The Novavax COVID-19 vaccine, sold under the brand names Nuvaxovid and Covovax, among others, is a subunit COVID-19 vaccine developed by Novavax and the Coalition for Epidemic Preparedness Innovations (CEPI).
Medical uses
The Novavax COVID19 vaccine is indicated for active immunization to prevent COVID19 caused by SARS-CoV-2.
Efficacy
A vaccine is generally considered effective if the estimate is ≥50% with a >30% lower limit of the 95% confidence interval. Efficacy is closely related to effectiveness, which is generally expected to slowly decrease over time.
In December 2021, Novavax reported that its phase III trial showed the vaccine achieved its primary endpoint of preventing infection at least seven days after the second dose. Overall efficacy against different SARS-CoV-2s was 90.4% and efficacy against moderate-to-severe disease was 100%. Trials were conducted before the emergence of the SARS-CoV-2 Omicron variant, which has sharply reduced the effectiveness of authorized vaccines in preventing infections.
Side effects
The most common side effects include fever, headache, nausea, muscle and joint pain, tenderness and pain at the injection site, tiredness, and feeling unwell.
Additional possible side effects include anaphylaxis (severe allergic reaction), paresthesia (unusual feeling in the skin, such as tingling or a crawling sensation) and hypoesthesia (decreased feeling or sensitivity, especially in the skin), and pericarditis (inflammation of lining around the heart).
On 27 January 2023, Australia's Therapeutic Goods Administration indicated it will add tinnitus to its label.
Handling and administration
The vaccine requires two doses and is stable at refrigerated temperatures.
Technology
NVX-CoV2373 has been described as both a protein subunit vaccine and a virus-like particle vaccine, though the producers call it a "recombinant nanoparticle vaccine".
The vaccine is produced by creating an engineered baculovirus containing a gene for a modified SARS-CoV-2 spike protein. The spike protein was modified by incorporating two proline amino acids in order to stabilize the pre-fusion form of the protein; this same 2P modification is being used in several other COVID19 vaccines. The baculovirus is made to infect a culture of Sf9 moth cells, which then create the spike protein and display it on their cell membranes. The spike proteins are harvested and assembled onto a synthetic lipid nanoparticle about 50 nanometers across, each displaying up to 14 spike proteins.
The formulation includes a saponin-based adjuvant named Matrix-M.
Manufacturing
In February 2021, Novavax partnered with Takeda to manufacture the vaccine in Japan, where its COVID19 vaccine candidate is known as TAK-019.
Novavax signed an agreement with Serum Institute of India for mass scale production for developing and low-income countries. In 2020 it was reported, that the vaccine would be manufactured in Spain and in November 2021 it was reported to be produced in Poland by the Mabion company. As of 2021, antigens were made at Novavax's factory Novavax CZ in the Czech Republic; Novavax CZ was also marketing authorisation holder of its EU authorization.
In May 2021, Serum Institute of India said that it started the production of the Novavax COVID19 vaccine candidate branded as Covovax in India after receiving permission from the Indian government.
History
In January 2020, Novavax announced development of a vaccine candidate, codenamed NVX-CoV2373, to establish immunity to SARS-CoV-2. Novavax's work is in competition for vaccine development among dozens of other companies.
In March 2020, Novavax announced a collaboration with Emergent BioSolutions for preclinical and early-stage human research on the vaccine candidate. Under the partnership, Emergent BioSolutions was supposed to manufacture the vaccine at large scale at their Baltimore facility. However, following production issues with the Johnson & Johnson and Oxford–AstraZeneca vaccines at its Baltimore plant and to decrease the burden on the plant, Novavax subsequently partnered with a different manufacturer in a new agreement overseen by the U.S. government.
Trials have also taken place in the United Kingdom. The first human safety studies of the candidate, codenamed NVX-CoV2373, started in May 2020 in Australia.