FOI release

Freedom of Information request (FOI 22/1066)

Published 17 January 2024

FOI 22/1064

5th December 2022

Dear

Thank you for your email and we apologise for delay in response.

The temporary authorisations of the Pfizer/BioNTech, Oxford/AstraZeneca and Moderna vaccines was done through an expedited rolling review. A ‘rolling review’ can be used to complete the assessment of a promising medicine or vaccine during a public health emergency in the shortest time possible. This is done as the packages of data become available from ongoing studies on a staggered basis. The temporary authorisation under Regulation 174 permits the supply of identified vaccine batches, based on the safety, quality and efficacy data submitted to MHRA. These authorisations do not constitute a marketing authorisation.

All vaccines are tested through three phases of clinical trials to ensure they meet the gold standard. Phase 1 trials are with a small group of people to make sure there are no safety concerns and determines the appropriate dosage for the best immune response. Phase 2 trials are conducted on a larger group of people to check the vaccine works consistently and that the immune response is sufficient. Phase 3 trials test the vaccines on thousands of people for scientists to assess if the vaccine is producing immunity that will prevent disease. Usually, these phases are run in sequence, but in an effort to find a safe and effective Covid-19 vaccine as quickly as possible, once safety has been ascertained through Phase 1, Phases 2 and 3 are being run in parallel. Extensive checks and balances are required at every stage of the development of a vaccine, and this is no different for a Covid-19 vaccine. No stages in the vaccine development processes were bypassed. 

The temporary authorisations for use of the COVID-19 vaccines in the UK followed a rigorous scientific assessment of all the available evidence of quality, safety and effectiveness by the UK regulator, the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA expert scientists and clinicians reviewed data from the laboratory pre-clinical studies, clinical trials, manufacturing and quality controls, product sampling and testing of the final vaccine, and also considered the conditions for its safe supply and distribution. The decision was made with advice from the Commission on Human Medicines (CHM), the government’s independent expert scientific advisory body. Regarding the MHRA approval of the Pfizer/BioNTech, Moderna and the Oxford/AstraZeneca COVID-19 vaccines, further information (including information for physicians and recipients of the vaccine, and Public Assessment Reports [PARs] for each vaccine) are available on the MHRA website. Links to these are provided below:

https://www.gov.uk/government/publications/regulatory-approval-of-pfizer-biontech-vaccine-for-covid-19

https://www.gov.uk/government/publications/regulatory-approval-of-covid-19-vaccine-astrazeneca

https://www.gov.uk/government/publications/regulatory-approval-of-covid-19-vaccine-moderna

Please note that a marketing authorisation was granted for the Pfizer/BioNTech vaccine (Comirnaty) following a European Commission (EC) decision on 21 December 2020 (PLGB 53632/0002). Further information is available on the European Medicines Agency (EMA) website, a link to this is provided below:

https://www.ema.europa.eu/en/medicines/human/EPAR/comirnaty

Please also note that a marketing authorisation was granted for the Moderna vaccine on 31 March 2021 following an EC Reliance Procedure (PLGB 53720/0002). Further information is available on the MHRA website and the EMA website, links to these are provided below:

https://www.gov.uk/government/publications/regulatory-approval-of-covid-19-vaccine-moderna 

https://www.ema.europa.eu/en/medicines/human/EPAR/covid-19-vaccine-moderna

A marketing authorisation has been granted for the Janssen Covid-19 vaccine on 28 May 2021. Further information is available via the below link:

https://www.gov.uk/government/publications/regulatory-approval-of-covid-19-vaccine-janssen

In addition, a marketing authorisation was granted for the Oxford/AstraZeneca vaccine on 24 June 2021 following an EC Reliance Procedure (PLGB 17901/0355). Further information is available on the MHRA website and the EMA website, links to these are provided below:

https://www.gov.uk/government/publications/regulatory-approval-of-covid-19-vaccine-astrazeneca

https://www.ema.europa.eu/en/medicines/human/EPAR/vaxzevria-previously-covid-19-vaccine-astrazeneca

A marketing authorisation was granted for Valneva suspension for injection (PL 43185/0002) on 13 April 2022. A link to the Public Assessment Report is provided below:

https://mhraproducts4853.blob.core.windows.net/docs/27680d2f701880f90f62740cab6adb4d939b54b4

Further information on other vaccines for Covid-19, including the bivalent vaccines are available on the MHRA website, please see the link below:

https://mhraproducts4853.blob.core.windows.net/docs/27680d2f701880f90f62740cab6adb4d939b54b4

In regards to your questions

However I cant seem to be able to see any details or indeed the trial study for Ivermectin ,you state that the trial for Ivermectin and was paused in July 2022 can you please clarify why this was the case as Ivermectin is a very cheap drug that won a noble prize in medicine in 2015 and is on the WHO list of essential medicines .WHO model list of essential medicines

The MHRA would like to clarify that we did not state that the trial had but paused, but that the Ivermectin treatment arm was closed on recommendation from the trial safety committee due to trial data meeting pre-specified criteria. Further to this, we can confirm that recruitment has been paused as recruitment targets have been met.

In the times we are living in at the moment we are virtually solely relying on New Mrna technology for the treatment of Sars cov2 (Covid19) of which there has been NO long term safety data studies carried out ,prior to vaccines we didn’t have any treatment protocol . Under the emergency use of the current vaccines it has been stated that these Mrna vaccines can be used providing that NO other treatments are available (can you please confirm this).

There is no such thing as emergency use. Authorisation under Regulation 174 allowed for specific batches of vaccine to be authorised for use at the start of the vaccine rollout, ahead of the conditional marketing authorisations that were granted shortly afterwards. There was no requirement that these batches of vaccine could only be authorised for use if there were no other treatments available. It should be noted that currently there are both vaccines authorised for the prevention of Covid-19 as well as treatments for Covid-19 available

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Yours sincerely

MHRA Customer Experience Centre