The public has more options for covid-19 vaccine boosters, and seven domestic vaccines are included in the scope of intensive injections
Figure/IC
Text | Caijing reporter Zhao Tianyu
Edit | Sun Aimin
Thousands of calls have begun to come out, and there are more options for the NEW CROWN vaccine booster.
"With the approval of the joint prevention and control mechanism of the State Council, the National Health Commission has begun to deploy a sequential strengthening of immunization." On February 19, 2022, at the press conference of the joint prevention and control mechanism of the State Council, Wu Liangyou, deputy director of the Disease Control Bureau of the National Health Commission, said that people who have been vaccinated with Sinopharm Zhongsheng Beijing Company, Wuhan Company and Kexing Zhongwei inactivated vaccine have more options for strengthening the needle, and can also use The recombinant new coronavirus vaccine of Zhifeilong Kema, or the adenovirus vector vaccine of CanSino.
The public vaccination of the new crown vaccine booster, if the technical route is different from the first and second injections, is called "sequential booster immunization", or "heterologous vaccination". Prior to this, China's intensive vaccination program was only "homologous", that is, if the first and second injections were inactivated vaccines, then the intensive injections were also inactivated vaccines; if the adenovirus vector vaccine was previously administered, the same was true for the intensive injections.
Today, Wu Liangyou said that the homologous enhancement of immunization and the sequential strengthening of immunization, the public can choose one of them.
As of February 18, 2022, 31 provinces (autonomous regions and municipalities directly under the Central Government) and the Xinjiang Production and Construction Corps have cumulatively reported more than 3 billion doses of COVID-19 vaccine, while as of February 7, China has completed nearly 460 million boosted immunizations.
Wang Huaqing, chief expert of the immunization program of the Chinese Center for Disease Control and Prevention, told the "Finance and Economics Health" reporter that "sequential immunization" has also been applied in the past, such as for polio vaccination, which is also considered to improve the protective effect of vaccines and reduce risks.
The safety and effectiveness of heterologous reinforcing needles are guaranteed
Since the second half of 2021, "strengthening needles" have attracted wide attention, and which technical vaccines can be used as booster needles has always been a topic of concern to researchers.
Chinese mainland, there are now seven domestic vaccines approved for conditional listing or emergency use, including three technical routes, of which the inactivated vaccine comes from Sinopharm Zhongsheng Beijing Company, Sinopharm Zhongsheng Wuhan Company, Kexing Zhongwei, Kangtai Biology, Institute of Biology of the Medical Academy, adenovirus vector vaccine from CanSino, and recombinant protein subunit vaccine from Zhifeilong Kema, a subsidiary of Zhifei Biologics.
In Hong Kong, China, Fosun Pharma's mRNA vaccine, in collaboration with bioNTech, was approved for emergency use in January 2021, and the vaccine was also approved for import in Macau, China, and has been vaccinated since March last year.
What kind of vaccine is more effective in vaccination, and many institutions around the world have stepped up research in the past year. Both the data of Chinese researchers and similar studies overseas show that the strengthening needle is worth a dozen.
A real-world data study published in Chile confirms that those who have received two doses of inactivated vaccine, with another booster, whether continued inactivated or other types of vaccines, can improve the effectiveness of immunization.
On 16 December 2021, the World Health Organization (WHO) issued the Interim Guidelines for Heterologous Enhancement of COVID-19 Vaccines, which recommends that if the first dose is given with the Messenger ribonucleic acid (mRNA) vaccine, the booster needle can be vaccinated against viral vectors; and vice versa. If inactivated vaccine is initially given, follow-up vaccination with viral vector vaccine or mRNA vaccine may be given.
The WHO said in the guidelines that homology vaccination is currently considered standard practice, given vaccine accessibility, heterologous vaccination using vaccines produced by different manufacturers can increase the flexibility of the vaccination regimen, and other benefits of heterologous vaccination include reduced responseivity, enhanced immunogenicity and increased effectiveness of vaccines.
Since the first half of 2021, researchers have opened research on mRNA and recombinant protein new crown vaccine heterologous enhancement needles, demonstrating the effectiveness and safety of different technical routes to strengthen needles.
A study published in Cell Research on November 23, 2021 by Zhang Wenhong, director of the Department of Infectious Diseases at Huashan Hospital affiliated to Fudan University in Shanghai, showed that two inactivated vaccines plus one dose of recombinant protein subunit vaccine boosters can significantly enhance the neutralizing antibody titer against the new crown virus and mutant strains.
In May 2021, Zhu Fengcai, deputy director of the Jiangsu Provincial Center for Disease Control and Prevention and WHO covid-19 vaccine priority review expert, and collaborators initiated research on cansino adenovirus vector vaccine and subunit protein vaccine as heterologous enhancement needles.
There are three main schemes for the reinforced injection "mixed beating" studied by Zhu Fengcai's team: one is to strengthen the adenovirus vector vaccine of intramuscular injection of cansino six months after the two-shot inactivated vaccine is immunized; the other is to nebulize and inhale one dose of the cansino adenovirus vector vaccine injected intramuscularly six months after the two-shot inactivated vaccine; and the third is to inject a subunit protein vaccine 28 days or 56 days apart after intramuscular injection of a dose of cansino adenovirus vector vaccine.
In the first protocol, antibody levels exceeded five times that of inactivated vaccine homologous booster immunity after Xenovirus immunization was injected intramuscularly, an increase of 78 times compared with pre-immunization, and in the second regimen, the antibody level of the nebulized inhaled adenovirus vaccine was also seven times higher than that of the inactivated vaccine homologous booster immunity. Zhu Fengcai's team believes that the safety and tolerance of the two schemes are good.
