Seven months after the onset of the world’s worst health crisis in a century, the race is on its way to finding the medical equivalent of the Holy Grail: a COVID-19 vaccine.
To date, the new coronavirus has killed some 590,000 people worldwide and infected nearly 14 million in 196 countries since the outbreak first emerged in China late last year.
How to stop a pandemic that has wreaked havoc on the global economy is now the urgent multi-billion dollar problem for vaccine developers aware that every suggestion the target may have in sight will be analyzed in microscopic detail.
– How many vaccines? –
In its most recent evaluation this month, the World Health Organization identified 21 “vaccine candidates,” nearly half with Chinese companies or institutes, after a series of global clinical trials.
Many are still in what is called the first phase, which seeks to establish the safety and dosage of a product,
However, some have graduated to phase two, which examines how effective a drug can be.
Two candidate vaccines have reached stage three, whereby developers monitor problems such as the degree of potential toxicity on a much larger scale and test it under a broader range of conditions before it is sent for approval.
The duo in question is a European project being carried out at the University of Oxford together with AstraZeneca and a Chinese variant of the biopharmaceutical company Sinovac in collaboration with the Brazilian research institute Butantan.
Sinovac’s project is among the most advanced: it will begin testing its vaccine on volunteers in Brazil this month.
A Canadian clinical trial to involve CanSino Biologics was also given the green light, and the company said last month that the Chinese military had approved the use within its ranks of the vaccine it helped develop.
Sinopharm, which is working with the United Arab Emirates for the trials, completed construction of a new production facility with a capacity of 100 million doses on July 1, Chinese authorities said on social media.
Beyond the tests already underway, the WHO is monitoring 139 other potential vaccines that are still in the preclinical evaluation stage, which involves animal testing.
Britain, Canada and the United States this week accused hackers linked to Moscow of attacking laboratories in their countries conducting research on the coronavirus vaccine.
– What techniques? –
There are a variety of approaches and techniques in all tested or experimental vaccines.
Some teams work on inactivated “classic” vaccines that use a virus germ that has been “killed”, while others, known as attenuated or weakened strains, involve the use of a live virus that becomes less virulent.
Other types still include “subunit” vaccines, which contain a fragment of the pathogen from which it is derived to produce an appropriate immune response.
Then there are more innovative varieties of “viral vectors” that use live viruses to deliver DNA to human cells to trigger an immune response.
An example is taking a virus like measles and, as the Pasteur Institute is doing, modifying it with a coronavirus protein and deploying it against COVID-19.
Then there are new experimental developments involving gene-based DNA or RNA vaccines that use fragments of modified genetic material.
“The more candidate vaccines there are, and above all the more types of candidate vaccines, the greater the chances of getting somewhere” in terms of beating the virus, says Daniel Floret, vice chairman of the French Technical Committee on Vaccination.
– Results so far –
For now, only the partial results have been made public, some are promising by the companies behind them.
Jean-François Delfraissy, chairman of the French scientific council that has been guiding French authorities on the subject throughout the pandemic thus far, said the claims should be closely investigated as the trade effect of a potential breakthrough, but not confirmed, it can be huge.
“There is a considerable effect on the pharmaceutical industry of an advertisement that one should view with the utmost caution,” the immunologist told AFP.
“An injection of (tested) vaccine into 30 people that is advertised as a result, well, that’s not a result,” Delfraissy said.
Floret agreed that many ads target at least both the stock market and the general public.
“It is never neutral. It is important that they show us that they are accelerating things, but they will still have to see the results and at the moment that is not happening.”
– Going fast? –
All the time, with the pressure of finding a way to deal with the pandemic, procedures have escalated around the world like never before.
“Things are moving at knot speed … and the projects are moving perhaps a little faster than anticipated,” Christophe d’Enfert of the Pasteur Institute told AFP.
Both states and major foundations have been crumbling to drive fundraising efforts.
And while the United States has been seeking to do it alone, Europe and most other countries are seeking cooperation.
The Trump administration has established “Operation Warp Speed” in an attempt to deliver 300 million doses, essentially to US citizens, of a safe and effective vaccine for COVID-19 in January.
The companies “are trying to develop a vaccine and at the same time launch an industrial process to produce it, while you normally expect to see the results” of the first of those operations, Delfraissy says.
“That is why they are asking the states for financing, saying: ‘We are running the risk of starting (developing) a vaccine that may not work and if we implement the industrial (production) process we will have to be partially covered by international financing.” .
– Security issues –
“To authorize any COVID-19 vaccine, EMA will need to have strong evidence from clinical trials on the safety, efficacy and quality of this vaccine,” says the European Medicines Agency, an EU body.
Pushing the pace in clinical trials “can cause problems” with regard to safety, says Floret, who says that “it is key to have evidence that the vaccine cannot exacerbate the disease.”
That, he recalls, happened in some tests on monkeys “during vaccine development tests for MERS-CoV and SARS,” other strains of coronavirus.
A similar problem arose in terms of some measles tests in humans in the 1960s that were withdrawn, as well as some bronchiolitis tests that were also abandoned, says Floret.
– How long? –
EMA warns that “vaccine development timelines are difficult to predict.”
Based on past development timelines, he said it may take up to next year before a COVID-19 vaccine is ready for widespread use.
Still, some companies are optimistic that wins may appear before the end of the year.
In Floret’s opinion, “I am not sure it is very realistic (to say) that there will be a vaccine for the fall, we have to moderate such enthusiasm.”
He believes that the first quarter of next year is more likely and “if we get there by then we will have done extremely well”, given that the usual development period is several years.
– How about never? –
The world is now waiting for a vaccine, as it was a kind of messiah as the only foolproof means of defeating the pandemic.
But what if one never comes?
Delfraissy said: “We have never perfected a coronavirus vaccine, even if we have never fully given ourselves the means to do so.
“There is a degree of uncertainty about our ability to perfect a coronavirus vaccine, but all the elements to get there are in place,” he emphasized.
“Everything is possible, the maximum means and the different techniques planned are available and it would be surprising if we did not get there,” said Floret.
However, even if researchers reach the finish line, one big question remains: will people accept being vaccinated in a world where there is growing distrust of vaccination?
Maybe not.
“As repeated measles outbreaks demonstrate, we haven’t done a great job of addressing people’s concerns about vaccines. And if we don’t learn from our failed response to them, a coronavirus vaccine program will be doomed,” Phoebe Danziger, a pediatrician at the University of Michigan, told the New York Times.
