Covid-19 vaccine rollout: how effective is the Covid vaccine?

Vaccine rollouts across the globe to alleviate the Covid-19 pandemic are making daily progress. In the United Kingdom, the first approved Covid-19 vaccinations have been around since the end of December 2020, with particularly vulnerable groups of people standing first in line to become vaccinated. But it will still take months before the vaccinations can effectively resolve or provide a remedy to the Covid-19 pandemic and its restrictions.

So, with a long road ahead of us, why do experts have such high hopes for these vaccinations – are vaccines really our way out of the pandemic? Who will be vaccinated first and how long will it take to vaccinate the population? How do the vaccines that have now been approved work and how safe and effective are they?

Allow us to give you some initial answers to these questions and delve into how vaccine effectiveness against Covid-19 is tested and why it is important to test for how much protection each vaccination offers – whilst also considering Covid-19 variants.

Why is the Covid-19 vaccine rollout so important?

In medicine, vaccination is the ultimate go-to treatment for infectious diseases. After all, when we are vaccinated, our bodies are able to fight off a disease before it can develop.

And not only that – widespread vaccination creates immunity in the population. In the best case, this makes it significantly more difficult for a pathogen, such as a virus, to spread. In the past, various pathogens have been almost or completely eradicated. Polio and smallpox, for example, are considered to have been eradicated in the United Kingdom. Whooping cough, measles, diphtheria and tetanus (lockjaw) have become rare.^[1]

Why vaccinate against Covid-19?

When it comes to the SARS-CoV-2 virus, a vaccine rollout has become a race against time – made even more urgent by the emergence of mutated and faster-spreading virus variants, such as those found in South Africa, Brazil and the United Kingdom.

Effective vaccination is seen as the way out of the pandemic. Because if enough people are successfully vaccinated and thus immune to the coronavirus, the disease can no longer spread rapidly.

Without a vaccine, one of these two scenarios would probably occur:

• Scenario 1: We would have to live with drastic restrictions in everyday life for years, so that Covid-19 cases do not overwhelm our hospitals.
• Scenario 2: We would allow the virus to spread more rapidly without implementing restrictions, which would likely result in an overburdened health system and many deaths.

Who should get the Covid-19 vaccine first?

On 8 December 2020, the United Kingdom became the first country worldwide to announce its Covid-19 vaccine rollout, with care home residents and staff, people over the age of 80 and health and social care workers among the first to receive the first dose of the vaccine.^[14]

When you are called up to get the vaccine will depend on various factors, such as your age group, occupation and any health issues you have. For example, care home residents and employees were announced as the first group in line to be vaccinated back in December 2020.

The current schedule for the vaccine rollout is as follows.^[16]

• Cohort 1: Care home residents, residential care workers
• Cohort 2: People over 80 years of age, healthcare workers, social care workers
• Cohort 3: People between 75 and 79 years old
• Cohort 4: People between 70 and 74 years old, clinically extremely vulnerable people under 70 years of age
• Cohort 5: People between 65 and 69 years old
• Cohort 6: People considered a risk group under 65 years of age
• Cohort 7: People between 60 and 64 years old
• Cohort 8: People between 55 and 59 years old
• Cohort 9: People between 50 and 54 years old
• Cohort 10: Rest of adult population

Similar schedules prioritising the elderly and vulnerable members of society have also been rolled out in Europe and the United States. 

You might also ask yourself: Where will I be vaccinated? Large-scale venues – such as football stadiums – hospital hubs, pharmacies, mobile units and many more vaccination centres will be used across the country. According to a government report, every UK resident should live within ten miles of a vaccination centre.^[16]

When can everybody be vaccinated?

The UK government has issued a statement that it aims to offer all UK adults their first Covid-19 vaccine dose by 31 July 2021.

Vaccination best practice dictates that at least 75 per cent of the population is vaccinated against Covid-19 in order to achieve herd immunity. This should prevent the virus from spreading unchecked. The vaccination process will therefore prove lengthy.

How does the Covid-19 vaccination work?

Researchers all over the world are working on vaccines against the SARS-CoV-2 coronavirus, and the projects are at different stages. A handful of these vaccines have already been approved in some countries – in the United Kingdom as well as in the European Union. These are the BioNTech/Pfizer and AstraZeneca vaccines.

