The doomsters are in full cry again. A rolling maul of lockdowns looms, businesses will be closing down, jobless numbers will rise exponentially. We’re becoming tetchy under the stresses of the Covid-19 pandemic, and those who have been working round the clock on testing are becoming exhausted. It feels as if 2020 has been going on too long already.
Health Minister Chris Hipkins in a classic bit of understatement says:
“People have found it very difficult these past few weeks”.
News from Hong Kong of the first reinfection deepens anxiety. Nations are queuing up for a vaccine against the virus but authorities like WHO warn it could be two years before a fully tested vaccine becomes available globally.
In the prevailing atmosphere where the doomsters dominate the headlines, Point of Order has been searching for something positive.
Possibly the best new is that in the few months since the pandemic began, several strong vaccine candidates have made it to final stage clinical trials. Thousands of dedicated scientists and medics are working to produce a vaccine faster than any other in history.
If they succeed, each candidate will then require regulatory approval.
In the UK the most advanced work has been done on a vaccine candidate, known as ChAdOx1, by Oxford University scientists in partnership with AstraZeneca.
The ChAdOx1 vaccine is being tested in phase 3 clinical trials with more than 10,000 people from across the UK, including children and the elderly. The vaccine is also being tested in Brazil and South Africa.
With support from the Coalition for Epidemic Preparedness Innovations (CEPI), AstraZeneca will manufacture 300m doses of this coronavirus vaccine candidate in anticipation of the vaccine proving to be both safe and effective. If it is, the first doses are expected to be available in late 2020.
The Australian government is reported to have placed orders for this vaccine candidate
Nine candidate vaccines are being supported by CEPI, seven of which are in clinical trials. Governments, vaccine manufacturers (in addition to their own R&D), organisations and individuals have committed $US1.4bn towards vaccine R&D so far.
In the US, the Cambridge (Massachusetts) company Moderna has developed a vaccine candidate which has been tested in phase 1 trials on volunteers in Seattle. Moderna has run phase 2 trials on participants of a wide range of ages and started phase 3 trials in July.
The company was able to develop the vaccine at lightning speed in part because, unlike most existing vaccines, they aren’t using a weakened or killed version of the virus – they are using messenger RNA (or mRNA) based on the genetic code for the virus that Chinese researchers sequenced and made freely available.
The theory is that the artificial mRNA will act as an instruction book, telling human cells to build a protein found on the surface of SARS-CoV-2 (the virus that causes COVID-19), which should trigger an immune response to the virus.
Another reason this vaccine had been made so rapidly is that Moderna researchers were already were working on a vaccine for a previous coronavirus MERS-CoV, which targets the spike that coronaviruses have on their surface.
The German company BioNTech, working together with Pfizer, started testing its BNT162 vaccine in humans in global trials initially in Germany and recently started trials in the USA. BiotNTech has also entered into a €100 million debt financing agreement with the European Investment Bank to scale-up the production of the vaccine in Europe.
On 27 July, it announced the launch of a phase 2/3 trial with 30,000 volunteers in the United States and other countries including Argentina, Brazil, and Germany.
Another German company, Curevac’s vaccine candidate is based on an RNA platform. It has received € 300 million backing from the German government, €80 million from the European Commission and €8.3 million from the CEPI. The two-dose vaccine will be tested in 168 healthy individuals between the ages of 18 and 60.
Earlier this year, the Bill & Melinda Gates Foundation also made a commitment to invest $US52m in CureVac to support its platform technology and the construction of a Good Manufacturing Practice (GMP) production facility
Researchers at the University of Queensland, in Brisbane, are using a patented vaccine-development technique called a ‘molecular clamp’. They first create a synthetic version of the characteristic ‘spike’ protein that covers the virus, as this can trigger an immune response in the human body. They then attach a ‘clamp’ onto this synthetic protein to ensure it remains stable enough to trigger antibodies (the protein would normally denature in the human body).
The big Australian company CSL is working with the Queensland University on the project.
In the US Novavax is using a nanoparticle technology platform to generate antigens from the protein found on the spikey outer shell of the coronavirus. The company has started testing on people and was due to get preliminary data in July. The vaccine also received the highest funding from CEPI with a total of $US388m.
Johnson and Johnson has developed vaccines for Ebola and other diseases with Recombinant Adenovirus Serotype 26 (Ad26) and has now made one for the coronavirus. It launched phase 1/2 trials in July, with hopes of making up to a billion doses in 2021.
US-based Inovio put its INO-4800 DNA vaccine into human trials early in April. So far, it’s the only company with a phase 2 vaccine against the related MERS-CoV coronavirus. The company plans to start human clinical trials in the USA, and shortly after in China and South Korea.
Other countries working on Covid-19 vaccines include China, Japan and India. And, of course, Russia already claims to have one for immediate injection. Good luck with that.
Point of Order leaves the last word with a British scientist: “I will be extremely surprised if we never develop an effective vaccine”.
Point of Order 