The race to develop a COVID-19 vaccine
The race for a coronavirus (COVID-19) vaccine is on in the ugliest of ways. Since December, scientists around the world have been racing to create the first vaccine against COVID-19, with vaccine trials either starting or poised to begin in the US, China and Europe. Be patient, because the process may take up to two years. Vaccines in a pandemic are not a 100 percent solution if they are rushed or, worse, politicized.
Genetic sequencing plays a role in finding a vaccine via different approaches and speed. Britain’s Oxford University is beginning to deliver a vaccine, ChAdOx1, in animals in the hope of launching trials in humans next month. At Kaiser Permanente Washington Health Research Institute in the US, medical scientists are using SARS-CoV-2, the virus that causes COVID-19. Biotech company Moderna developed a sequence, mRNA-1273, of the virus’s genetic code, rather than a piece of the virus, in order to develop a vaccine faster.
Fastest, and out in front for now, the Chinese biopharmaceutical company CanSino Biologics announced its vaccine Ad5-nCoV had been approved to start a phase one clinical trial in humans. CanSino Biologics partnered with the Beijing Institute of Biotechnology to develop this vaccine. The team hopes to spark the creation of antibodies against SARS-CoV-2 by taking a piece of its genetic code and combining it with a harmless virus. CanSino claims that the use of Ad5-nCoV shows that the vaccine candidate can induce a strong immune response in animal models. The pre-clinical animal safety studies demonstrated by the Chinese company illustrate a good safety profile.
Meanwhile, US companies Arcturus Therapeutics, Inovio Pharmaceuticals, and Johnson & Johnson, the UK’s GlaxoSmithKline, and Germany’s BioNTech and CureVac are all pursuing their own variants, which are in the pre-clinical stages of development. Dozens of other companies are racing to see how they can contribute to this emerging medical market and disease response capability. The competition is stiff.
With mortality rates expected to peak in June and July in some parts of the world, there is an urgency to find acceptable half-solutions to ease the burden on overtaxed health care systems. Lockdowns and the physical separation of people are very significant in terms of protecting the community. To be sure, this unprecedented global health situation requires an accelerated pathway to speed up the process of finding a vaccine.
This unprecedented global health situation requires an accelerated pathway to speed up the process of finding a vaccine.
Dr. Theodore Karasik
There is also a base of public-private partnerships (PPPs) that are helping with data distribution and sharing awareness, including the Biomedical Advanced Research and Development Authority in the US and the Coalition for Epidemic Preparedness Innovations internationally. The PPP example serves as a model for the development of other contributing partnerships by reaching out to pharmaceutical corporate social responsibility departments to augment funding and speed, and to offer any other assistance. In other words, they are developing a robust supportive network for those entities working on vaccines so transparency and accountability are also maintained during these transformative times.
While vaccines are being developed, antiviral medicines are also being used to help limit the effects of the COVID-19 infection on the human body. Antivirals are needed while a vaccine is developed, hopefully over the coming year.
Antivirals are being explored to provide respite from the pathogen’s attack on the human respiratory system and thus lower the strain on hospitals’ emergency departments. This type of approach targets the virus in people who already have an infection and they work in different ways. Antivirals sometimes prevent the virus from replicating, while others prevent the infection of other cells.
There are several antivirals being considered. Remdesivir’s development a decade ago to fight Ebola failed in clinical trials, but was found to be relatively safe and potentially applicable to other pathogens. Research with MERS showed that the drug blocked the virus from replicating, and it is now being used in five COVID-19 clinical trials. The first results are due next month. Kaletra is a combination of two drugs that work against HIV and clinical trials are planned. A third antiviral, chloroquine, is an antimalarial drug that may block infection. France is working on this antimalarial drug as a treatment, not a cure, for COVID-19. This type of treatment program is supported by World Health Organization Executive Director Dr. Michael Ryan. Finally, Favipiravir is a drug approved outside the US to treat influenza that can be taken to mitigate the effects of the disease.
There is a third approach to fighting the virus via antibodies. Monoclonal antibodies are drugs that trigger the immune system to attack the virus. Stem cell treatments are also seen as beneficial.
Importantly, Chinese scientists have shared the genetic sequence of the virus to different companies for research purposes. In Seattle, Moderna has begun testing its messenger RNA (mRNA) vaccine in a phase one clinical trial. The study includes 45 healthy volunteers aged 18 to 55. The company has developed other mRNA vaccines in the past. Those earlier studies showed that their platform is safe, which allowed the company to skip certain animal testing stages for this specific vaccine. Nevertheless, the war of words between Beijing and Washington over the “rights” to the vaccine is part of the larger geopolitical picture.
Overall, this process of testing a vaccine is time-consuming and the race is on between pharmaceutical companies and the pathogen. Mutation is possible with the vaccine, so how mutation occurs in terms of the timing of the distribution of any vaccine in key breakout areas is crucial. A vaccine hurried into the population can produce ill-effects as well as positive results, so results matter. One does not want to introduce an untested vaccine that may cause another wave of global infection that transforms the human experience.
Dr. Theodore Karasik is a senior adviser to Gulf State Analytics in Washington, DC. Twitter: @tkarasik