People on six continents are already being hit in the arm as the race for the COVID-19 vaccine enters a watershed summer, with even larger studies set to prove whether a vaccine really works – and perhaps offer a reality .
British and Chinese researchers are already chasing the coronavirus beyond their borders, testing potential vaccines in Brazil and the United Arab Emirates because there are too few new infections at home to get clear answers.
The United States is expected to open the largest trials – 30,000 people to test a government-created plan from July, followed about a month later, another 30,000 to test a British one.
These will likely be split between Americans and volunteers in other countries such as Brazil or South Africa, said Dr. Anthony Fauci of the National Institutes of Health to the Associated Press.
While optimistic, “we have already been burned,” warned Fauci.
Multiple successes in several parts of the world are essential.
“It’s not a race to come first. It’s, get as many approved, safe and effective vaccines as possible,” said Fauci.
Vaccine experts say it’s time to define public expectations. Many scientists do not expect a coronavirus vaccine to be almost as protective as the measles vaccine.
While the best COVID-19 vaccine is only 50% effective, “it’s still a great vaccine for me,” said Dr. Drew Weissman of the University of Pennsylvania.
“We have to start this conversation now,” so people are not surprised, he added.
And for all the government’s promises to stockpile doses hoping to start vaccinations by the end of the year, here’s the catch: even if a shot comes out – and this is the one your country has stored – only certain high-risk people, such as essential workers, go to the front of a very long line.
“Will you and I be vaccinated this year? No way,” said David Ridley, health economist at Duke University.
Vaccines train the body to quickly recognize and repel an invading germ. Fifteen COVID-19 experimental vaccines are in various stages of human studies worldwide.
And while there is no guarantee that this will happen, moving three different types into the final tests offers better chances – especially since scientists don’t yet know how strong a immune response is. shots must fire to protect.
Measuring that with the first proven vaccine “will really help us understand for all the other vaccines in development, do they also have a chance?” said Oxford University principal investigator Sarah Gilbert.
Only China releases “inactivated” vaccines, made by growing and killing the new coronavirus. Sinovac Biotech and SinoPharm vaccines use this old-fashioned technology, which requires high-security laboratories to produce but is reliable, the way polio and some flu vaccines are made.
Most of the other vaccines in the pipeline do not target the whole germ but a key element – the “spike” protein that nails the surface of the coronavirus and helps it invade human cells. The best candidates use new technologies that make shots faster to produce, but have not yet proven themselves in humans.
Oxford Method: Genetically generate a chimpanzee cold virus so that it does not spread, but can carry the gene for this advanced protein in just enough cells to trap the immune system than an infection infestation.
Another vaccine made by NIH and Moderna Inc. simply injects a piece of the coronavirus genetic code that instructs the body to produce copies of harmless spikes that the immune system learns to recognize.
CHASING THE VIRUS
Researchers must test thousands of people not where COVID-19 rises – because it’s too late – but where it incubates, said Fauci.
It is only if the virus begins to spread in a community several weeks after volunteers have received either a vaccine or a mock injection – enough time for the immune system to strengthen – that scientists have the best chance to compare the group that has the most disease.
In the absence of a crystal ball, the NIH has vaccine testing networks in the United States, South America and South Africa on hold while finalizing decisions on summer testing.
“We will do this on multiple sites with a certain degree of flexibility” so that researchers can evolve quickly as the virus moves, said Fauci. “Nothing is going to be easy.”
The Oxford photo, with a study of 10,000 people underway in England, has already encountered this obstacle. Gilbert told a committee of Parliament last week that there was “little chance, frankly” of proving the effectiveness of the vaccine in Britain after infections fell with the lock.
His team therefore looked abroad. In addition to the study planned by the United States, Brazil started last week a last stage test of the Oxford shooting on 5,000 health workers, the first experimental COVID-19 vaccinations in South America. In another first, South Africa opened a smaller Oxford fire safety study.
With few new infections in China, Sinovac will begin final testing of 9,000 Brazilian volunteers next month. And SinoPharm has just signed an agreement with the United Arab Emirates; the size of this study is unclear.
WAIT FOR IMPERFECT PROTECTION
Animal research suggests that COVID-19 vaccines may prevent serious illnesses but do not completely block the infection. A study that leaked the coronavirus into monkeys showed that vaccinated animals avoided pneumonia but had a virus hidden in the nose and throat. It is unclear whether it was enough to spread to unvaccinated people.
It would still be a big win.
“My expectations have always been to get rid of symptomatic disease. From what we’ve seen from vaccines so far, that’s what they do,” said Penn’s Weissman.
The initial vaccines could be replaced by later and better arrivals, as has historically happened in medicine, noted Duke’s Ridley.
And while the shots in the arm are the quickest to take, those for respiratory illnesses require anti-virus antibodies to enter the lungs. Gilbert said that Oxford would eventually explore nasal birth.
WARNING AGAINST SHORTCUTS
Some U.S. lawmakers are concerned about pressure from the Trump administration to postpone an unproven coup during the fall election season.
“We want a vaccine, not a title,” said Rhode Island Democrat Senator Jack Reed during a recent Senate committee hearing.
Food and Drug Administration Commissioner Dr. Stephen Hahn promised a committee of the House last week that any decision would be based on science.
Different countries have different rules about when to release a vaccine. For the United States, Fauci insisted that there will be no security shortcuts, one of the main reasons why the NIH is investing in such gigantic studies.
No matter how and when a vaccine arrives, each country will also prioritize who is first online as doses become available. Presumably, they will start with the health workers and those most vulnerable to serious illness – as long as there is evidence that each injection works in risk groups such as the elderly.
Because each vaccine works differently, “which population group it will protect, we don’t know yet,” said Dr Mariangela Simao of the World Health Organization, which advises countries on how to choose.
The Associated Press Department of Health and Science is supported by the Scientific Education Department of the Howard Hughes Medical Institute. The AP is solely responsible for all content.