How do vaccinations work? Vaccinations stimulate your immune system to build up a defence against a certain pathogen – for example, by producing antibodies. Classic vaccines usually contain either living but weakened pathogens (live vaccine) or dead cells of the pathogens (inactivated vaccine). Successful vaccinations reduce the risk of people becoming infected with a disease and spreading it further.^[1]

How do the vaccines work?

BioNTech/Pfizer is the first mRNA vaccine ever approved. The vaccine contains genetic fragments of SARS-CoV-2 that are temporarily taken up by cells of the body. This leads to the creation of immune cells and antibodies that recognise the virus and enable the immune system to fight it – in the best case, before it can spread. Subsequently, the viral genome is quickly broken down again by the body.^{[6, 7]}

The AstraZeneca vaccine is an adenovirus vaccine: the vaccination is administered via a weakened version of the cold virus (adenovirus) from chimpanzees. This virus is harmless to humans. The virus used has been modified to appear similar to Covid-19; this then forms the so-called blueprints for a surface protein of the coronavirus and is introduced into the body. The immune system can then build up a defence against SARS-CoV-2.^[10]

The AstraZeneca vaccine has received some criticism because the effectiveness is said to be lower than with the mRNA vaccines. Some studies, for example, reveal that the vaccine is, in some cases, 60 to 82 per cent effective. However, medical experts emphasise that the vaccine – like all other vaccines approved so far – is still expected to be very good at preventing severe Covid-19 infections.^[11]

Please note: You will only be protected from coronavirus from a certain amount of time after receiving the vaccine: with the Pfizer/BioNTech vaccine, for example, immunity from the virus is effective two weeks after vaccination.

Which other Covid-19 vaccines are out there?

Scientists all over the world have been researching vaccines at full speed for about a year. More than 200 different vaccine candidates are now in development, including so-called classic inactivated and live vaccines as well as mRNA vaccines – but also those with a different model. ^{[8, 9]}

Naturally, therefore, there are other vaccines that will also soon be available for use in the United Kingdom. The Moderna vaccine, approved for use in the United Kingdom back in January 2021 is already being distributed in the European Union and in the United States. Also an mRNA vaccine, like the Pfizer/BioNTech vaccine, the Moderna vaccine provides an effectiveness of up to 92 per cent when it comes to fighting off Covid-19, according to the World Health Organization. This protection kicks in approximately two weeks after the first dose.

The SARS-CoV-2 vaccine created by US biotechnology company Novavax may also soon become available in the United Kingdom – along with the Johnson & Johnson vaccine by Belgian company Janssen. The Johnson & Johnson vaccine is also, like the AstraZeneca vaccine, an adenovirus-type vaccine.^[16]

Covid-19 vaccine efficacy

How effective are the vaccines?

Public Health England released an initial report on the effectiveness of the Pfizer/BioNTech Covid-19 vaccination so far. According to a study it conducted, healthcare workers were 72 per cent less likely to develop a Covid-19 infection (with or without symptoms) after one dose of the vaccine. This increased to 86 per cent after the second dose. In older people who received the vaccine, effectiveness was at 57 per cent four weeks after the first vaccination and at 85 per cent after the second dose.^[14] 

In terms of hospitalisation and death rates, the PHE study revealed that numbers are currently falling in all age groups in the United Kingdom, as more people receive their first Covid-19 vaccine. Even more promising is that the hospitalisation rate of those 75 years and over is currently seeing the sharpest decline out of all age groups.^[14]

This data supports the claim that the first dose of the vaccine is capable of providing sufficient protection from the virus. However, whether the vaccination also ensures that vaccinated persons can no longer pass the virus on to others has not yet been conclusively clarified.

Not all vaccinations provide 100 per cent protection. You may know this from receiving the flu vaccination that there is still a small risk of catching it. However, when we talk about effectiveness, we only talk about the risk of catching the disease. In the event of becoming infected, the disease is usually milder in vaccinated people. This is likely to also be the case with the Covid-19 vaccines that have been approved so far – even if you become infected after  vaccination, the vaccine reduces the risk of a severe infection.^[2]

You can check whether your body has developed antibodies against Covid-19 with the a Covid-19 vaccine effectiveness test. Such tests identifiy various IgG-class antibodies against Covid-19, which are usually present after receiving a coronavirus vaccine or being infected with the virus. More specifically, these two antibodies are known as the anti-S1 antibodies and the anti-NP antibodies.

What about the virus variants?

