Pfizer-BioNTech's Covid-19 vaccine: The path ahead in UK

London, United Kingdom - Pfizer said on Wednesday it will begin transporting the vaccine to Britain's state-run National Health Service (NHS) within days.

The British government has accepted a recommendation by the country's independent medicines regulator to approve Pfizer-BioNTech's Covid-19 vaccine for general use.

Here are some of the next steps.

- When will it be available? -

Pfizer said on Wednesday it will begin transporting the vaccine to Britain's state-run National Health Service (NHS) within days.

The NHS, charged with delivering the free mass vaccination programme, will start administering jabs to the most vulnerable early next week.

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"The NHS has decades of experience in rolling out successful widespread vaccination programmes and has put in place extensive deployment plans," the UK's health ministry said.

Pfizer said it has no current plans to provide the vaccine to private sector buyers in Britain.

- How many doses are on order? -

The vaccine, which proved 95 per cent effective in global trials, requires two doses 21 days apart.

BioNTech and Pfizer have said they expect to supply up to 50 million doses globally in 2020, and up to 1.3 billion in 2021.

Britain has pre-ordered 40 million doses in total, and expects to receive an initial batch of 800,000 to begin next week's rollout.

Pfizer says it will "scale up from there through the remaining weeks of this year" and into 2021.

Regulators are still to approve the vaccine in the United States, which has ordered 100 million doses, or in the European Union, where 300 million are on order.

- Who will get it first? -

UK health officials have drawn up criteria to decide when people will receive any approved Covid-19 vaccines.

Preventing further deaths and protecting health and social care staff and systems are the top priority.

Elderly care home residents and their carers will be the very first to get inoculated, then those aged 80 and over and frontline health and care staff.

Other elderly people and the clinically extremely vulnerable will be next, with the rest of the population then prioritised by age.

In the US, a high-level panel of experts voted Tuesday for a similar plan that will see health care workers and residents of long-term care facilities get the jabs first.

- What are the challenges? -

Pfizer-BioNTech's vaccine poses significant obstacles when it comes to transport and storage.

It must be stored at -70 degrees Celsius (-94 degrees Fahrenheit), temperatures much colder than those of a standard freezer, for periods up to six months.

The vaccine will be manufactured at Pfizer's plant in Puurs, Belgium, and transported in temperature-controlled thermal shippers that use dry ice.

It can then be stored for up to five days at 2-8 degrees Celsius, which will allow for transportation and regular fridge storage  at distribution centres, according to Pfizer and the UK government.

The health ministry, which said last month it was "confident" in its cold supply chain plans, said Wednesday it will initially only deliver the vaccine to hospital hubs with ultra-cold storage capacity.

The doses will then also be distributed to "local community services" and vaccination centres for administering.

- How did the UK approve it first? -

Britain's independent Medicines and Healthcare products Regulatory Agency (MHRA) used a "rolling review" process since June to assess the vaccine in record time.

"We have carried out a rigorous scientific assessment of all the available evidence of quality, safety and effectiveness," MHRA chief executive June Raine said Wednesday.

"Our expert scientists and clinicians worked tirelessly, around the clock, carefully, scientifically, robustly and rigorously poring over hundreds of pages and tables of data, methodically reviewing the data."

Penny Ward, professor in pharmaceutical medicine at King's College London, said the MHRA was aided by being less constrained than the European Medicines Agency (EMA) and the US Food and Drug Administration.

"Unlike the EMA (European Medicines Agency), they can ask questions as they go and obtain responses faster as a single agency," she said.

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