The world is living in a nationwide lockdown from the past 4.5 months while the spread of Coronavirus SARS-CoV-2 was first detected in China late in 2019. The beginning of spread was slow in some places but as of 21 July 2020, 14.7 million people had been infected while 611k died due to COVID-19.
Currently, researchers around the world are in the race to find an effective Coronavirus vaccine and control the unprecedented situation with experiences from past several diseases and outbreaks. The world is developing more than 165 vaccines against the Coronavirus, and out of which 27 are in human trials. Vaccines usually take years of research and testing before landing at the clinic, but scientists are racing at a quick pace to produce effective vaccines by 2021.
The work on Coronavirus medicine development began in January 2020 after the World Health Organization activated R&D Blueprint to advance diagnostics, vaccines, and therapeutics. On 30th January 2020, the Emergency Committee recommended to the Director-General of WHO that the outbreak constitutes a Public Health Emergency of International Concern (PHEIC).
Meanwhile, world scientists on COVID-19 communicated with WHO’s Geneva headquarters on 11-12 February 2020 to assess the situation and conclude with an agreement that accelerated to first curb the virus and then support for those infected. This included the use of repurposing existing drugs and non-drug therapies suppressing the demand for hospitals and intensive care.
Increasingly, the world is now prepared with new drugs, new diagnostics, antibody tests, patient and contact tracing technologies, disease surveillance, early warning tools that help to prepare for anticipated ‘second wave’ of a global pandemic.
There are many stages required in the development and production of a vaccine, including from academic research to distribution to various locations, hospitals, and doctors. The vaccine production process timeline is 8-15 years, whereas the target for the Coronavirus vaccine is 12-18 months.
Research – Normally requires 3 to 4 years, but in case of the current outbreak, it is 6 months.
Pre Clinical Preparation – 2 years is necessary, but it’s six months for COVID-19.
Clinical trials – At least 5 years is necessary, but it can be accelerated to 1.5 years.
Approval – With no urgency, it takes 1 year but currently is shifted to six months.
Manufacturing – After all those experiments, the manufacturing of units needs 2 years, but at present, it is 3-6 months.
Distribution – The period of 3-6 months but now it is accelerated to 1 month only around the globe.
COVAX Advance Market Commitment is a global solution to the COVID-19 pandemic formed in collaboration with Gavi, the Coalition for Epidemic Preparedness Innovations, and WHO. The partnership ensures vaccine and Tools (ACT) Accelerator to middle and low-income countries from developed and developing country vaccine manufacturers. Moreover, CEPI supports seven of nine candidate vaccines that are already in clinical trials.
As announced on 5 July 2020, seventy-five countries expressed their interests to COVAX facility and joined 90 lower-income countries through COVAX AMC. All those 75 countries will support with finance for COVID-19 vaccine progress from their finance budgets. The COVAX aims to deliver 2 billion doses of vaccine by the end of 2021 with passed regulatory approval and/or WHO qualifications.
This vaccine was started in Germany in late April and based on messenger RNA encoding viral proteins, which hold experimental status at present. The medicine is on run with BioNTech and Pfizer collaboration and hopes to receive approval from the US Food and Drug Administration for a new vaccine as early as October 2020 with 20 million doses by end of 2020.
The Wuhan, China-based vaccine with the scientific name of AD5-nCov has completed phase 1 trial with 108 subjects aged between 18 to 60. The testing was started in March 2020 that verifies the safety and immune response generated as it’s developed from respiratory virus, adenovirus. On 12 April 2020, the center completed phase 2 trial with 500 participants, which is expected with results in January 2021, while the phase 1 trial examination is expected in late December 2020.
The experimental status vaccine was formerly known as ChAdOx 1 and developed by Oxford University from non-replicating chimpanzee adenovirus vectors. The testing of human trials began in April 2020 while the data of May 2020 showed the positive outcome of single doses on chimpanzees fighting SARS-Cov-2 within 28 days, preventing lungs but continued to replicate itself.
Another vaccine mRNA 1271 made of messenger-RNA encoding tested on eight participants in phase 1 trial at three locations in the United States. The vaccine developed immune responses with no adverse effects and now expected to start large trials in late July, which will get FDA “fast-track” review.
Non-profit IAVI uses a recombinant version of the weakened virus, vesicular stomatitis virus to develop antigen proteins against SARS-CoV2. This same technology was used in Merck’s Ebola vaccine ERVEBO, is now approved by European Commission and US Drug and Administration while human testing is expected to begin in summer 2020.
Lentiviral Minigene vaccine is also known as LV-SMENP is a minigene encoded viral antigen designed to infect dendritic and T cells – key components of the immune system. On 31 July 2020, trials on 100 adults will be completed in Shenzhen, China.
INO-4800 is a DNA-plasma based vaccine injected into the skin via a patch-style device that uses a low-voltage pulse to induce cell membranes. Clinical trials launched on April 3 planned to launch preliminary data by late summer. Companies can develop 1 million vaccines by the end of the year for trials and emergencies.
Ad26 SARS-CoV-2 developed with Beth Israel and Deaconess Medical Center in Boston, which uses the same platform as used in Ebola, HIV, and respiratory syncytial virus and Zika. The US administration pledged to develop half a billion doses to support the development and set to begin clinical trials in July whereas phase 3 trials are expected to initiate in September 2020.
Above mentioned are some major vaccines ongoing in the market with continuous experimentation whereas some other vaccines, including Themis Bioscience/ Merck (Measles Vector candidate), Curevac AG (mRNA mobile unit), NOVAVAX (NVX-CoV2373), Murdoch Childrens Research Institute/UMC Utrecht (BCG Tuberculosis vaccine) and SANOFI, GSK (Adjuvanted vaccine candidate) are on expanding the reach to develop COVID-19 vaccine.
Coronavirus is, however, not undefeatable, and there are ways where people can work together to achieve full eradication, such as preventive measures or herd immunity. Different methods require varying approaches, but such immunity is a term not exactly very clear to many in the masses. To know more about herd immunity click here.
WHO is working with public and private organisations around the world to develop a vaccine that can end the stress created in different sectors due to Coronavirus. However, it’s a tremendous challenge to produce enough of it for the world population. Well, estimates disclosed billions of doses would need to be manufactured just to vaccinate workers in healthcare and other essentials. Extraordinary efforts to secure a vaccine, scientists are still investigating to answer questions, which will also help in the development of vaccines.