When it comes to the Pfizer/BioNTech vaccine, studies have shown that people who have received two doses of the vaccine still show strong immune responses to the South African and UK variants of the virus.^[17] Public Health England has stated that it is confident the vaccines currently in use nationwide will promise at least 50 per cent protection against the South Africa variant.^[15] It is assumed that more will be learnt about vaccine efficacy against this particular variant through South Africa’s vaccination programme – and also through conducting an AstraZeneca trial over there.

The reality is that UK scientists will have to work on new versions of the vaccine to keep up with the mutating virus.

How safe are the Covid-19 vaccines?

Some people are concerned that the new vaccines may not be well-tested enough. Normally, it actually takes several years to develop a new vaccine.

But in the case of the coronavirus, an extreme amount of manpower and money was invested around the world to speed up the vaccine testing process. This allowed the vaccine development to be carried out at an unprecedented speed, including all the important testing stages. In addition, many processes took place at the same time, which otherwise take place one after the other. Among other things, vaccination commissions were already testing the vaccines in parallel with the vaccination trials.

Any vaccine that is to be rolled out in the United Kingdom needs to undergo a strict testing procedure that meets very high standards to determine whether or not it is safe to be distributed within the population. The vaccines that have been approved by the United Kingdom have already been tested on tens of thousands of people in trials. Experts consider the vaccination to be safe. ^{[5, 6]}

If you are concerned or have queries about whether or not the vaccine is suitable for you, you should consult with your doctor.

What are the vaccine side effects?

As with all vaccinations, there can be side effects and reactions to vaccinations, but these are usually harmless and only last for a short time. Deaths did not occur during the vaccine studies.

The following side effects were documented for the BioNTech/Pfizer vaccine: ^[12]

• Pain and redness at the injection site (usually in the upper arm)
• Fatigue, headache and muscle aches
• Fever
• In more severe, but very rare, cases (i.e. only ever occurring once): swollen lymph nodes, shoulder injury, cardiac arrhythmia, paraesthesia in the leg)

If any of these side effects are causing you a great deal of discomfort, it is important that you get plenty of rest; according to government advice, it is also fine to take a normal dose of paracetamol (following packaging advice). The side effects usually last less than a week. 

To find out more about how to boost your immune system generally during the pandemic, we recommend also reading our dedicated blog article.

Covid-19 vaccine rollout – at a glance

Why is the Covid-19 vaccine rollout important?

In medicine, vaccination is the ultimate go-to treatment for infectious diseases. After all, when we are vaccinated, our bodies are able to fight off a disease before it can develop.

And not only that – widespread vaccination creates immunity in the population. In the best case, this makes it significantly more difficult for a pathogen, such as a virus, to spread. Several viruses that were once considered deadly and widespread have been wiped out due to effective immunisation.

When can I receive the Covid-19 vaccine?

How long you will have to wait to be offered the vaccine will depend on various factors, such as your age group, occupation and any health issues you have. For example, those on the front line in hospitals and most health care workers will be prioritised in the UK vaccination programme.

Older persons are classed as higher priority than younger age groups; vaccine cohorts will start at people over 80 years of age.

How does the Covid-19 vaccine work?

There are several different types of Covid-19 vaccine models, such as the mRNA vaccine and the adenovirus vaccine model that are currently available in the United Kingdom. Other vaccine model types that we may soon see distributed include Novavax, which is a protein adjuvant.

How safe are the Covid-19 vaccines?

Rigorous tests have been carried out to ensure that each vaccine is safe to distribute within the general population. Not only that, several studies are being carried out to continually monitor vaccination among all age groups. The speed at which vaccines against Covid-19 were created should not be a cause for concern, as an extreme amount of both manpower and money was invested around the world to speed up the vaccine testing process.

Sources

^[1]        Robert Koch-Institut und Paul-Ehrlich-Institut, ‘Bedeutung von Impfungen - Antworten des Robert Koch-Instituts und des Paul-Ehrlich-Instituts zu den 20 häufigsten Einwänden gegen das Impfen’. https://www.rki.de/DE/Content/Infekt/Impfen/Bedeutung/Schutzimpfungen_20_Einwaende.html#doc2378400bodyText2, accessed on 27 April 2020.

^[2]        Robert Koch-Institut, ‘Epidemiologisches Bulletin 2/2021’, p. 69, 2021.

^[3]        Blickle, P., Stahnke, J., Tröger, J. Venohr, S., Stockrahm, S. ‘Corona-Impfungen in Deutschland: So viele Menschen wurden bisher gegen Covid-19 geimpft’, Die Zeit, Hamburg, 11 January 2021.

