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Jenny Strasbourg of the WSJ provides this much needed report from London about the courageous decision by AstraZeneca and Oxford University to give vaccines away at no profit to the whole world, to billions of people in Africa, Asia, and Latin America. Without this brave decision by a British company and a British University the world would be a lot poorer, more variants could have happened, making us realize the great contribution Britain has made and how indispensable it is to the planet. Add to this the effort of Indian companies including Serum Institute that provided the manufacturing facilities and capabilities for making most of the British vaccine. AstraZeneca delivered 2.3 billion doses of the vaccine globally as of mid-December, according to the company. The International Monetary Fund estimates that low and middle income countries received 3.25 billion vaccines as of Dec. 11, About half of this or 1.6 billion doses were Astra Zeneca shots. This is a bigger share than any other vaccine by far and a life saver to the world. AstraZeneca stepped up early in a true to the best ideals in Britain to meet the needs of the world-  aiming to deliver 3 billion doses in 2022 and sell them at no profit as long as the pandemic continues. As the shot does not need cold storage it is ideal for India and other Asia, Africa and Latin America. "We are all very proud throughout the company of the impact we have had," says AstrZeneca CEO Pascal Soriot. By far the biggest manufacturing was done at Serum Institute of India which supplied 1.3 billion doses of the AstraZeneca vaccine to 70 countries. Mr. Modi pushed forward the export of vaccine made in India to the world from the beginning in the same spirit of cooperation and the best ideals that Britain was living upto. Serum Institute can produce as much as 250 million doses of vaccine a month making it possible for India to tackle the vaccination population of 1.3 billion people.   None of this could have happened without Oxford University and AstraZeneca and Indian companies with Mr. Modi's active support living up to the best ideals of Britain and India for the world. "When you add up the benefits to humanity, I think you'll find the vaccine holds up pretty well in terms of the ill health it has prevented, and the deaths it has prevented," says John Bell, a senior Oxford academic who in 2020 guided the University through its vaccine-partnership talks with Astra Zeneca. Because in the real world AstraZeneca shot has held up so well it is also a choice for booster shots. ...

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The UK and the European Union compete for limited vaccine supplies as a plant in Belgium has production problems and Astra Zeneca says it can only supply half of what it promised to Europe.

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The Oxford vaccine manufactured and distributed by Astra Zeneca faced manufacturing problems in 2020. The company is fixing these manufacturing problems and plans to meet demand from Britain, the European Union, and the rest of the world. It plans to double vaccine monthly production to 200 million doses monthly by April. CEO Pascal Soriot says "Is it perfect? No, it's not perfect, but it's great, and tell me who else is making 100 million doses in February?" The Oxford vaccine has shown strong protection against severe coronavirus symptoms and is important in the fight against the pandemic. To tackle variants of the coronavirus the company plans to have another jab developed by autumn this year.

Britain and India are depending on Oxford vaccine to vaccinate large parts of the population. India has a second vaccine developed by Indian scientists at Bharat Biotech that is also in use.

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Researchers point out that their findings show Oxford vaccine based on preliminary evidence could prevent a asymptomatic infection. The half dose followed by full dose regimen would give 90% protection against symptomatic infection and 60% against asymptomatic infection.

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This report in the WSJ shows Pfizer is expected to make $8 billion in profit on its vaccine business, and Astra Zeneca barely breakeven in the vaccine business. The British-Swedish drugmaker Astra Zeneca had offered to distribute the vaccine at no profit during the pandemic. For this reason Astra Zeneca is the only vaccine that is available in 170 countries with 1 billion doses released. One of the main recipients is India with a population of 1.2 billion, which is also a vaccine maker for the Astra Zeneca vaccine that was developed at Oxford University, under Indian brand name Covishield. The Pfizer vaccine by contrast was sold to governments in the US and European Union, and Britain, who could afford the large outlay of funds and signed contracts early.

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Astra Zeneca vaccine effectiveness gets a new boost from the late stage trial results for US, Chile and Peru that has 32,000 volunteers. The study shows Astra Zeneca vaccine 100% effective to prevent hospitalization and deaths, and 79% effective to prevent symptomatic illness. The vaccine is also known as the Oxford vaccine because it was developed at labs in Oxford University, England.

The vaccine is now preparing for US FDA regulatory approval. Its worldwide use will give new hope to the world's population because it is being given at cost and can be stored in ordinary refrigerators for long periods. Conditions that give it wide access in poor countries. It is also manufactured in India by The Serum Institute, one of the largest vaccine manufacturing labs in the world, which would make it possible to make the billions of doses needed.

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The U.S. is moving quickly to gain access to an effective vaccine by September or October 2020. It is doing this by providing the money for companies to conduct trials and ramp up manufacturing in a big way. The U.S. government has agreed to give Astra Zeneca upto $1.2 billion to secure supply of a Oxford University developed vaccine which could be ready by October. Astra Zeneca has agreed to make the vaccine under a licensing deal with Oxford University's Jenner Institute and promised it will not make a profit on this. U.S. has also given $483 million to Moderna in Cambridge, Massachusetts, for making the vaccine. Both Oxford and Moderna are testing the vaccine on humans. Oxford uses a tested older technology, Moderna a new technology. UK has given Astra Zeneca $79 million to secure 100 million doses of the vaccine, with 30 million ready by September. Oxford is also in negotiations with Gavi the international vaccine alliance, and Coalition for Epidemic Preparedness Innovations on further deals to boost production. Oxford began a 1100 person study in April, and is  doing a 5000 person trial in late May.  ...

