Read on Twitter
1./ The Global Race to Vaccinate has begun. Here are just some of the obstacles scientists and countries have to overcome in the biggest medical challenge in history. The good news, as stats from @OurWorldInData show, the UK has started well. But we're only on the first lap.
2./ As people compare their govt's performance it's accentuating bunfights for resources similar to those in the summer when countries trounced each other to obtain PPE. Every element of the vaccine supply chain is vital and now being fought over.
https://www.telegraph.co.uk/news/2020/04/02/french-officials-describe-assault-course-nations-obtain-protective/
https://www.telegraph.co.uk/news/2020/04/02/french-officials-describe-assault-course-nations-obtain-protective/
3./ There are good signs the UK govt learned from its disastrous experience then (when test targets were undermined by shortages of reagents). As early as July it ordered 65M extra syringes. They'd grasped the need to put money on the table fast. https://www.pulsetoday.co.uk/news/clinical-areas/immunology-and-vaccines/government-orders-65m-syringes-ahead-of-potential-covid-19-vaccine/
https://www.pulsetoday.co.uk/news/clinical-areas/immunology-and-vaccines/government-orders-65m-syringes-ahead-of-potential-covid-19-vaccine/
4./ But money can't buy you everything. For months specialist glass makers have been boosting production of the heat-resistant 'borosilicate' glass that's used to make the vials that vaccines come in. Making billions of vials really does take time. https://www.wsj.com/articles/coronavirus-vaccine-makers-are-hunting-for-vital-equipment-glass-vials-11592317525
https://www.wsj.com/articles/coronavirus-vaccine-makers-are-hunting-for-vital-equipment-glass-vials-11592317525
5./ The German supplier Schott (whose founder invented the glass) quite rightly refused advance orders from pharma companies until they had approval for their vaccines; which is another reason the UK's early approval of vaccines was super-smart. https://www.reuters.com/article/us-health-coronavirus-schott-exclusive-idUSKBN23J0SN
https://www.reuters.com/article/us-health-coronavirus-schott-exclusive-idUSKBN23J0SN
6./ The UK would be making this glass ourselves; if the only large manufacturer hadn't closed in 2007. J A Jobling in Sunderland made kitchen Pyrex, a similar glass. Who knew then its special furnaces might have been a link in a life-saving chain now? 
http://www.bbc.co.uk/insideout/northeast/series11/week7_pyrex.shtml
http://www.bbc.co.uk/insideout/northeast/series11/week7_pyrex.shtml
7./ As @dbreznitz & David Adler point out in the @nytimes the pandemic has exposed the absurdity of allowing swathes of strategic manufacturing to be outsourced. We've just had a crash course in why nations need to retain some strategic production. https://www.nytimes.com/2021/01/04/opinion/manufacturing-united-states-masks.html?smid=tw-share
https://www.nytimes.com/2021/01/04/opinion/manufacturing-united-states-masks.html?smid=tw-share
8./ You can't make borosilicate glass unless you have a source of borates. Luckily, a big new source has been found in Serbia, by the British-Oz company @RioTinto We need to discuss with our green mates: if we need raw materials shouldn't we mine locally? https://www.mining.com/rio-tinto-confirms-potential-for-jadar-project-in-serbia/
9./ Ironically, the UK govt was recently converted to thinking strategically. In 2018 they commissioned our first ever state of the art Vaccine Manufacturing Centre. They're now rushing to complete it ahead of schedule. Better late than never. https://www.pharmaceutical-technology.com/projects/vaccines-manufacturing-oxfordshire/
10./ Our early approval of vaccines and firm early orders gave us an early advantage. With no other buyers taking receipt we could get our Pfizer and Oxford vaccines delivered despite them being made in the EU. But that didn't mean it was trouble free. https://www.europeanpharmaceuticalreview.com/news/135830/supply-chain-challenges-cause-pfizers-covid-19-vaccine-production-target-to-be-slashed/
11./ Dramatically scaling up the manufacture of any new product is always beset with challenges. Both Pfizer and AstraZeneca had to scale back. The fact these products are injected into people means quality control slows everything down. It has to. https://www.cnbc.com/2020/11/18/what-are-the-big-challenges-to-mass-producing-a-coronavirus-vaccine.html
12./ Our govt decided (rightly) after the first batches we'd need our own vaccine production. It's brought together @AstraZeneca with @OxfordBiomedica and @CobraBiologics. Those precious vials will be filled in a @WockhardtUk factory in Wales. God speed!
