The Race to Vaccinate the World: A Look at Pfizer, Moderna, and Oxford

Comparing the Method, Efficacy, Cost, Timeline, and Accessibility of Three Major Vaccines

10 min readDec 12, 2020

Last Update: December 11, 2020

Remember when Coachella 2020 got postponed to October because we all thought it would be over by then? And now we’re in December. So just how close are we to a vaccine?

Recently there have been three major COVID vaccines enjoying the spotlight — Pfizer/BioNtech, Moderna, and Oxford University/AstraZeneca. Each has its own strengths and drawbacks when it comes to efficacy, cost, ease of production and storage, and accessibility. So let’s talk about it. We’ll look at how the vaccines compare, a quick overview of each, why I think they’re safe, vaccine accessibility for underdeveloped nations, and an estimated timeline for when “ordinary” US citizens can get their doses.

How the Vaccines Compare
What You Should Know About Each
Is it Safe?
Accessibility for Underdeveloped Nations
When Will I Get the Vaccine?

COVID-19 particle | Source: US Department of Energy, Flickr

How the Vaccines Compare

Here’s What You Should Know About Each

Pfizer/BioNtech

Pfizer, an American pharmaceutical company, teamed up with BioNtech, a German biotechnology company, to develop an mRNA-based COVID vaccine that is currently priced at $20 per dose, requiring two doses.

Out of the three major vaccines, the Pfizer one seems to have moved along the furthest, becoming the first COVID vaccine worldwide to receive authorization for emergency use. As of December 11th, it has received emergency authorizations from four countries: UK, Bahrain, Canada, and US. It is also the most finicky vaccine, with a storage condition of -70C. That is ridiculously cold. For reference, your freezer is -18C. And a Costco walk-in fridge is about 3C. I usually only last about 10 seconds max in those fridges.

On December 8th, the UK began the very first nationwide COVID vaccine campaign using the Pfizer vaccine, with Margaret Keenan as the first recipient.

Source: https://www.freepik.com/photos/medical

So, everyone’s talking about an mRNA vaccine. How does it work and why is it so good?
mRNA is genetic material (like a blueprint) that encodes a protein. When mRNA is injected into the arm, the muscle cells read the blueprint and build the protein.

For COVID vaccines, the mRNA blueprint encodes for the coronavirus spike protein. So, after receiving the COVID vaccine, your body produces spike proteins that your immune system can then recognize and develop immunity to.

There are several key benefits to this method:

This vaccine will work for many different coronavirus mutations, because the spike protein is highly conserved — it always stays the same because it’s just that important. So your body will recognize the spike protein on any mutated virus.
This vaccine is much safer, since it uses genetic material rather than an actual (weakened) virus the way traditional vaccines do. Without the presence of the actual virus in the vaccine, there is much less risk of a negative response. The mRNA inside the human body lasts only for a few days maximum.
mRNA vaccines are relatively quick to manufacture. Rather than making the actual virus or proteins, producers only have to make the mRNA. It’s like if you only had to write a recipe rather than make the actual dish. Furthermore, mRNA structure is much simpler and therefore much easier to manufacture than proteins or viruses. mRNA vaccines can be easily scaled up and mass-produced.

Now, back to Pfizer.

Pfizer/BioNtech Vaccine Timeline
November 9: Reported 95% success in Phase 3 results
November 20: Applied to US FDA for emergency use authorization
December 2: UK authorized Pfizer COVID vaccine for emergency use
December 4: Bahrain authorized Pfizer COVID vaccine for emergency use
December 8: UK administered very first Pfizer vaccine to Margaret Keenan to began nationwide COVID vaccine campaign
December 9: Canada authorized Pfizer COVID vaccine for emergency use
December 11: US FDA authorized Pfizer COVID vaccine for emergency use

Moderna

Moderna is another American biotechnology company that has developed an mRNA-based COVID vaccine with promising results. And, Moderna is really good at what they do — they actually specialize in mRNA. In fact, the company name “Moderna” comes from “modified mRNA” (or so I’ve heard, but I just tried googling it and couldn’t find anything about it so… idk).

