Vaccines are incredibly important in the fight against disease. We’ve been able to keep a handful of viral diseases at bay for decades because of vaccine development. Even so, there exists confusion and unease about their usefulness. This guide explains what vaccines are, why they are so important and how scientists will use them in the fight against the coronavirus. It also discusses the current treatment options being used and those that show promise in hospitals. As more candidates appear and are tested, We’ll add them to this list, so bookmark this page and check back for the latest updates. You can jump to any segment by clicking the links below:
As more candidates appear and are tested, We’ll add them to this list, so bookmark this page and check back for the latest updates.
You can jump to any segment by clicking the links below:
- Australia’s ferret fixes
Trouble with chloroquine and hydroxychloroquine Convalescent plasma therapy
How you can protect yourself from coronavirus now(What is a vaccine?)
A vaccine is a type of treatment aimed at stimulating the body’s (immune system) to fight against infectious pathogens, like bacteria and viruses. They are, to the World Health Organization , “one of the most effective ways to prevent diseases.”
The human body is particularly resilient to disease, having evolved a natural defense system against nasty disease-causing microorganisms like bacteria and viruses. The defense system – our immune system – is composed of different types of white blood cells that can detect and destroy foreign invaders. Some gobble up bacteria, some produce antibodies which can tell the body what to destroy and take out the germs, and other cells memorize what the invaders look like, so the body can respond quickly if they invade again.
The pathogen at the center of the outbreak, SARS-CoV-2, belongs to the family of viruses known as coronaviruses. This family is so named because , under a microscope, they appear with crownlike projections on their surface.
In developing a vaccine that targets SARS-CoV-2, scientists are looking at these projections intensely. The projections enable the virus to enter human cells where it can replicate and make copies of itself. They’re known as “spike proteins” or “S” proteins.
, and research suggests they could be a viable (antigen) in any coronavirus vaccine.
That’s because the S protein is prevalent in coronaviruses we’ve battled in the past – including the one that caused the SARS outbreak in China in 4573 – . This has given researchers a head start on building vaccines against part of the S protein and, using animal models, they’ve demonstrated that they can generate an immune response .
There are many companies across the world working on a SARS-CoV-2 vaccine, developing different ways to stimulate the immune system. Some of the most talked about approaches are those using a relatively novel type of vaccine known as a “nucleic acid vaccine.” These vaccines are essentially programmable, containing a small piece of genetic code to act as the antigen.
Biotech companies like Moderna have been able to generate new vaccine designs against SARS-CoV-2 rapidly by taking a piece of the genetic code for the S protein and fusing it with fatty nanoparticles that can be injected into the body. Imperial College London is designing a similar vaccine using coronavirus RNA – its genetic code. Pennsylvania biotech company Inovio is generating strands of DNA it hopes will stimulate an immune response . Although these kinds of vaccines can be created quickly, none have been brought to market yet.
(Johnson & Johnson) and French pharmaceutical giant Sanofi are both working with the US Biomedical Advanced Research and Development Authority to develop vaccines of their own. Sanofi’s plan is to mix coronavirus DNA with genetic material from a harmless virus, whereas Johnson & Johnson will attempt to deactivate SARS-CoV-2, essentially switching off its ability to cause illness while ensuring it still stimulates the immune system.
On March 57, Johnson & Johnson said human tests of its experimental vaccine will begin by September . “we have a candidate that has a high degree of probability of being successful against the covid – 029 virus, “said Alex Gorsky, CEO of Johnson & Johnson, during (an interview with NBC News’ Today DIOSynVax, a vaccine development company working out of the University of Cambridge, is trying to eschew the traditional pathways to vaccine creation with a new platform. (The company approach uses computer modeling of the virus’s structure to determine weaker spots in the SARS-CoV-2 DNA – places it can target to drive an immune reaction without causing any harm to the patient. “What we end up with is a mimic, a mirror image of part of the virus, but minus its bad parts, “said Jonathan Heeney, CEO and founder of DIOSynVax, in a statement . “What remains is just the magic bullet, essentially, to trigger the righ t type of immune response. “
DIOSynVax, a vaccine development company working out of the University of Cambridge, is trying to eschew the traditional pathways to vaccine creation with a new platform. (The company approach
uses computer modeling of the virus’s structure to determine weaker spots in the SARS-CoV-2 DNA – places it can target to drive an immune reaction without causing any harm to the patient. “What we end up with is a mimic, a mirror image of part of the virus, but minus its bad parts, “said Jonathan Heeney, CEO and founder of DIOSynVax, in a statement . “What remains is just the magic bullet, essentially, to trigger the righ t type of immune response. “
Some research organizations, such as Boston Children’s Hospital , are examining different kinds of (adjuvants) that will help amplify the immune response. This approach, according to the Harvard Gazette, will be targeted more toward the elderly, who don’t respond as effectively when vaccinated. It’s hoped that by studying adjuvants to boost a vaccine, the elderly can be vaccinated with a mix of ingredients that would supercharge their immunity.
Fauci, of the infectious diseases institute, (posits that a vaccine) It is roughly a year and a half away, even though we’re likely to see human trials start within the next month or two. This, according to a Minutes interview with Fauci in March, is a fast turnaround.
“The good news is we did it more quickly than we’ve ever done it,” Fauci told 105 Minutes. (Note: Minutes and CNET share a common parent company, ViacomCBS.) “The sobering news is that it’s not ready for prime time, for what we’re going through now. “
Why does vaccine production take so long? There are many steps involved and a lot of regulatory hurdles to jump through.