https://www.thetimes.co.uk/article/behind-the-scenes-of-britains-coronavirus-vaccine-factory-0bkwd95pg
https://www.thetimes.co.uk/article/behind-the-scenes-of-britains-coronavirus-vaccine-factory-0bkwd95pg
13./ The UK govt is also funding a new biosecure production line in Livingstone in Scotland. By the end of 2021 it may be producing a vaccine based on inactivated virus by @valnevaSE which has just started trials. French company, UK money, Scottish talent. https://www.bbc.co.uk/news/uk-scotland-edinburgh-east-fife-55316690
14./ But once all the vaccines are in production new, surprising bottlenecks will appear. The entire Pfizer/BioNTech production at the moment depends on a brilliant but tiny family-owned Austrian supplier of the nanolipids that package the mRNA code. https://www.wsj.com/articles/if-one-leading-coronavirus-vaccine-works-thank-this-tiny-firm-in-rural-austria-11604664001
https://www.wsj.com/articles/if-one-leading-coronavirus-vaccine-works-thank-this-tiny-firm-in-rural-austria-11604664001
15./ Many vaccines contain an adjuvant, a chemical that increases immune response. It takes time to build stocks. The Chilean soapbark tree is a source of one, saponin. For a time it looked like sharks might be slaughtered to provide another: squalene. https://www.nationalgeographic.co.uk/science-and-technology/2020/11/why-a-covid-19-vaccine-could-further-imperil-deep-sea-sharks
https://www.nationalgeographic.co.uk/science-and-technology/2020/11/why-a-covid-19-vaccine-could-further-imperil-deep-sea-sharks
16./ The Pfizer and Oxford vaccines don't use either. Most others in trials use an aluminium salt so the hammerhead shark can rest easy. Adjuvants are only the tip of an iceberg of materials that companies and nations are competing to source. https://www.bloomberg.com/features/2020-covid-vaccine-manufacturing-essentials/
https://www.bloomberg.com/features/2020-covid-vaccine-manufacturing-essentials/
17./ That's why armchair critics must cut the vaccine makers slack. We'll know about production issues with ours cos we live in an open society. We won't hear what goes wrong with others. Mr Putin will just assure us everything is working perfectly. https://tass.com/society/1194433
https://tass.com/society/1194433
18./ Sputnik V was licensed after a trial of only 76 people. Here's hoping (genuinely) it works as well as claimed. This video of it arriving in Argentina is lovely. Even if geopolitics played a role we need as many vaccines to work as possible. https://twitter.com/sputnikvaccine/status/1342491045993574401?s=20
https://twitter.com/sputnikvaccine/status/1342491045993574401?s=20
19./ In our understandable haste tho we will face ...surprises. Reports suggest 1% of those injected in Argentina had minor side effects. Plastic surgeons in the US have just warned people with 'face fillers' of side effects from the Moderna vaccine.
https://www.nbcsandiego.com/news/local/fda-modernas-covid-19-vaccine-may-cause-side-effects-in-people-with-facial-fillers/2485434/
https://www.nbcsandiego.com/news/local/fda-modernas-covid-19-vaccine-may-cause-side-effects-in-people-with-facial-fillers/2485434/
20./ So will the UK meet its target of vaccinating 13M by mid Febuary? Given all these challenges, it seems optimistic. Building to 1M+ a week takes us to April/May which may be doable. At least tho we've passed the first challenge, unlike the EU. https://www.dw.com/en/germanys-covid-vaccine-procurement-labeled-a-gross-failure/a-56115322
21./ The German press are eviscerating the EU. It sensibly decided to leverage its huge negotiating clout and resources. BUT being big can sometimes make you slow and the EU is now accused of signing contracts too late and for too few vaccines. https://www.spiegel.de/international/europe/the-planning-disaster-germany-and-europe-could-fall-short-on-vaccine-supplies-a-3db4702d-ae23-4e85-85b7-20145a898abd
22./ Some critics lambast the EU's "political" decision to bet big on @sanofipasteur That's unfair. It's one of the finest vaccine firms in the world. But the legendary Frenchman whose name it uses would despair of the French govt's tardy response. https://www.france24.com/en/france/20210103-france-vows-to-boost-pace-of-vaccinations-after-slow-rollout-fiasco
23./ It was just bad luck the Sanofi vaccine didn't work. But being complacent and bureaucratic while keeping citizens in lockdown is unforgiveable. At least the UK doesn't have one challenge the French govt confronts: insane levels of vaccine skepticism. https://www.connexionfrance.com/French-news/Covid-anti-vax-sentiment-rises-above-50-in-France-with-new-poll
24./ It's almost worse in Italy where the current nutjob govt won election on an anti-vaxx platform it only recently disavowed (after a measles epidemic). @RobertoBurioni is on a one man mission to remind Italians of their great scientific heritage. https://www.sciencemag.org/news/2020/01/italian-scientist-has-become-celebrity-fighting-vaccine-skeptics
https://www.sciencemag.org/news/2020/01/italian-scientist-has-become-celebrity-fighting-vaccine-skeptics
25./ This year is bound to be a rollercoaster of bottlenecks, supply chain logjams, hoarding by companies and nations and anti-vaxx scares. Politicians will be accused of incompetence and stupidity. There will be side effects, mistakes and worse. But... https://www.theguardian.com/world/2020/dec/03/cyberspies-target-covid-vaccine-cold-chain-distribution-network
https://www.theguardian.com/world/2020/dec/03/cyberspies-target-covid-vaccine-cold-chain-distribution-network
26./ It'll also see unbounded heroism. We're embarking on a medical "Olympics" which no nation can win on its own. We should applaud every team's excellence and every nation's success and try to remember, like us, all the decision-makers are only human. Our lives depend on it.