Like the Pfizer vaccine, this one requires two doses. It has less stringent storage restrictions, lasting up to 6 months when stored at -20C. However, it is the most expensive of the three, priced at $33 per dose.

Moderna Vaccine Timeline
November 16: Reported 94.5% success in Phase 3 results
November 30: Applied to FDA for emergency use authorization
…
December 21: Moderna vaccine available in the US if approved by FDA

Oxford University/AstraZeneca

Of the three, Oxford University/AstraZeneca’s vaccine is the only one that uses viral vector delivery (basically a virus as a transport system) rather than mRNA. The vaccine is made from a chimpanzee common cold virus, modified so that it does not replicate in humans. When this virus is injected, it delivers instructions for the human cell to make the spike protein — it’s like a little mail carrier. This spike protein then stimulates memory and immunity in the same way that a normal vaccine would.

This vaccine is much cheaper than the other two at $4 per dose (that’s the price of a boba!). It is also much easier to distribute due to its forgiving storage conditions (normal fridge temperature). Like the other two, this vaccine also requires two doses.

There is a little more uncertainty surrounding the efficacy of the Oxford vaccine. An “unplanned” dose error during clinical trials resulted in a small subset of volunteers receiving a half dose and a full dose, rather than two full doses. This resulted in drastically different results — participants with the half dose saw a 90% success rate, whereas participants with the full dose saw a success rate of only 62%. This averages out to the 70% that is often reported. To achieve authorization, Oxford may need to perform more testing and gather more data to explain why there is such a discrepancy.

Oxford University/AstraZeneca Vaccine Timeline
November 23: Preliminary data of 62-90% efficacy released
November 27: UK government asked MHRA to assess the Oxford COVID vaccine

Is it Safe?

Of course, concern over the safety of these vaccines is perfectly understandable. After all, can we really trust a vaccine that has been developed in such a short period of time? Personally, as someone working in biotech, I trust the other professional scientists, researchers, and regulators to know what they’re doing. But in case you need some more convincing…

Here are some things to think about:

mRNA-based vaccines are very safe. Remember, the Pfizer and Moderna vaccines simply contain a blueprint, not an actual virus. The Oxford vaccine also does not contain the live coronavirus, although it does contain a harmless “virus shuttle.”
In the Moderna trial, no one who received the vaccine developed severe COVID-19. No one! Similarly, in the Pfizer trial no safety concerns were observed.
Although these vaccine trials seem “rushed” compared to other vaccines that took many years to develop, the quick turnaround time is actually very reasonable. Previous vaccine trials spent a lot of time obtaining funding and recruiting participants, and even more time waiting for people to actually become infected. It could take several months or even years for infection to occur in enough people that a statistical analysis could be done. With COVID, funding and recruitment took an impressively short amount of time, and the rampant spread of COVID actually helped to speed up the clinical trial timeline by providing large amounts of data very quickly.
Coronavirus vaccines are not completely new, as scientists had already started working on a coronavirus vaccine during the SARS and MERS outbreaks back in 2003 and 2013. So, although these specific COVID-19 vaccines are new, there was already plenty of useful data to build upon.
For those over the age of 20, the risk of death from COVID is more than one out of 20,000. Based on data that has been released about the vaccines so far, you would be less likely to die from the vaccine than from the infection itself. So, even if the vaccine is not 100% safe, maybe the risk of taking the vaccine is worth it.
It’s true that we do not know the long-term affects of the vaccine. And it would be impossible to know until many years later. However, these mRNA-based vaccines are unlikely to cause long-term effects because mRNA is very short-lived (several days or less), and would not duplicate nor stay dormant in your body. Thus, any serious adverse reactions should occur within the first month, and would absolutely be captured during clinical trials. For more perspective on this, read here.

Source: https://www.freepik.com/photos/health

Accessibility for Underdeveloped Nations

Another equally important aspect of the COVID vaccine is its accessibility, specifically for underdeveloped nations that cannot afford to reserve doses.

