The rollout of the Covid-19 vaccine is now well under way with NHS staff working through the priority lists to ensure that as many people as possible are given the opportunity to be vaccinated, as quickly as possible. Scientists are now researching and developing oral vaccines which can be administered by tablet rather than injection. It is thought that a vaccine in this form would cost a lot less to produce, distribute, store, and administer, the main benefit being that is does not require refrigeration like most injectable vaccines.

With ImmunityBio (A US based company) having acquired worldwide rights to the technology, developed in the UK, required to deliver a vaccine in a pill or tablet form that will activate the immune system through virus-specific T-Cells, clinical trials have now started.

The vaccine is designed to work through the body’s immune system by generating memory cells, with neutralising antibodies, that will act against the virus and could act against any emerging coronavirus mutations. The plan is that the vaccine will serve as a “Universal T-Cell Boost to existing vaccines that have been developed and potentially address mutations that current vaccines may not be able to deal with.

The vaccine being developed by ImmunityBio is designed to target both the mutation prone outer spike of the virus and the more stable inner protein. The purpose being to activate antibodies, memory B-Cells & T-Cells to try and provide long-term protection.

Having the vaccine in a pill form will allow it to be delivered straight to the gut which is where most the body’s immune cells are. In addition, with it being in pill form the vaccine will be able to be delivered by placing it under the tongue. The oral vaccine delivery platform technology “has the potential to transform the way people take vaccines and addresses the challenges of storage and global distribution of vaccines”.

Technology is playing a major part in the development of orally delivered vaccines and the research and development undertaken by ImmunityBio is instrumental in ensuring that it is done without the loss of efficiency and that it provides the opportunity to truly transform the delivery of vaccines.

The development of oral vaccines provides the opportunity for them to be self-administered reducing the dependency on professionally trained NHS staff to run immunisation programmes and presents a future where vaccines could be delivered directly to people’s homes. Oral vaccines also provide a more cost-effective solution from the point of view of production, storage and transportation around the world.

There are three vaccinations which are currently available in the UK; Pfizer, Moderna and Oxford University vaccines are approved for use, they have been shown to be many times more effective than initially predicted, in some cases above 90 percent.

With the Oxford University vaccine approved and the first dose delivered on the 4^th of January 2021. the Moderna vaccine is the most recent- being approved on the 7^th of January, while Pfizer vaccine, the first to be rolled out, was approved on the 2^nd of December 2021.

Vaccinations from India

India is home to the world’s largest pharmaceutical manufacturing capacities, making a total of 60% of the world’s vaccines and is home to half a dozen major manufacturers. India’s drug regulator has maintained the go-ahead for Covishield (the local name for the Oxford-AstraZeneca vaccine developed in the UK) and Covaxin, locally made by pharma company Bharat Biotech.

Of the two vaccines approved, Covishield is the better known. It is a version of the Oxford University-AstraZeneca vaccine that was found to have an average efficacy of 70.4% in a peer reviewed study. Covishield is an Indian version made by the world’s largest vaccines manufacturer, the Serum Institute of India, and phase III trials on an Indian cohort have begun, with 1600 people enrolled in November.

Covaxin is India’s first home produced vaccine against Covid-19. It was developed by Bharat Biotech in collaboration with the Indian Council of Medical Research and the National Institute of Virology, and 25 800 people have been registered for trials across the country. On 21 January, The Lancet published Covaxin’s phase I trial data, giving it a green light for safety and stating that it generates adequate immune response, but said further efficacy trials were warranted.

Covishield has been sent out to several different countries so far- Bhutan, Maldives, Bangladesh, Nepal, Myanmar and Seychelles. With further plans to be sent out to many more low and middle income countries.

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