Covid-19 Vaccination

The information on the COVID-19 changes every day and it is getting difficult for people to catch up with the latest situation.  Therefore, Marina Medical will like to contribute by providing what we have learned and organised them in a way that hopefully, you can understand and get yourself prepared. We will actively update on anything new that we have learned.

Written by Dr Ivan Chow (December 14, 2020.  HKT 10:00)

Information from the World Health Organization, UpToDate Inc, Pfizer, Moderna, AstraZeneca, the Lancet, The New England Journal of Medicine, Hong Kong Government, 

Declaration of Interest: Nil

Latest Update
Latest Update

Jab scheme to cover people aged 16 to 29

Updated on 16 Apr 2021

The Hong Kong Government announced the COVID-19 Vaccination Programme will be expanded to cover people aged 16 to 29. The minimum age for receiving the BioNTech vaccine is 16 and that for receiving the Sinovac vaccine is 18. The community vaccination centres (CVCs) are expected to operate until the end of September, and people wishing to receive the BioNTech vaccine have to get the first dose by the end of August.

Citizens aged 16 to 29 can make reservations starting from 9am on April 23 through the online booking system to receive vaccines at 29 CVCs and 18 general out-patient clinics of the Hospital Authority (HA) or make appointments for vaccinations with private doctors or clinics participating in the programme. Click here to view the vaccination priority group.

Source: https://www.news.gov.hk/eng/2021/04/20210415/20210415_162622_934.html

 

Covid-19 vaccination programme will open to 1.3 million more Hongkongers from Tueday

Updates on March 8th, 2021

Hong Kong’s city-wide vaccination drive will open to seven more priority groups from March 9th (Tuesday) onwards, Secretary for the Civil Service Patrick Nip announced on March 8th (Monday). It means the vaccination programme will now able to cover additional 1.3 million Hongkongers. 

The seven priority groups include staffers from eateries, supermarkets, markets, convenience stores, and those working food delivery. Transport workers were also prioritized for the inoculation program.

Construction workers, property management staff, school staff including school bus drivers and staffers from the travel industry were also included on the list.

As for staffers working at gym centres and the beauty industry, they can also make their booking starting tomorrow morning.  Click the link to view if you are eligible

source: GovHK

 

Updates over the 2 ready COVID-19 vaccines in Hong Kong 

Updates on February 22, 2021

We have updated the Vaccination comparison table to provide a more complete overview of the 2 available COVID-19 Vaccines in Hong Kong,(vaccine table)

 

Conclusion and Recommendation from Centre for Health Protection on 8 Feb 2021 regarding Covid-19 vaccineBNT162b2

Updates on February 16, 2021

There is currently no evidence suggestive of any unexpected or untoward increase in mortality in frail elderly following the use of COVID-19 vaccine by Fosun Pharma/BioNTech (i.e. Comirnaty COVID-19 mRNA Vaccine). There is also no clear evidence suggesting the reported deaths were due to the use of the vaccine. For most frail elderly, the benefit of reducing the risk of a severe COVID-19 disease course outweighs the risk of receiving the vaccine.

For elderlies with severe frailty (e.g. bedridden elderly), especially those at the most extreme age groups (such as those above 85 years old), any mild adverse event from pharmaceutical products including vaccines might worsen their original disease course or condition. The benefits and risks of receiving the vaccine in these particular groups should be evaluated separately by attending clinicians and such clinical assessment should be exercised with greater caution.

Any individual who is experiencing acute febrile diseases should delay their vaccination.

Currently, safety data on the use of the vaccine remains limited and long term data are lacking. As mass COVID-19 vaccination programs continue worldwide, information regarding rare adverse events and long term side effects will be emerging.

 

Pfizer-BioNTech COVID-19 vaccination (BNT162b2) data report by CDC

Updates on February 3, 2021 

According to the CDC, during December 14-23 2020, there were 21 cases of anaphylaxis after administration of a reported 1,893,360 first doses of the Pfizer-BioNTech COVID-19 (BNT162b2) vaccine (11.1 cases per million doses); 71% of these occurred within 15 minutes of vaccination.