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A Phase 1 trial of over a thousand volunteers shows the Oxford vaccine works well with minimum side effects that can be handled with acetaminophen. Phase 2 trial is underway with volunteers in UK, Brazil and South Africa. Participants given the vaccine had significant increase in antibodies to neutralize the disease, and T cells for long term protection. About 70% reported fatigue or headaches which can be handled with acetaminophen. After the Ebola crisis of 2014 in West Africa the British government invested 120 million pounds to form a group to develop vaccines for top 10 likely threats dubbed "Disease X." On this list was the coronavirus. Scientists at the Jenner Institute at Oxford formed a team as part of this effort. Sarah Gilbert and Adrian Hill led the scientists at Jenner and pioneered research for  a new way to do this- to first replace a part of the virus with a component of the new virus. Then to remove the part of the virus that allows it to replicate in humans. This method is called recombinant adenovirus vector. The Oxford scientists used existing technology in new ways to increase the chances of getting a good vaccine early.  The first vaccine could be developed and tested for mass production by September. A 30,000 participant trial begins in U.S. in August. About 1 billion doses could be manufactured by end of 2020. India's Serum Institute has the manufacturing facilities to do this near Pune, India.  ...

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So far 17 million people in the UK have received the Astra Zeneca vaccine.  35 cases of blood clots, 15 of pulmonary embolism and 22 of deep vein thrombosis have been reported across the UK and EU. In a normal year more than this number of cases of blood clots are seen say experts. These occur naturally in the population, including elderly population. Astra Zeneca's chief medical officer, Ann Taylor, says the number of blood clots in the 17 million people who have received the vaccine across Europe is actually lower than would be expected in the general population. The EU countries of Germany, France, Netherlands and Italy have temporarily stopped using it after 3 healthcare workers in Norway had blood clots. In Germany 7 out of 1.6 million had a rare condition of cerebral sinus thrombosis. Both EU and medical regulators say that there is no evidence that these blood clots are caused by the vaccine. The number of clots are similar to what was seen in the population before the coronavirus. Also this report in The Times says taken together there is no difference between the number of clots in the population that received the Pfizer vaccine or the Astra Zeneca vaccine.  The Daily Telegraph reports that one in 1000 people have blood clots every year, so that for 17 million people in vaccinated population with the Astra Zeneca vaccine there would be 17000 cases of blood clots over 12 months. During the clinical trials Astra Zeneca reported there were fewer people with blood clots who had been vaccinated than in the people who were not vaccinated. ...

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Closed vaccination centers in Rome soon after the Italian government with EU backing stopped a shipment of Astra Zeneca vaccines made in Italy that were being sent to Australia, show the extent of lack of clear direction in the EU on vaccination. Both the European Medicines Agency and the British Health and Medicines Regulatory agency have said that the Astra Zeneca vaccination of people has benefits that far outweighs any reports of risk from rare kind of blood clots. A professor of Imperial College, London, says that "the pause is a disaster for the vaccination uptake in Europe, which was already on slightly unsteady ground in some countries." 

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Moderna, J&J, Pfizer in the U.S., Sanofi in France, AstraZeneca in Britain, have accelerated their efforts to have a vaccine ready by the fall.  Moderna and Pfizer use new technologies. Astra Zeneca is working with Oxford University on a vaccine that builds on existing technologies. Both AstraZeneca and Sanofi are building capacity to make hundreds of millions of doses of the vaccine. 

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The Oxford vaccine is showing promising results and is expected to be authorized for use by December 2020. The vaccine being developed in partnership with Astra Zeneca PLC for marketing and Serum Institute of India for mass manufacturing is shown to be proven 90% effective in preventing infections in clinical trials. The partners say there were no serous safety events and the vaccine has proven 62% to 90% effective with an average of 70%.  This vaccine is significant because it is being developed with this partnership not seeking profits from this venture, providing it at cost and keeping the price to about $4 a dose compared to competitors Moderna and Pfizer whose vaccine is expected to be at $24 a dose. The Oxford vaccine also uses existing technology for vaccines and manufacturing is being done in India with the world's top manufacturer of vaccines. By using existing technology unlike the Pfizer and Moderna technology Oxford has taken an approach that could prove to be unique by minimizing side effects for vaccines that are being developed with such speed. By not requiring refrigeration at very low temperatures the vaccine makes itself ready for immediate and widespread uses all over the world. By use in its home country India with its large population Oxford vaccine can gain even wider acceptance because of India's long experience in pharmaceutical technology and manufacturing. Of particular interest is the study of 23,000 participants showing that the 90% effective dosage is one that only requires half a dose for the first shot. This say scientists is because the vaccine first dose prepares the body for a more powerful second dose and creates the maximum effect. This means the vaccine can be used for more doses than 2 full doses. It can be stored in a fridge making it easy to use in many countries. The full study will have 60,000 participants spread across U.S. Britain, Brazil South Africa and India. ...

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Slow progress of vaccination drives in the European Union has led to rising frustration. This is leading to action from the EU. The EU and Italy have halted export of 250,000 doses of vaccine bottled at a factory in Rome, that is part of the Astra Zeneca supply chain.