As the world grapples to contain and combat the coronavirus pandemic, there have been reports of the health industry trying several treatments – from HIV medication to antimalarial drugs. But the question on everyone’s minds is – when are we going to have a vaccine? When are we going to have that solution which will prevent people from getting the disease altogether?
Scientists worldwide are racing to study and understand the novel coronavirus so as to fast-track a vaccine against the disease. However, the World Health Organisation has said that a vaccine for SARS-CoV-2 will only be available in 12 to 18 months, achievable through funding and public interest in the same even if the threat level of the COVID-19 reduces. Incidentally, this did not happen with the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) which happened previously. These two are also caused by coronaviruses. The work on SARS and MERS vaccines was shelved once the diseases were contained.
These are some of the significant developments towards treatments and vaccine for COVID-19.
>> The World Health Organisation (WHO) on March 27 announced a Solidarity Trial to test and compare the effectiveness of four different drugs or drug combinations against COVID-19. “This is a historic trial which will dramatically cut the time needed to generate robust evidence about what drugs work,” WHO Director-General Tedros Adhanom Ghebreyesus said.
The trial is underway in Norway and will have over 45 countries participating. India’s Indian Council of Medical Research has also volunteered to participate in the same.
In the meantime, several global as well as Indian authorities have warned against self-medication of unprescribed drugs.
>> The first human trials for a vaccine are underway in the United States, with a vaccine developed by Moderna Therapeutics (a biotechnology company) and funded by the National Institutes of Health. Four people were the first to be administered the vaccine on March 16. The vaccine is being called mRNA-1273, and has used lab-made generic material – messenger RNA – copied from the culprit virus. The trial has 45 participants.
Among the other companies using a similar genetic technology to develop a vaccine are Novavax and CureVac. Novavax had worked on the SARS and MERS vaccines, and is now repurposing and tweaking those for the SARS-CoV-2 vaccine.
>> At least 43 companies are already working on vaccines, using different approaches ranging from using antibodies, to using antivirals, to using Ribonucleic Acid (RNA)-based treatments.
According to this list compiled by the Milken Institute, 24 of them are in the clinical trial phase. A majority of the vaccines in development are using DNA or RNA technology.
>> The Coalition for Epidemic Preparedness Innovations (CEPI), a global alliance funding and coordinating development of vaccines against emerging infectious illnesses is doing the same for COVID-19.
CEPI has collaborated with British pharmaceutical company GlaxoSmithKline (GSK) to help the efforts worldwide to develop a vaccine, and is also funding and tying up with several other institutes like the French Institut Pasteur and the University of Hong Kong. CEPI is also funding Novavax, and the University of Oxford project, explained below.
Incidentally, a CEPI-funded vaccine for the Nipah virus, whose outbreak left many people dead in Kerala in 2018, is set to reach phase 1 of clinical trials.
>> Researchers at the University of Oxford who have been working on developing a vaccine, have now started screening volunteers between the ages of 18 and 55 who are healthy for trials in the Thames Valley Region. Called ChAdOx1 nCoV-19 vaccine, it has been approved by the British regulators.
The vaccine uses adenovirus vaccine vector i.e. a weakened form of the virus to produce the vaccine. Adenoviruses are commonly used vectors, employed in cancer gene therapy, and are also being tested as subunit vaccine systems for malaria, HIV and other illnesses.
>> Scientists at Israel’s Institute for Biological Research have reportedly had a significant breakthrough in decoding the biological mechanisms and qualities of the novel coronavirus. This boosts their diagnostic capability and production of antibodies.
However, there are still a series of tests and experiments required that could take many months, and until then, the vaccine cannot be deemed safe and effective to use.
After this news came out, misleading posts started doing the rounds on social media saying Israel had produced a vaccine for COVID-19. This post was being shared with a photo of a bottle bearing the words “Coronavirus vaccine”, with a syringe in the background. However, this was merely a stock photo.
>> The speed at which scientists are able to produce prototypes is owing to a change in approach. For instance, a company called Inovio Pharmaceuticals based in California was able to produce a prototype vaccine within just three hours of work, for initial testing.
Earlier, vaccines used a weakened form of the pathogen to make the vaccine which would build immunity in the host. These could take decades to make. Now however, vaccines are able to use “short copies of parts of the germ’s genetic code – its DNA or RNA – which can produce fragments of the germ within our bodies,” reports The Guardian.
However, the problem comes later, because testing the vaccines in on humans and mass manufacture are much slower processes. DNA or RNA vaccines have not been licensed for use on human beings so far. So, proving the efficacy of these vaccines outside the laboratory continues to take time.
>> Another reason why vaccines take so long to get approval is because of the clinical trial process. It involves three phases: the first involves a small number of healthy volunteers, as in Moderna’s case where 45 people are participating. The second phase requires several hundred people, traditionally in place where people are affected by the disease to ascertain the vaccine’s effectiveness. And the third involves several thousand people to be vaccinated.
“But there’s a high level of attrition as experimental vaccines pass through these phases,” reports The Guardian. Weeding out what doesn’t work is essential, which is why clinical trials can be long drawn out; and can’t be hurried either. Add to this the fact that no RNA or DNA based vaccine has yet been approved yet – which makes the race for a COVID-19 vaccine a long and difficult one.