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A nurse holds a vial of the Pfizer/BioNTech Covid-19 vaccine.
A nurse holds a vial of the Pfizer/BioNTech Covid-19 vaccine. Photograph: Reuters
A nurse holds a vial of the Pfizer/BioNTech Covid-19 vaccine. Photograph: Reuters

FDA approves Pfizer/BioNTech coronavirus vaccine for emergency use in US

This article is more than 3 years old

Approval marks a turning point in pandemic but distribution presents major logistical problems

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The US Food and Drug Administration has given emergency approval to a coronavirus vaccine developed by Pfizer and BioNTech, the first drug to prevent Covid-19 approved in the US.

The FDA commissioner, Dr Stephen Hahn, confirmed the news in a statement on Friday night.

“The FDA’s authorization for emergency use of the first Covid-19 vaccine is a significant milestone in battling this devastating pandemic that has affected so many families in the United States and around the world,” Hahn said.

The approval marks a turning point in a pandemic that has claimed more than 294,000 American lives and 1.5 million lives globally.

The vaccine was set to roll out of Pfizer’s principal manufacturing facilities in Michigan within hours and could be administered to the first, highest-priority recipients by the end of Monday.

The importance of the vaccine “cannot be overstated”, Dr Eric Wei of New York’s Elmhurst hospital, one of the hardest-hit places at the start of the pandemic, told NBC’s Today program on Saturday.

“This is what we have been praying for,” he said.

The US follows other countries, including the UK, Canada and Mexico, which have also authorized the Pfizer/BioNTech vaccine for broader public use.

“While not an FDA approval, today’s emergency use authorization of the Pfizer-BioNTech Covid-19 vaccine holds the promise to alter the course of this pandemic in the United States,” said Peter Marks, the director of the FDA’s Center for Biologics Evaluation and Research, in a statement. “With science guiding our decision-making, the available safety and effectiveness data support the authorization of the Pfizer-BioNTech Covid-19 vaccine because the vaccine’s known and potential benefits clearly outweigh its known and potential risks.”

In a video posted to Twitter on Friday night, Donald Trump praised the vaccine as “one of the greatest scientific accomplishments in history”, and said the first dose would be administered in less than 24 hours.

The FDA authorized the vaccine, called BNT162b2, after a trial involving more than 43,000 people found it was effective at preventing the coronavirus 95% of the time. The vaccine uses innovative messenger RNA technology to introduce the body to the spike protein on the surface of the coronavirus. Results of the trial were published in the New England Journal of Medicine on Thursday.

Scientists are still studying how long the immune response provoked by the vaccine will last, called the “duration” of immunity, the rate of asymptomatic disease among people who receive the vaccine, and whether the vaccine can prevent transmission of Covid-19. The vaccine will be authorized for people aged 16 years and older in the US. Pfizer is continuing to study the vaccine in children aged 12-15.

States will receive an initial allotment of 2.9m doses, sent directly from Pfizer within days of authorization. Those doses will be distributed among healthcare workers and long-term care residents, who were deemed the highest priority for vaccination by the US Centers for Disease Control and Prevention (CDC).

Pfizer will then send out a second 2.9m dose allotment weeks later, for the same people to receive a booster shot, necessary to achieve the vaccine’s 95% efficacy. The administration is aiming to vaccinate 20 million health workers and residents of long-term care homes before the end of the year.

Distributing the vaccine is expected to be among the most logistically complex public health campaigns in history. The vaccine requires storage at -94F (-70C), and Congress has failed to provide funding needed to advance the effort, leaving stretched public health authorities on their own to distribute it.

Even as a highly effective vaccine is on the eve of distribution, experts continue to warn it will not immediately herald a return to normalcy. Initial supplies of the vaccine will be extremely constrained, with some experts predicting the vaccine will not reach lower-risk adults until mid- to late 2021.

That means individual Americans will need to continue to wear masks, social distance, hand-wash and avoid crowds, while public health agencies continue to test and contact trace, to eventually bring the pandemic to heel.

Experts believe the US will need to vaccinate upwards of 80% of all adults to reach “herd immunity”. That is an exceptionally high level of vaccination that has never been reached by, for example, a seasonal flu campaign.

The FDA’s decision to approve the vaccine on Friday night is likely to draw consternation from experts, who have said the agency must closely balance speed needed to save lives against a public perception that the vaccine is rushed.

The authorization comes after the White House chief of staff, Mark Meadows, reportedly called Hahn to push for approval on Friday evening. An FDA vaccine advisory panel recommended the agency give the company emergency authorization to distribute the vaccine on Thursday evening.

The administration’s reported move to heap on pressure was heavily criticized by health experts, some of whom argued the FDA would save more lives if it waited, because it would not stoke vaccine hesitancy among the American public.

In total, federal health authorities hope to vaccinate 20 million people before the year is out. That number would still fall short of vaccinating all of the nation’s 21 million healthcare workers and 3 million long-term care residents.

An FDA advisory panel will hear evidence on a second vaccine next week, this one developed by Moderna and the National Institute of Allergy and Infectious Diseases and called mRNA-1273.

The Trump administration issue another indication of support for the Moderna vaccine on Friday evening, when it announced the government had purchased an additional 100m doses. That brings the total doses purchased to 200m, and will allow for “continuous delivery” of vaccine through June 2021.

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