When Prime Minister Scott Morrison announced on Wednesday the government had signed a letter of intent that would make Australians among the first to have access to a COVID-19 vaccine, it gave the nation a glimmer of hope that perhaps life may return to normal in a few short months.
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However, that shimmer on the horizon may just be a mirage. Here's why.
What is the Oxford vaccine?
The Oxford vaccine - otherwise known as ChAdOx1 nCoV-19 or AZD1222 - is being developed by the University of Oxford in partnership with Swedish-British biopharmaceutical company AstraZeneca.
It is one of the most advanced and promising vaccine candidates for COVID-19 in the world.
If it is approved, it would be manufactured in Australia and would be free to all Australians in a deal likely to cost the federal government billions of dollars.
How does it work?
Coronavirus gets its name from the crown-like spike proteins across its surface - and it's those proteins the Oxford vaccine targets.
To create the vaccine, scientists inserted the part of the SARS-CoV-2 DNA that tells cells how to build the spike protein into a non-replicating version of a common cold virus, a genetically modified chimpanzee adenovirus known as ChAdOx1.
As a result, the immune system is primed to attack the coronavirus and its surface spike proteins if it later infects the body.
According to early results, the vaccine produced a strong antibody response in all volunteers.
During the clinical trial, 543 healthy adults aged between 18 and 55 were given a single dose of the vaccine, while another 534 people were given a control vaccine.
The vaccine provoked a T cell response within 14 days - AKA, created white blood cells which could attack cells infected with the SARS-CoV-2 virus - and an antibody response with in 28 days - antibodies neutralise the virus, so it cannot infect cells if contracted.
Ten volunteers also received a second booster shot of the vaccine, which induced an even stronger antibody response in the laboratory.
This may mean people are likely to need yearly booster shots, like the annual flu vaccinations, according to one of the leading researchers on the project, Rebecca Ashfield.
How soon could it be ready?
The Phase 3 trials are expected to run into late 2020 into 2021, and involve thousands of volunteers across current hotspots in South Africa, Brazil and Europe.
Prime Minister Scott Morrison said on Wednesday Australia would start manufacturing the vaccine as soon as it proved safe and effective.
"I think we'd be in place early next year and the production process would take a month or two, I'm told," Mr Morrison told radio station 3AW.
However Australian National University infectious disease expert Professor Peter Collignon warned it could be mid to late 2021 before Australians could start lining up for their jabs.
"It's three to four months before we get the data, then three months to manufacture then two months to get it out to people," Professor Collignon said.
This was not a process that should be rushed, he said.
"This will be rolled out to billions of people so you need to know if it works."
AstraZeneca's Australia and New Zealand division president Liz Chatwin also warned an adenovirus vector vaccine had never been produced in Australia. Manufacturing the vaccine locally would require a massive scale-up of activity, she said.
Who would be vaccinated first?
This would depend on the results of the vaccine trials and the advice from the expert medical panel.
However Mr Morrison said on Wednesday an obvious starting point would be health workers, including those in aged care, as well as more vulnerable members of the community. Disability workers and those working in remote communities may also be brought to the front of queue.
How would the vaccine be administered?
The Commonwealth has secured nearly $25 million worth of needles and syringes from medical technology company Becton Dickinson to ensure the vaccine can be delivered as soon as it's ready. This equates to around 100 million needles and syringes.
However, the CSIRO's Australian Centre for Disease Preparedness is currently considering whether a nasal spray could be more effective than an injection.
"More than 2000 samples are currently being analysed by the team as part of the study," the centre's director Dr Trevor Drew said.
Could it be mandatory to receive the vaccine?
Mr Morrison said a 95 per cent vaccination rate would be needed across Australia in order to protect the community from COVID-19.
He strongly hinted there could be tough measures in place if people did not get the vaccine.
"I have a pretty strong view on vaccines, being the Social Services Minister that introduced no jab, no pay," Mr Morrison said.
Under that policy, parents of children aged under 20 years who are not fully immunised miss out on payments like the Child Care Benefit.
However acting chief medical officer Professor Paul Kelly said the vaccine would be rolled out on a voluntary basis first.
What happens if it turns out not to be effective?
As promising as the Oxford vaccine is, there is a very real possibility it will not work.
Professor Collignon said many vaccines in the past have looked promising in the laboratory but have failed during Phase III testing.
Vaccines for HIV, Dengue fever and golden staph are good examples of vaccines which worked in the test tube but not in the next stage, Professor Collignon said.
However, there are 167 vaccine candidates in pre-clinical and clinical trials, including 29 undergoing clinical trials in humans.
Health Department head Professor Brendan Murphy is heading up an expert medical panel looking at other potential vaccine candidates, with the government prepared to strike up further partnerships as needed.
If none of these are viable candidates though, Mr Morrison said Australians may have to get used to living with the virus.
"That's why having strong testing, tracing and outbreak capacity, capabilities are so critical to enable Australians to get on with their lives," Mr Morrison told the ABC.
- For information on COVID-19, please go to the ACT Health website or the federal Health Department's website.
- You can also call the Coronavirus Health Information Line on 1800 020 080
- If you have serious symptoms, such as difficulty breathing, call Triple Zero (000)
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