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Covid-19: Novavax vaccine efficacy is 86% against UK variant and 60% against South African variant

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n296 (Published 01 February 2021) Cite this as: BMJ 2021;372:n296

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Money, Market, Media and vaccine nationalism in the pandemic era

Dear Editor

I read with great interest your news item reporting Novavax vaccine efficacy (1). In this era of pandemic rules of scientific publication and peer review have been rewritten and important studies with huge significance are reported not through peer reviewed publications but through press releases to the markets which have the potential to make money for the shareholders or increase the investment in these companies.

Both Novavax (2) and Johnson & Johnson (3) announced the results of their phase III trials through press releases aimed at the stock market. Novavax press release proclaimed “NVX-CoV2373 is the first vaccine to demonstrate not only high clinical efficacy against COVID-19 but also significant clinical efficacy against both the rapidly emerging UK and South Africa variants,”. Words such as “spectacular” “extremely encouraging" form part of the press release. Johnson & Johnson press release declared “Protection Against Severe Disease Across Geographies, Ages, and Multiple Virus Variants, including the SARS-CoV-2 Variant from the B.1.351 Lineage Observed in South Africa”. When there are grave concerns regarding the emergence of new variants no wonder the results attracted widespread media attention (4-5).

Novavax also hosted a conference call to present the results (6) which have not been peer reviewed yet but have been widely publicised and available to all. In the early stages of the pandemic I cautioned against abandoning the “Ingelfinger rule”(7), which was put in place to protect both the researchers and patients and to uphold humanity’s scientific integrity and the high standards we set for ourselves.

The difficulties in interpreting and understanding COVID research reports and publications have been discussed in great detail (8). According to Wired, “Studies are rapidly pouring out of labs and hospitals, but not all of that information is rigorously vetted before it makes its way into the world. Some studies are small and anecdotal. Others are based on bad data or misplaced assumptions. Many are released as preprints without peer review. Others are hyped up with big press releases that overstate the results—but when scientists are finally able to dive into the research, sometimes the study isn’t as groundbreaking as it seemed”. Both the lay and professional media need to behave very responsibly during the pandemic as the coverage by the media can have adverse impact on the mental health of the population (9).

The pandemic also has given rise to the phenomenon of vaccine nationalism with countries clamouring for vaccine for their population and threatening export ban (10). Germany (11) and France have recommended AstraZeneca vaccine to under 65 years old in spite of the European Medicines Agency issuing emergency use authorisation for over 65s (12). Vaccine nationalism is not only afflicting nations but also their citizens (13).

Although the indicators in containing the pandemic are going in the right direction for many European countries, still there is a long way to go before we conquer this unseen enemy. This can only be achieved by adhering to high scientific standards and fostering international collaboration and cooperation in all our scientific endeavours in combating this pandemic. I would like to draw the attention of authors and editors to the importance of adhering to high standards in their research and publishing the findings (14) which will help us disseminate good quality peer reviewed research benefitting the population & communities we are here to serve and protect.

References:

1 Covid-19: Novavax vaccine efficacy is 86% against UK variant and 60% against South African variant. [BMJ]1st February. BMJ 2021;372:n296 [accessed 7th February 2021]; Available from https://www.bmj.com/content/372/bmj.n296

2 Novavax COVID-19 Vaccine Demonstrates 89.3% Efficacy in UK Phase 3 Trial [BMJ] 28th January 2021. [accessed 7th February 2021]; Available from: https://ir.novavax.com/news-releases/news-release-details/novavax-covid-...

3 Johnson & Johnson Announces Single-Shot Janssen COVID-19 Vaccine Candidate Met Primary Endpoints in Interim Analysis of its Phase 3 ENSEMBLE Trial. [internet] 29th January [accessed 7th February 2021]; Available from: https://www.jnj.com/johnson-johnson-announces-single-shot-janssen-covid-...

4 Novavax offers first evidence that COVID vaccines protect people against variants. [Internet] 29th January [accessed 7th February 2021]; Available from: https://www.nature.com/articles/d41586-021-00268-9

5 Will Novavax and Johnson & Johnson Covid vaccines work against variants? [Internet] 29th January [accessed 7th February 2021]; Available from: https://www.theguardian.com/society/2021/jan/29/how-effective-novavax-co...

6 Announcement of UK and South Africa Trial Results. [Internet] 28th January [accessed 7th February]; Available from: https://ir.novavax.com/static-files/2f6f14cb-3205-4719-b28c-1711793b9782

7 Have we abandoned the Inglefinger rule in the COVID era? [BMJ] 20th June [accessed 7th February 2021]; Available from: https://www.bmj.com/content/369/bmj.m2279/rr-1

8 How to Read Covid-19 Research (and Actually Understand It). [Internet] 8th July [accessed 7th February 2021]; Available from: https://www.wired.com/story/how-to-read-covid-19-research-and-actually-u...

9 Su, Z., McDonnell, D., Wen, J. et al. Mental health consequences of COVID-19 media coverage: the need for effective crisis communication practices. Global Health 17, 4 (2021). https://doi.org/10.1186/s12992-020-00654-4

10 European Commission introduces vaccine export controls amid AstraZeneca supplies dispute. [Internet] 29th January [accessed 7th February 2021]; Available from: https://www.independent.co.uk/news/world/europe/eu-export-controls-vacci...

11 Germany recommends AstraZeneca COVID vaccine only for people under 65. [Internet] 30th January [accessed 7th February]; Available from: https://www.euronews.com/2021/01/30/germany-recommends-astrazeneca-covid...

12 EMA recommends COVID-19 Vaccine AstraZeneca for authorisation in the EU [Internet] 29th January [accessed 7th February 2021]; Available from: https://www.ema.europa.eu/en/news/ema-recommends-covid-19-vaccine-astraz...

13 COVID-19: 'I'll wait for the English vaccine' - How 'nationalism' is affecting the fight against coronavirus [Internet] 6th February [accessed 7th February 2021]. Available from https://news.sky.com/story/covid-19-ill-wait-for-the-english-vaccine-how...

14 Wager E, Kleinert S. Why do we need international standards on responsible research publication for authors and editors?. J Glob Health. 2013;3(2):020301. doi:10.7189/jogh.03.020301

Dr Padmanabhan Badrinath, Consultant in Public Health Medicine, Director, Public Health Specialist COVID19 Centre Suffolk County Council & Associate Clinical Lecturer, University of Cambridge. Directorate of Public Health, Endeavour House, Suffolk County Council, Ipswich, IP1 2BX. p.badrinath@suffolk.gov.uk

Disclaimer: The views expressed here are the personal view of the author and in no way represent the views of his employer, Suffolk County Council.

Conflict of interest: The author works in a local authority Public Health Department and leads the local specialist COVID response team.

Competing interests: No competing interests

07 February 2021
Padmanabhan Badrinath
Consultant in Public Health Medicine & Associate Clinical Lecturer
Suffolk County Council & University of Cambridge
Endeavour House, Suffolk County Council, Ipswich IP1 2BX