As put by Frontline AIDS director Lois Chingandu:

“This pandemic is a global problem that requires a global solution. The global economy will continue to suffer so long as much of the world does not have access to a vaccine.”

According to the People’s Vaccine Alliance (PVA), a coalition working towards fair vaccine access, only 10% of the population in poorer countries would get vaccinated by the end of 2021. In fact, many of these people may not get vaccines until 2023 or 2024. Can you imagine three or four more years of this?

And that’s because, at the start of the pandemic, richer countries went on massive “panic buying” sprees. It’s kind of like how we were all desperately buying toilet paper at the start of the pandemic. Or like how every year on Black Friday I would also go on a massive shopping spree. Anyways, these countries made deals with biopharmaceutical companies to purchase vaccines, even when clinical trials were not yet finished. Big gamblers huh.

Rich countries have so far pre-ordered enough doses to vaccinate their population an average of three times over. Canada in particular has ordered enough vaccines to dose each Canadian eight to nine times. Remember, all three vaccines only require two doses per person. While representing only 14% of the world’s population, the richest nations have claimed 53% of the promising vaccines so far.

COVAX — the effort to provide equitable access

COVAX is a global collaboration, co-led by the WHO and partners, that aims to “accelerate the development and manufacture of COVID-19 vaccines, and to guarantee fair and equitable access for every country in the world.”

According to the PVA, the poorest countries would only gain access to a vaccine through the help of COVAX. But COVAX has only been able to reserve 700 million vaccine doses so far, shared amongst 3.6 billion citizens across 92 poorer nations.

Dear rich countries, please donate your extra doses to COVAX.

So far, the EU, France, Spain, Korea, and the Bill & Melinda Gates Foundation have pledged $360 million to COVAX. On the other hand, the Trump administration has announced that the US would not participate in financing COVAX and would instead further reserve vaccines for Americans. Honestly, given the state that America is in right now, I can’t really blame him. That must have been a hard decision to make… good thing I’m not a world leader.

Oxford/AstraZeneca vaccine is absolutely “critical“ for lower-income nations

Oxford University and AstraZeneca have committed 64% of their doses to developing countries. Not only that, but they have also shared their technology with other vaccine manufacturers in an effort to scale up more rapidly. In contrast, Pfizer and Moderna both did not agree to PVA and COVAX’s request for technology and intellectual property sharing.

And let’s not forget the significantly cheaper cost ($4) of the Oxford vaccine. Or the forgiving storage condition (normal fridge temperature). Many hospitals and medical centers, especially those in rural areas, may not have access to the special freezers that would be necessary to keep the Pfizer and Moderna vaccines at -70 or -20C.

For all of these reasons, this vaccine is seen as “critical for closing the gap in accessibility around the world,” according to Kalipso Chalkidou, director of global health policy at the Center for Global Development.

“AstraZeneca has signaled that they want to make this available to people in in poorer countries at the lowest price possible... If the world wants to end this pandemic, it needs to produce billions of doses of not just a vaccine, but an affordable one.” -Kalipso Chalkidou

Finally, the question we all care about. When will I get the vaccine?

In short, nobody knows. US infectious disease expert Dr. Anthony Fauci hopes that ordinary citizens will be able to get the vaccine by April, May, or June of 2021, so let’s go with that. Speaking of Fauci, apparently vets have reported a drastic increase in the number of dogs named Fauci this year. Isn’t that so cute? Imagine a pug named Fauci.

Anyways, if you’re a frontline healthcare worker, nursing home resident/staff, essential worker, person with pre-existing condition, or older adult, you will likely get a vaccine before then. In fact, limited doses of vaccines could be available this month.

Dr. Anthony Fauci | Source: The White House from Washington, DC, Public domain, via Wikimedia Commons

Closing Thoughts

Despite being an extraordinarily difficult year worldwide, 2020 has also seen amazing resilience and compassion, not to mention remarkable scientific advancement.

See you all at Coachella next year? Frank Ocean, please be there.