Last Tuesday, 21 July, an article published in the medical journal The Lancet (read HERE) was widely disseminated in various mass media. The article, dated 20 July, reports the preliminary results of the COVID-19 vaccines research phasevaccine being developed at the Jenner Institute at Oxford University (UK), in collaboration with pharmaceutical company AstraZeneca. In this regard, it is notable, first of all, that there is no mention of the results of the Chinese vaccine, sponsored by CanSino Biologics in collaboration with the University of Wuhan (read HERE), also published in the same issue. According to The Lancet, both vaccines are at a very similar stage of development.

This is undoubtedly very positive news, although it could give rise to somewhat over-the-top excitement.

COVID-19 vaccines research phase call the major public attention

An Editorial by Naor Bar-Zeer and William J. Moss of the International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health in Baltimore (USA), commenting on both articles (read HERE), was also published in the same issue of the journal. It begins by saying that the published results augur well for the development of phase 3 clinical trials of both vaccines, adding that these trials are still to be conducted, and that there are objective unknowns about what will happen during this development. They also say that, “These COVID-19 vaccine trials are small so inferential caution is warranted, but the explorations are laudable.” Nevertheless, they note that “much remains unknown about these and other COVID-19 vaccines in development.” Consequently, the editorialists wonder: How are phase 3 trials to be developed? Should they be rapid, pragmatic and large enough to ensure efficacy in particular groups of people? Will a single dose be sufficient for adults to be immunized? Will the immune response be enough in terms of how long it grants immunity to patients? Will this response vary between the two vaccines? Will there be differences in the immune response about the age, sex, or ethnicity of the people who receive it? Might there be specific adverse effects on pregnant women? In other words, there are still many questions that arise about this vaccine. The authors of the Editorial thus declare that “The success of COVID-19 vaccines […] requires comprehensive and transparent evaluation of risk and honest communication of potential harms.”

Finally, they reflect on the problems that equitable distribution of the vaccine may entail, in relation to local needs and priorities of the population groups.

That is to say, what has been disseminated by the media based on the two Lancet studies is very positive, but there is a danger that a message not entirely in line with reality has been conveyed about the development and research phase of both the Oxford and China vaccines.

Justo Aznar MED PhD

Bioethics Observatory

Institute of Life Sciences

Catholic University of Valencia