 

Fosun Pharma-BioNTech vaccine (BNT162b2) arrival at end of Febuary 

Updates on January 27, 2021 

The Secretary for Food and Health (SFH) authorised the COVID-19 vaccine  (BNT162b2) by Fosun Pharma-BioNTech on January 25 for emergency use in Hong Kong. The vaccine fulfilled the criteria of safety, efficacy and quality for specified use in Hong Kong under emergency situation. According to the information provided by the vaccine supplier, the first batch of 1 million doses of the Fosun Pharma/BioNTech vaccine to be supplied to Hong Kong have completed production and are undergoing safety and quality testing. Subject to the completion and passing of the relevant tests, the relevant vaccines are expected to arrive in Hong Kong from Germany in late February. The territory-wide vaccination programme led by the Government will be launched as soon as possible after completing all necessary quality assurance procedures. 

 

Sinopharm vaccine proves its safety and effectiveness in Phase III clinical trial

Updates on January 23, 2021

About 200 politicians from Hong Kong travelled to Shenzhen on 22 Jan 2021 for a Covid-19 vaccination (Sinopharm). According to the news released from Sinopharm on 2 Jan 2021, in Phase III clinical trial efficacy rate is 79.34%. A large sample of injection and data prove its safety and effectiveness. Besides, the vaccine doesn’t require freezing temperatures for storage, making transport and distribution much easier. The vaccine requires two doses in 21 to 28 days apart.

Source: http://www.sinopharm.com/en/s/1395-4689-38862.html

 

Recommendation on COVID-19 vaccines in Hong Kong by The Scientific Committees

Updates on January 22, 2021

The Scientific Committee on Vaccine-Preventable Diseases and the Scientific Committee on Emerging and Zoonotic Diseases under the Centre for Health Protection of the Department of Health published the consensus interim recommendations on the use of COVID-19 vaccines in Hong Kong.
The current recommendations focused on two vaccines, namely BNT162b2 provided by Fosun Pharma/BioNTech and AZD1222 provided by AstraZeneca. 
The recommendations are summarised below:
Both vaccines consist of a schedule of two doses. Individuals should complete their vaccination with the same type of vaccine.

  • Priority should be accorded to high-risk groups that are most vulnerable to the development of severe disease or death from COVID-19 infection, have greater risks of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and transmitting the virus to susceptible and vulnerable patients, or are critical for maintaining essential societal functioning.
  • Priority has been suggested to be accorded to the following groups:
    First: Residents and staff of residential care homes for the elderly/persons with disabilities and other institutional facilities;
    Second: Workers in health-care settings, workers in other essential services who are at increased risk of exposure to COVID-19, and persons aged 60 years or above; and
    Third: Persons with chronic medical problems aged between 16 and 59 years.

Vaccination is only one of the tools in the overall public health response to COVID-19. There is a need to continue public health strategies on non-pharmaceutical interventions, including social distancing, good hand hygiene and wearing a mask in public, to reduce the risk of transmission.

 

Sinovac clinical study reported by The Butantan Institute and the Government of Sao Paulo 

Updates on January 20, 2021

The Butantan Institute and the Government of Sao Paulo report that the coronavirus vaccine (Sinovac) achieved a 50.38% overall efficacy rate in the clinical study conducted in Brazil, in addition to (an efficacy rate of) 78% for mild cases and 100% for moderate and severe cases of Covid-19.

Sources: https://butantan.gov.br/noticias/coronavac-tudo-que-voce-sempre-quis-saber-e-nao-tinha-para-quem-perguntar

 

Vaccination program begins by early Feb 2021 at 18 districts' vaccination centres 

Updates on January 7, 2021

Dr Thomas Tsang Ho Fai, a member of the government's vaccination program task force, said on a radio program that authorities plan to set up vaccination centres at 18 districts in the city and start the vaccinations early February 2021. The first batch of 1 million doses of vaccine is produced by Sinovac, a mainland pharmaceutical company.

According to Reuters, the vaccine developed by China’s Sinovac Biotech was 78% effective in a late-stage Brazilian trial with no severe COVID-19 cases. There is no detailed data available yet.

 

Hong Kong Government reached agreements with Sinovac and Fosun Pharma

Updates on December 11, 2020

The Hong Kong Government held a press conference on December 11, 2020. Hong Kong has reached agreements with two COVID-19 vaccine manufacturers (Sinovac and Fosun Pharma), securing 15 million shots, the first million of which could be available as early as January. 

The Government will soon reach a deal with a third manufacturer (AstraZeneca) which will also provide 7.5 million doses to the city.

