Will we pick which vaccine we take?

While the UK has started its coronavirus vaccine rollout, Belgium is still waiting for an approved vaccine, with many questions about the vaccination strategy remaining unanswered.

Will we pick which vaccine we take?
Credit: pixabay

Following the news that the first UK patients have received the coronavirus vaccine, people in Belgium – and Europe – are starting to wonder just how things could look once they start here in 2021.

While the UK currently only has access to one vaccine - from Pfizer/BioNTech - there is every chance coming months could bring multiple options for vaccinations in Europe, providing they gain approval.

"It is very hard to say anything about this at this stage," a European Commission spokesperson told The Brussels Times. As it stands, no vaccine has been approved for use by the European Medical Association (EMA), so no drug is currently eligible for use here, with no absolute timeline for when.

So What If There Are Multiple Options?

"At the moment, there are still a lot of unanswered questions about the vaccination strategy, but not all of them can be answered as we do not yet have all the information ourselves," a spokesperson for Belgium's Corona Commissioner Pedro Facon told The Brussels Times.

However, Belgians will not be able to have the luxury of choosing which vaccine they will receive in the initial phase, according to professor Pierre Van Damme, who is part of the task force for the vaccination strategy.

"With the vaccines that are available, the priority groups will be vaccinated first," Van Damme told reporters, adding that the European approval, however, will guarantee that all vaccines are good ones.

If several vaccines differ in their efficacy in one group or another, the vaccine working group will decide who gets which vaccine, Van Damme said. Patients will not be allowed to choose for the time being. "It will be a choice based purely on scientific facts," he added.

Whether people will be able to choose which vaccine they want once sufficient doses are available and the priority groups have been vaccinated is not yet clear.

"Although there is already quite some positive reporting about the vaccines, it cannot be excluded that one or more of the vaccine candidates will not receive a positive recommendation from the EMA, in which case they will not be made available to the Member States," the EC spokesperson added.

Waiting For EMA

At this point in time, only 2 companies have submitted a request for approval, they are:

BioNTech Pfizer - The EMA will probably be able to complete the first evaluations late-December or early January 2021, according to Belgium's Federal Agency for Medicines and Health Products (FAMHP).

“We expect the first vaccines in January,” Xavier De Cuyper, administrator general of the FAMHP, said at a press conference unveiling Belgium's vaccination strategy. “Pfizer-BioNtech will deliver approximately 600,000 doses (for 300,000 people). Pfizer’s vaccines must be given in two doses, with three weeks in between.”

Moderna - EMA and its scientific committees will continue working on the assessment of the vaccine over the Christmas period, the agency stated. If the data submitted are sufficient, EMA’s scientific committee for human medicines (CHMP) will conclude its assessment during an extraordinary meeting, scheduled for 12 January at the latest.

The Belgian Approach

For Belgium, the issue is yet to come to light. Speaking on 2 December, PM Alexander De Croo said that Belgium would be ready to start vaccinating on 5 January, if the EU gives the green light for the vaccines.

If all candidate vaccines that Belgium has subscribed to are given market authorisation, the country should receive a total of 22.4 million doses of vaccines, which would be sufficient for its entire population.

When announcing the country's vaccination strategy, health officials stated that vaccinations would be phased, depending on the number of vaccines available at the time.

Phase 1a is expected to start with the arrival of the Pfizer/BioNTech vaccine at the beginning of January, and will see staff and residents in care centres being vaccinated.

When more vaccines are available, Belgium will enter Phase 1b, and start vaccinating people over 65 years old and other high-risk patients.

While there are still uncertainties about the timing of the availability of the different vaccines, Phase 2, in which low-risk patients will be vaccinated, is scheduled to start when a sufficient supply is available.

The FAMHP hopes that by March-April, there will be an acceleration in the production and that the various phases can take place together.

The actual deployment and use of any approved vaccine will be a matter of national competence, leaving the possibility for different outcomes for different countries. "When deploying vaccines, they will also have to take into account the technical specificities of the different vaccines to see in what circumstances they are best used," the Commission spokesperson added.

"The availability and delivery of the vaccines depend on the timing of the request of a market authorisation, and on the time the EMA needs to make its assessment. Vaccinations will start as soon as the first vaccines are made available," he added.

A section of questions and answers is being prepared to deal with what the difference between the different vaccines is, The Brussels Times has learned.  The information will be available by the beginning of next week at the latest.

Maïthé Chini, Jules Johnston & Mose Apelblat

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