unvaccinated,” mentioned Greg Poland, director of the Mayo Vaccine Analysis Group, who spoke on behalf of the Novavax vaccine at yesterday’s assembly. “For these people who are usually not absolutely vaccinated and are ready for an additional choice, having a vaccine platform that a number of stakeholders—together with regulators, physicians, and the general public—are aware of can assist mitigate among the challenges we’re dealing with right now.”
Although some committee members have been skeptical that an alternative choice would sway holdouts, prime FDA vaccine regulator Peter Marks appeared to purchase it. “We do have an issue with vaccine uptake that may be very critical in the USA, and something we are able to do to get folks extra snug to have the ability to settle for these probably life-saving medical merchandise is one thing that we really feel we’re compelled to do,” Marks mentioned. He additionally famous that some Individuals aren’t in a position to get mRNA vaccines attributable to opposed reactions, thus the protein-based vaccine could be a welcome new choice.
Efficacy, Variants, and Security
Novavax’s vaccine had stable efficacy estimates in a medical trial printed in February in The New England Journal of Medicine. Within the trial of greater than 29,000 individuals, the vaccine had an general efficacy estimate of 90.4 % in opposition to symptomatic Covid-19. Security knowledge for the vaccine suggests it is typically secure and nicely tolerated, although there could also be a hyperlink to uncommon circumstances of coronary heart irritation (myocarditis) seen with the mRNA vaccines.
That mentioned, the trial was accomplished final 12 months earlier than Delta and Omicron (with all its subvariants) got here alongside. It is unclear how the vaccine’s efficacy will stand as much as these newer variants.