Zhu Fengcai once told the "Finance and Economics Health" reporter that there are large differences in the level of neutralizing antibodies and protective efficacy induced by different technical routes of new crown vaccines. Therefore, the use of vaccines with different technical routes complements each other's advantages to achieve better immune protection effects.
Nowadays, there are two new coronavirus vaccines knocking on the door of heterologous reinforcing needles in China, namely the recombinant protein subunit vaccine of Zhifei Biological Company and the adenovirus vector vaccine of CanSino Company.
The relevant person in charge of Zhifei Biology told "Finance and Economics Health" that the company is responsible for supplying the new crown vaccine to the disease control department, and as for whether it is used as a reinforced injection, the disease control vaccination points in various places are responsible, and the types of vaccines provided by the vaccination points are also implemented in accordance with the national vaccination guidelines.
On February 15, CanSino told Caijing Health that it had not yet obtained detailed vaccination information about heterologous enhancement injections.
At present, the strategies of enhanced immunization of COVID-19 vaccines vary from country to country around the world, and most countries use heterologous immunization, such as Germany, which is a homologous mRNA vaccine-1273 booster vaccine, and the United Kingdom, the United States, Canada, Chile, Thailand, Brazil, the United Arab Emirates, Peru and Argentina are mainly heterologous immunity.
Vaccination of "heterogeneous" COVID-19 vaccines has strengthened the injection, and the preparation progress of disease control systems in various places is different.
On February 17, a staff member of the Center for Disease Control and Prevention in Jiaxing City, Zhejiang Province, told Caijing Health that it has not yet received a plan for strengthening injection vaccination from different sources in the province, "However, if you must 'mix it', you can wait a while, it is recommended to pay attention to the relevant policies, this idea is more 'advanced', there is this possibility."
On the same day, a disease control person from a county under Handan City, Hebei Province, told "Finance and Economics Great Health" that there is no specific documented information about the plan to strengthen the needle from different sources.
On February 19, Wu Liangyou said that the National Health Commission has begun to deploy a sequential strengthening of immunization.
Who pays for the third stitch?
"The booster injections that have been vaccinated are mainly provided free of charge by enterprises." This is the news revealed at the National Medical Security Work Conference on January 14.
Previously, under the strategy of strengthening the needle as a homologous vaccine, the enhanced needle market consisted of three inactivated vaccines and one adenovirus vector vaccine: the inactivated vaccine came from Sinopharm Zhongsheng Beijing Institute, Sinopharm Zhongsheng Wuhan Institute, Kexing Zhongwei, and the adenoviral vector vaccine came from Cansino.
Once the heterogeneous reinforcement policy is approved, more companies will participate. Zhifei Bio got the ticket to strengthen the injection market, and the scope of application of the CanSino vaccine is wider.
There are also more participants in the homologous reinforcement needle. At a press conference of the Joint Prevention and Control Mechanism of the State Council on February 19, Wu Liangyou said that the inactivated vaccines of Kangtai Biology and the Institute of Biology of the Chinese Academy of Medical Sciences can also be vaccinated as homologous reinforcing needles.
So far, China has been approved for conditional marketing or emergency use of seven new crown vaccines, all of which are included in the scope of enhanced injections.
This is undoubtedly a good opportunity for the latecomers of the new crown vaccine to expand the market. However, in the step of strengthening the needle, is the inactivated vaccine of Kangtai Biology and the Institute of Biology of the Chinese Academy of Medical Sciences used as a homologous reinforcing needle, and the vaccine of Zhifei Biologics and CanSino as a heterologous reinforcing needle, whether it is still provided free of charge by the enterprise, and is the enterprise capable of providing it free of charge? The relevant information was not released at the February 19 press conference of the Joint Prevention and Control Mechanism of the State Council.
Related companies are secretive. Zhifei Biology told the "Finance and Economics Health" reporter that the official release prevails, and CanSino said that there is no detailed information.
In any case, no COVID-19 vaccine company is willing to give up the market for booster injections.
Haitong International has calculated the potential market size of the new crown vaccine. If the COVID-19 vaccine is like the flu vaccine, it will also need to be vaccinated once a year, and global sales are expected to reach $42.67 billion by 2022 and $38.418 billion in 2025. There is still a lot of room in the COVID-19 vaccine booster injection market.
Before strengthening the needle manufacturers to play the "free to provide" card, the cost of covid-19 vaccination was originally borne by the financial department and the medical insurance department.
Specifically, it is common for local health insurance bureaus to advance funds to COVID-19 vaccine companies, so that local vaccines can be obtained in a timely manner. For example, Dongguan, Guangdong Province, uniformly prepaid funds to vaccine manufacturers, that is, to let "money wait for vaccines".
The same is true of Guizhou Province. In order to ensure that the local government does not affect vaccination due to the problem of money, the Guizhou Provincial Medical Insurance Bureau and the Provincial Department of Finance took the lead in starting the special fund budget and allocation of new crown vaccination costs, and the Provincial Health Commission coordinated and docked to raise vaccine procurement funds and allocate them.
The funds are allocated to the provincial CDC, the vaccine procurement agency, and then, the provincial CDC transfers the funds to the vaccine production enterprises in advance through advance payment to ensure the smooth progress of local COVID-19 vaccine procurement.
Seeing these cheerful payers, those companies that have not yet listed the new crown vaccine are still running in many ways to promote the approval progress of their own products.
The level of revenue from the COVID-19 vaccines already on the market has confirmed this. According to canSino's product commercial sales data in the first half of 2021, the revenue exceeded 2 billion yuan and the profit was 937 million yuan; fosun Pharma's mRNA new crown vaccine cooperated with BioNTech was included in the government vaccination plan in Hong Kong and Macao in the first half of 2021, with sales revenue of 500 million yuan.