 

Pfizer and BioNTech
Pfizer and BioNTech

Pfizer and BioNTech

On December 8, 2020, the United Kingdom has become the world's first nation to begin vaccinating its citizens with a fully vetted and authorized COVID-19 shot, a landmark moment in the coronavirus pandemic.[1]

On December 10, 2020, The New England Journal of Medicine has published safety and final efficacy results from Phase 3 trial of mRNA-based COVID-19 vaccine. It demonstrated the vaccine has an efficacy of 95%. Efficacy was consistent across age, gender, race and ethnicity demographics.

Side Effects

Local reaction including pain, swelling and redness at the injection site. Systemic events like fatigue, headache, muscle pain, and fever were reported, more often by younger recipients and more often after the second dose. For adverse events, 0.3% of recipients reported lymphadenopathy. No deaths were related to the vaccine.

Limitations

Follow-up time was 2 months only, the duration is not long enough to detect less common adverse events. Moreover, the duration of protection remains to be determined.[2] 

Storage

The recommended storage temperature condition is -70°C for up to 10 days unopened. Then the vaccine can be stored at refrigerated 2-8°C conditions for 5 days.

 

[1]https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-achieve-first-authorization-world

[2] https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-achieve-first-authorization-world

 

Priority Group
Priority Group

Priority Group for vaccination

updates on April 16th, 2021

The Government decided to arrange priority vaccination for the groups below:

  1. Age 30 or above (a maximum of two carers who accompany elderly people aged 70 or above can also receive vaccination)
    • Age 16 to 29 years can make vaccination booking at the thematic website or designated private clinics starting 9am on 23 April (Friday).

  2. Personnel in healthcare settings and those participating in anti-epidemic related work;
  3. Residents and staff of residential care homes for the elderly / persons with disabilities;
  4. Personnel maintaining critical public services; and
  5. Personnel providing cross-boundary transportation or working at control points and ports.
  6. Staff of food and beverages premises, markets, supermarkets, convenience stores and couriers (including takeaway food delivery);
  7. Staff of local public transport service operators (e.g. taxi/bus/public light bus drivers, train captains and station staff)
  8. Registered construction workers
  9. Staff of property management (e.g. security guards, cleaning staff and property management office staff)
  10. Teachers and school staff (e.g. teaching and support staff of kindergartens, primary and secondary schools and universities; staff of special schools; and drivers and escorts of school buses and school private light buses)
  11. Staff of the tourism industry
  12. Staff of scheduled premises under the Prevention and Control of Disease (Requirements and Directions) (Business and Premises) Regulation (Cap. 599F) (e.g. staff of fitness centres and beauty parlours)
  13. Students studied abroad (age 16 and above)
  14. Domestic helper
Moderna
Moderna

Moderna

On November 30, 2020, Moderna announced mRNA vaccine efficacy of 94.1% in Phase 3 study.[1] 

Side effects

Adverse events included injection site pain, erythema, redness, fatigue, myalgia, bone pain and headache which were generally short-lived.[2] 

Storage

The vaccine can remain stable at 2° to 8°C, the temperature of a standard home or medical refrigerator, for 30 days.

[1] https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-primary-efficacy-analysis-phase-3-cove-study

[2] https://investors.modernatx.com/news-releases/news-release-details/modernas-covid-19-vaccine-candidate-meets-its-primary-efficacy

University of Oxford and AstraZeneca
University of Oxford and AstraZeneca

University of Oxford and AstraZeneca

On December 8, 2020, the Lancet has published safety and efficacy results of the replication-deficient chimpanzee adenoviral vector vaccine. In participants who received two standard doses, vaccine efficacy was 62.1% and in participants who received a low dose followed by a standard dose, the efficacy was 90.0%. .[1] 

Limitation

The median follow-up time was 3.4 months. It has not been able to assess the duration of protection.

Side Effects

Pain at the injection site was the most common local side effects. For systemic side effects, fatigue and headache were the most reported. Others side effects include muscle ache, malaise, chills and fever.

Three cases of transverse myelitis were reported as suspected unexpected serious adverse reactions, with two in the vaccine study arm, triggering a study pause. Independent clinical review of these cases has indicated that 2 cases are unlikely to be related to study interventions, but a relationship remained possible in the third case.[2] 

Storage

The vaccine can be stored, transported and handled at normal refrigerated conditions (2° to 8°C) for at least 6 months and administered within existing healthcare settings.