^[4]        Bundesgesundheitsministerium, ‘Fragen und Antworten zur COVID-19-Impfung’, Bundesgesundheitsministerium. https://www.bundesgesundheitsministerium.de/coronavirus/faq-covid-19-impfung.html?fbclid=IwAR3DHET5Eg-J1zNIIXDcZeutCSriR1s58isBiW4eWuL9K9CBa_V8NCRgyeY, accessed on 11 January 2021.

^[5]        Baden, L. R., et al. ‘Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine’, N Engl J Med, p. NEJMoa2035389, December 2020, doi: 10.1056/NEJMoa2035389.

^[6]        Polack, F. P., et al. ‘Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine’, N Engl J Med, vol. 383(27), 2603–2615, December 2020, doi: 10.1056/NEJMoa2034577.

^[7]        NDR, ‘Das Coronavirus-Update mit Christian Drosten, Folge 70: Coronavirus-Update: Die Mutanten im Blick behalten’. /nachrichten/info/70-Coronavirus-Update-Die-Mutanten-im-Blick-behalten,podcastcoronavirus276.html, accessed on 11 January 2021.

^[8]        Le, T. T., et al. ‘The COVID-19 vaccine development landscape’, Nature Reviews Drug Discovery, April 2020, doi: 10.1038/d41573-020-00073-5.

^[9]        Robert Koch-Institut, ‘Coronavirus SARS-CoV-2 – SARS-CoV-2 Steckbrief zur Coronavirus-Krankheit-2019 (COVID-19)’. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Steckbrief.html, accessed on 31 March 2020.

^[10]     ‘Paul-Ehrlich-Institut - Meldungen - Europäische Arzneimittelagentur EMA hat erstes Rolling-Review-Verfahren eines COVID-19-Impfstoffs für Europa gestartet’. https://www.pei.de/DE/newsroom/hp-meldungen/2020/201005-ema-hat-erstes-bewertungsverfahren-covid-19-impfstoff-fuer-europa-gestartet.html?nn=12248480, accessed on 22 January 2021.

^[11]      Fischer, L., Palm, T., Schumann, F. ‘AstraZeneca: Kein Impfstoff zweiter Klasse’, Die Zeit, Hamburg, 16 February 2021.

^[12]      Robert-Koch-Institut, ‘RKI - Impfen - Wirksamkeit und Sicherheit (Stand: 23.12.2020)’. https://www.rki.de/SharedDocs/FAQ/COVID-Impfen/FAQ_Liste_Wirksamkeit_Sicherheit.html;jsessionid=93C7DAACE7DB1E421494E107E76E8ED1.internet062#FAQId15234230, accessed on 8 January 2021.

^[13]      National Health Services (NHS), ‘Coronavirus (COVID-19) vaccine’, nhs.uk, 26 November 2020. https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/, accessed on 12 January 2021.

^[14]      Ramsay, M. ‘COVID-19: analysing first vaccine effectiveness in the UK’ Public Health England, 23 February 2021, available at https://publichealthmatters.blog.gov.uk/2021/02/23/covid-19-analysing-first-vaccine-effectiveness-in-the-uk/, accessed on 10 March 2021.

^[15]       ‘COVID-19 vaccines: What you need to know’, Public Health England, 4 February 2021, available at https://publichealthmatters.blog.gov.uk/2021/02/04/covid-19-vaccines-what-you-need-to-know/, accessed on 9 March 2021.

^[16]      ‘UK COVID-19 vaccines delivery plan’ Department of Health and Social Care, 11 January 2021, available at  https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/951928/uk-covid-19-vaccines-delivery-plan-final.pdf, accessed on 9 March 2021.

^[17]       Skelly, D. T., Harding, A. C., Gilbert-Jaramillo, J., Knight, M. L., Longet, S., Brown, A., Adele, S., Adland, E., Brown, H., et al. ‘Vaccine-induced immunity provides more robust heterotypic immunity than natural infection to emerging SARS-CoV-2 variants of concern.’ Research Square, posted on 9 February 2021, 10.21203/rs.3.rs-226857/v1

^[18]       ‘PHE monitoring of the early impact and effectiveness of COVID-19 vaccination in England’ Public Health England, 22 February 2021, available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/963532/COVID-19_vaccine_effectiveness_surveillance_report_February_2021_FINAL.pdf, accessed on 9 March 2021.

* Facts and figures are known to be accurate at publish date.