LOUISVILLE, Ky. — In the last two weeks, the Food and Drug Administration (FDA) has authorized two COVID-19 vaccines for emergency use. The vaccine-a-week trend isn't going to continue, but the shots from Pfizer and Moderna won’t be the only ones available for long.
The past year has seen more than 100 COVID-19 vaccines developed, with 40 reaching clinical testing so far, according to an analysis from the Washington Post. By February, the FDA is expected to receive requests to authorize two more vaccines for emergency use, with more to follow.
Earlier this month, Moncef Slaoui, the chief scientific officer of Operation Warp Speed, said a “portfolio” of five or six vaccines will be needed to achieve the lofty goal of vaccinating most Americans within the first half of next year. The number of doses the U.S. has ordered from Pfizer and Moderna can only cover 150 million Americans by the end of June. That's less than half of the country’s population and far fewer than the 270 million-plus needed to reach herd immunity.
“The more doses that you can get, the more patients you can protect as quickly as possible, the better,” said Jessica Daley, vice president of strategic supplier engagement for the health care company Premier. “We're really relying on this multi-company approach to ensure that we can get enough doses available to patients and individuals across the United States as quickly as we can.”
Here’s where the next wave of vaccines will be coming from:
Results from Johnson & Johnson’s 45,000-person Phase 3 trial are roughly a month away, the company said in a press release Thursday. If those results show that it has a safe and effective vaccine, it expects to ask the FDA for emergency use authorization (EUA) in February.
Over the weekend though, White House COVID-19 Task Force member Admiral Brett Giroir told ABC News that that he expects the vaccine to be approved even sooner. “We’re very hopeful, by January, we’ll have at least three vaccines, with more to come,” he said.
Unlike some of the other COVID-19 vaccines, Johnson & Johnson's doesn’t require extremely low temperatures for storage. Instead, the company says it can be stored at 35.6 to 46.4 degrees Fahrenheit for up to three months. It's also unique among competitors as the only vaccine meant to be administered in a single dose.
"One dose is definitely a benefit," Daley said, "and there are places where being able to only administer one dose will be a significant benefit."
The U.S. has a deal with Johnson & Johnson to buy 100 million doses of its vaccine.
The COVID-19 vaccine from the British pharmaceutical giant AstraZeneca, which is based on a virus that causes the cold in chimpanzees, has hit a few snags over the past few months. Its trials in the U.S. were halted in early September after a participant in the U.K. fell ill with a rare neurological illness. After more than a month, trials resumed.
As the U.S. trials continued, the company reported results from trials in the U.K. and Brazil in late November. The results were unexpected. When patients were given two doses one month apart, the vaccine had a 62 percent efficacy rate. When they were given a half dose followed by a full dose one month later, it had a 90 percent efficacy rate.
Slaoui last week predicted a similar rollout for AstraZeneca’s vaccine as Johnson & Johnson’s, with January trial results and a February EUA application. The company has a contract with the U.S. for 150 million doses of the two-dose vaccine.
A vaccine produced by the French pharmaceutical company Sanofi and U.K.-based GlaxoSmithKline has so far delivered disappointing results. The companies announced last week a delay in trials due to “insufficient response in older adults.” While the drug produced an acceptable immune response in those ages 18 to 49, older people, who are likelier to suffer from severe COVID-19, saw less benefit.
The new timeline for their vaccine has a new stage two trial starting next February and potential availability in the fourth quarter of 2021. The companies have a deal to sell 100 million doses of the vaccines to the U.S.
Despite never once bringing a drug to market, the Maryland-based vaccine development firm Novavax was one of a handful awarded a nine-figure deal by the U.S. government to develop a COVID-19 vaccine. The company is not there yet, but early results are promising.
Though it’s lagging well behind larger competitors such as Pfizer and Moderna, Novavax has the advantage of being able to be stored at regular refrigerator temperatures, “allowing for successful cold chain management with existing infrastructure,” the company said in a press release last August.
That’s meaningful, Daley said. “The more user-friendly a vaccine is to handle and administer, the more likely you are to get widespread adoption,” she said.