 

[1] Merryn V, Sue ACL, Shabir AM, et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2020; (published online Dec 8.) https://doi.org/10.1016/S0140-6736(20)32661-1

[2] Folegatti PM Ewer KJ Aley PK et al. Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial. Lancet. 2020; 396: 467-478

Sinovac
Sinovac

Sinovac

On November 17, 2020, the Lancet has published the safety, tolerability, and immunogenicity of CoronaVac, an inactivated vaccine (phase 1/2 clinical trial). Seroconversion of neutralising antibodies was 92%-100%.[1] Phase 3 trial results are not available yet.

[1https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30843-4/fulltext

 

Vaccines Comparison table
Vaccines Comparison table

Vaccines comparison table

Updated on March 24 2021

 

Vaccine name

COMIRNATY™

CoronaVac

Manufacturer/developer

Fosun Pharma in collaboration with the German drug manufacturer BioNTech

Sinovac Biotech (Hong Kong) Limited

Technology platform

mRNA vaccine

Inactivated virus

Injection method

Intramuscular

Intramuscular

Efficacy

95%

50.65%

Mild cases 83.7%

Moderate and severe cases 100.0%

Severe cases 100.0%

Duration of protection

Not known

Not known

Contraindication

Hypersensitivity to the active substance or to any other ingredient of this vaccine

Allergic reaction to any component of the vaccine or similar vaccines

Severe neurological conditions

Patients with uncontrolled severe chronic diseases

Pregnant and lactating women

Number of dosages

2

2

Interval between dosage

21 days apart

28 days apart

Posology

Individuals of 16 years of age and older

Susceptible people aged 18 and above

Interchangeability with other COVID-19 vaccines

No data

No data

Pregnancy

Not routinely recommended. Only be considered when the potential benefits outweigh any potential risks for the mother and foetus.

Contraindicated

Breast-feeding

Not routinely recommended.

Contraindicated

Fertility

Animal studies do not indicate harmful effects

No data

 

COVID-19 vaccination Side effect

 

COMIRNATY™

CoronaVac

Injection site pain and swelling

Very common. More than 1 in 10 people

Very common. More than 1 in 10 people

Tiredness

Headache

Muscle pain

Common. Up to 1 in 10 people

Joint pain

Chills

Fever

Uncommon. Up to 1 in 100 people

Injection site redness

Common. Up to 1 in 10 people

Common. Up to 1 in 10 people

Nausea

Enlarged lymph nodes

Uncommon. Up to 1 in 100 people

N/A

Feeling unwell

Pain in limb

Insomnia

Injection site itchy

Common. Up to 1 in 10 people

Temporary one sided facial dropping

Rare. Up to 1 in 1000 people

 

Severe allergic reaction

Cannot be estimated from available data

N/A

Burn in injection site

N/A

Uncommon. Up to 1 in 100 people

Pruritis

N/A

Common. Up to 1 in 10 people

Loss of appetite

Rhinorrhea and nasal congestion

Cough and sore throat

Abdominal pain and diarrhoea

Vomiting

N/A

Uncommon. Up to 1 in 100 people

Hypersensitivity

Abnormal skin and mucosa

Tremor

Flushing

Edema

Dizziness and drowsiness

Muscle spasm

N/A

Rare. Up to 1 in 1000 people

Eyelid edema

Hyposmia

Abdominal distension and constipation

Ocular congestion, conjunctival congestion

Hot flashes

Hiccup

Serious adverse event

N/A

Nil was identified up to February 3, 2021

 

COVID-19 vaccination Availability/logistics

 

COMIRNATY™

CoronaVac

Online booking

Available at Community Vaccination Centres only

Available at:

- Community Vaccination Centres OR

Designated private clinic

*Vaccination is available at our clinic. For online booking, please fill out personal information. Then, select "covid-19 vaccination" for service and "Central" for location (only central clinic is available for vaccination). 

Vaccination begins for priority groups in 5 Community Vaccination Centres and 18 general outpatient clinics (GOPCs) of the Hospital Authority

10-Mar-2021

26-Feb-21

Private clinics availability

Not available in private hospitals and clinics

Applicable

*Vaccination is available at Marina Medical. For online booking, please fill out personal information. Then, select "covid-19 vaccination" for service and "Central" for location (only central clinic is available for vaccination). 

