Why the Novavax vaccine has arguments to convince some skeptics

CORONAVIRUS – “The best vaccine against Covid-19”, The Atlantic newspaper enthused last August about NVX-CoV2373. The new preventive treatment against coronavirus developed by the American company Novavax has just been validated for the French market by the High Health Authority (HAS), and it is preceded by some enthusiasm.

Compared to its competitors Pfizer and Moderna, the newcomer, which also requires a double injection (not to mention boosters), has nothing to be ashamed of. A phase 3 trial conducted in more than 25,000 people in the United States and Mexico in 2021 shows an overall effectiveness of 93% against the coronavirus, a result comparable to the Comirnaty vaccine (Pfizer-Biontech).

But the past year has familiarized the planet enough with the differences between the variants that this figure is not, by itself, reassuring. The variants more or less escape vaccines, but the study does not detail their results. For Delta and Omicron, it is necessary to rely on another study, this phase 2, therefore in a smaller number of patients.

The people tested this time received a booster, a third dose, in a randomized trial. Here too the results are very good, with a level of antibodies equivalent to the vaccines already on the market, both for Delta and Omicron. But these reassuring figures are not the only ones generating excitement among some unvaccinated.

A proven technique

NVX-CoV2373 is not an RNA vaccine, and that’s what makes it popular, for good and not-so-good reasons. In fact, Novavax has developed a vaccine called “protein subunit” (find the differences between the vaccines in the video at the beginning of the article): concretely, this means that we inject S-proteins into the human body, these elements that are on the surface of the coronavirus and that allow it to be identified.

Our immune system recognizes them and develops the necessary antibodies to attack and destroy them effectively. This is a proven technique, widely used around the world since the 1980s, for vaccines that protect against hepatitis B, or even meningococcal meningitis.

This is what reassures some people concerned about vaccination, repelled by the “novelty” of RNA vaccines, even though they use a technology known since the 1970s and perfected in the 2000s. Unit vaccines use, it is true, a technology more conventional than the messenger. RNA vaccine.

As for side effects, already well known in the case of RNA vaccines, they are limited in newcomers. The result is even better than its competitors. Fatigue was reported by 40% of Phase 3 patients after the second injection of NVX-CoV2373, compared to 65% for Moderna and 55% for Pfizer. Even better, the reported symptoms are less bothersome than the competition.

The proportion of severe cases is comparable to that of RNA vaccines, that is, very low. In a UK trial of 15,000 participants, only 0.5% experienced “serious” side effects, as many as those given a placebo.

However, the Novavax vaccine contains an adjuvant, that is, a product intended to reinforce the action of the vaccine. A system used in many cases for conventional vaccines but that can cause allergies, or side effects in some cases. The adjuvant signed Novavax, based on saponin, gives very good results, despite a name that should not leave skeptics of vaccination insensitive: Matrix-M. Name aside, a hit, then. But the real advantage of the Novavax vaccine may well lie elsewhere than in its clinical results.

Cheap to produce and stable.

Unlike products from Pfizer or Moderna, which can be stored for up to a month at 2° to 8° Celsius, the Novavax vaccine is much more stable…and adaptable. It can thus remain six months in the refrigerator and retain all its effectiveness. This resistance could make a difference, especially in countries with less developed health systems.

Even better, the technology needed to produce this vaccine is more accessible, which means that, in principle, it will be easier to produce locally. As virologist Maria Elena Bottazzi told the journal Nature, “it is probably the easiest and cheapest vaccine” to produce.

This did not save Novavax from some painful pitfalls, particularly for its share price. After promising two billion doses to poor countries through the Covax system, the company has delayed its commitment throughout 2021 due to production implementation issues. The quality of his vaccine, when it left the factory, was not good enough in the eyes of the US authorities. “Conventional” or not, a vaccine remains a state-of-the-art treatment.

Based on a more classical technique for effects comparable to the competition, it therefore seems more like a real opportunity for developing countries, which lack the vaccine. According to the WHO, only 9% of the population of the African continent was vaccinated against Covid-19 at the end of 2021.

The fact is that in Europe, Novavax does not care as much as its competitors with part of the population. In the fall of 2021, a survey conducted on the Rhine by the Ministry of Health revealed that 56% of unvaccinated people would be more prepared to be vaccinated if a more “conventional” solution than RNA vaccines saw the light of day. . This “conventional” solution now exists, it is a subunit vaccine containing a viral Spike protein, produced in the laboratory by genetic engineering.

See also on The HuffPost: In the face of anti-vaccines, Senator Claude Malhuret has a suggestion

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