Priority Groups

Please click here

Vaccination records

- Paper vaccination records OR

- Download their electronic vaccination records via the "iAM Smart" mobile app, or through the “eHealth” mobile app

 

 

Updated on December 11, 2020

COVID-19 vaccination information

Company

Type of vaccine

Doses

Efficacy

Storage

Pfizer and BioNTech

RNA

2

95%

-70°C±10°C for up to 10 days unopened. 2-8°C conditions for 5 days.

Moderna

RNA

2

94.1%

-20°C for 6 months. 2°- 8°C for 30 days

University of Oxford and AstraZeneca

Replication-incompetent vector vaccines

2

62.1% - 90%

2° to 8°C for 6 months

When vaccines are ready to use?
When vaccines are ready to use?

When vaccines are ready to use? 

All vaccines must be proven safe and effective in large (phase III) clinical trials and a series of independent reviews of the efficacy and safety evidence is required.

Officials in individual countries decide whether to approve the vaccines for national use and develop policies for how to use the vaccines in their country based on the World Health Organization (WHO)  recommendations.

The vaccines must be manufactured in large quantities, which is a major and unprecedented challenge.

As a final step, all approved vaccines will require distribution through a complex logistical process, with rigorous stock management and temperature control.[1]

[1] https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines

 

What are Phase III clinical trials?
What are Phase III clinical trials?

What are Phase III clinical trials? 

These trials are designed to determine whether the vaccines prevent a disease. Subjects enrolled in phase III studies are randomly assigned and blinded to receipt of either vaccine or a control preparation (or comparator vaccine). Vaccine efficacy in percent is the reduction in specific disease incidence among those who received vaccine versus those who did not.[1]

Phase III clinical trials may not answer several efficacy questions related to SARS-CoV-2 vaccination. These include:

  • Duration of protection from disease
  • The potential need for and timing of additional booster doses
  • Effectiveness in subpopulations not evaluated in the clinical trials
  • Impact on community transmission

[1] https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-vaccines-to-prevent-sars-cov-2-infection?search=covid%20vaccine&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

 

What are the different types of potential vaccines for COVID-19?
What are the different types of potential vaccines for COVID-19?

What are the different types of potential vaccines for COVID-19? 

  • Inactivated vaccines (e.g. Sinovac) are produced by growing SARS-CoV-2 in cell culture then chemically inactivating the virus. The inactivated virus in the vaccine stimulates an immune response[1]
  • Protein-based vaccines, which use harmless fragments of proteins or protein shells that mimic the COVID-19 virus to safely generate an immune response.[1]
  • Replication-incompetent vector vaccines (e.g. AstraZeneca) use a different vector virus that has been engineered to not replicate in the human body and to express the viral protein. Many replication-incompetent vector vaccine candidates use adenovirus vectors. One drawback to vector vaccines is that pre-existing immunity to the vector can attenuate immunogenicity of the vaccine. This can be avoided by using viral vectors that are uncommon in humans, vectors derived from animal viruses, such as a chimpanzee adenovirus.[1]
  • RNA vaccines (e.g. Pfizer, Moderna) were the first vaccines for SARS-CoV-2 to be produced and represent an entirely new vaccine approach. Once administered, the RNA is translated into the target protein, which is intended to elicit an immune response. Since the technology is new, the ability to produce large quantities of RNA vaccines has not been previously tested, and some of the vaccines must be maintained at very low temperatures, complicating storage.[1] It was believed that injecting RNA into a person does not do anything to the DNA of a human cell.

Fig. 1 How are vaccines created?

Fig. 2 What happens after the vaccine enters our body?

[1] https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-vaccines-to-prevent-sars-cov-2-infection-search=covid%20vaccine&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

 

Questions not yet answered:
Questions not yet answered:

Questions not yet answered:

  1. How long after immunisation does it take to be protected?
  2. What is the estimated duration of protection?
  3. Can the vaccines prevent transmission?
  4. How the efficacy of the vaccines be affected by the cold-chain breach?
  5. What are the long-term side effects of the vaccines?
  6. Are the vaccines effective against all strains of SARS-CoV-2?
  7. Are the vaccines effective in all age and ethnic groups?
  8. Are the vaccines safe for an immunocompromised group and pregnant ladies?
COVID-19 Testing FAQs
Post-Covid Treatment

Get In Touch

For any enquiry, please contact us at +852 3420 6622 or info@marinamedical.hk

Service*:
Preferred Time:
Preferred clinic location*:
*required fields
Top