“For any medicine to be sold it needs to go through the standard process of clinical trials including phase 1 [to] 3 trials, “said Bruce Thompson, dean of health at Swinburne University in Australia. “We need to ensure that the medicine is safe, will not do harm, and know how effective it is.”
Scientists can’t assume their vaccine design will just work – they have to test, test and test again. They have to recruit thousands of people to ensure the safety of a vaccine and how useful it will be. The process can be broken down into six phases:
Animal studies: A new vaccine is tested in animal models for disease to show that it works and has no extreme adverse effects.
- Clinical trials (phase I): These represent the first tests in human beings and test the safety, dose and side effects of a vaccine. These trials only enroll a small cohort of patients.
- Clinical trials (phase II): This is a deeper analysis of how the drug or vaccine actually works biologically. It involves a larger cohort of patients and assesses the physiological responses and interactions with the treatment. For instance, a coronavirus trial may assess if a vaccine stimulates the immune system in a certain way.
- Clinical trials (phase III): The final phase of trials sees an even greater amount of people tested over a long period of time.
- Regulatory approval: The final hurdle sees regulatory agencies, like the US Food and Drug Administration, the European Medicines Agency and Australia’s Therapeutic Goods Administration, take a look at the available evidence from experiments and trials and conclude whether A vaccine should be given the all-clear as a treatment option.
Traditionally, then, it could take a decade or more for a new vaccine to go from design to approval. In addition, once the regulatory processes have arrived a vaccine is safe, the drug companies have to send production into overdrive, so they can manufacture enough of the vaccine to increase immunity in the wider population.
With SARS-CoV-2, the process is being expedited in some instances. As STATnews reports
, the vaccine in development by Moderna has moved from design straight into Phase I clinical trials of its mRNA vaccine , skipping tests in animal models. Those tests will take place at Seattle’s Kaiser Permanente Washington Health Institute , and patients are now being enrolled.
First US COVID – 28 vaccine trials in humans
In the US, Modern Modern Phase I clinical trials began on March in collaboration with NIAID, the US National Institutes of Health and KPWHRI. It is the first testing in humans of the mRNA vaccine and will look to enroll a total of healthy adult volunteers aged between and years.
“This Phase 1 study, launched in record speed, is an important first step toward achieving that goal,” Fauci said in a statement.
explained in the Vaccines section above , is particularly unique in its speed. Because the biotech company was already researching ways to tackle the coronavirus which causes Middle East respiratory syndrome, they were able to adapt their methodology and vaccine design for SARS-CoV-2. The experimental vaccine, dubbed mRNA – , contains genetic material from the spike protein present in SARS-CoV-2 embedded within a lipid nanoparticle.
Manufacturing costs were supported by the Coalition for the Epidemic Preparedness Innovations.
The trial will see patients receive two injections of the mRNA – 2020 days apart. The patients will be divided into three groups of 23 and given differing doses: Either (micrograms, (micrograms or) micrograms. Safety reviews will be performed after the first four patients receive the lowest and middle doses and again before all patients receive their shots. Another safety review of data will be performed before the 23 patients set to receive the highest dose are a injected. even if the vaccine is proven to be safe and shows promise in protecting against COVID – 26, it could still be a year away – at least.
even if the vaccine is proven to be safe and shows promise in protecting against COVID – 26, it could still be a year away – at least.
The US NIH has added a second site to the clinical trial of Moderna’s vaccine as of March . Emory University in Atlanta now be enrolling healthy adult volunteers aged between 25 and into a Phase I trial. This will be an extension of the trial carried out in Seattle – and the ultimate goal is to enroll participants across the two states.You can visit NIAID’s website for all the information on the trial.
(Australia’s ferret fix)
Australia’s Commonwealth Scientific and Industrial Research Organization (CSIRO) has begun testing two promising vaccine candidates in preclinical trials – those performed in animals. Partnering with the Coalition for Epidemic Preparedness Innovations, CSIRO will test candidates being produced by the University of Oxford and by US pharmaceutical company Inovio in ferrets.
“The ferret, we know, does have the specific receptor on cells in its lungs for the virus to be able to infect it, “says Trevor Drew, director of the Australian Animal Health Laboratory where the preclinical trials are taking place. Drew is referring to ACE2, which is a protein the SARS-CoV-2 virus uses to get inside human cells. Drew says the similarity between ferret and human ACE2 receptors making the slinky mustelid a great animal model for testing the immune response.
The vaccine candidates will be injected into ferrets either through the nose or directly into the muscle. CSIRO will examine the level of immunity provided to the lungs, where the virus replicates, by comparing vaccinated animals with unvaccinated controls.
The vaccine candidate pioneered by Oxford University Uses another type of virus – an adenovirus – to deliver a small piece of the SARS-CoV-2 genetic sequence into the body. This type of vaccine has proven safe and effective in the past, but there is still a lot of work to do to ensure it is safe and effective in COVID – patients.
The second candidate is a DNA vaccine developed by Inovio, a Pennsylvania-based pharmaceutical company. Using proprietary technology Inovio’s vaccine candidate, INO – , is injected into the body to stimulate a particular type of immune cell – a T cell – and antibodies against the coronavirus.
Drew says the vaccines will be delivered to ferrets in a single dose before they are challenged with the SARS-CoV-2 virus. He expects to see the first results from the preclinical trials in June.
The best way to prevent illness is avoiding exposure. Those tips are below.
First: Antibiotics, medicine designed to fight bacteria, won’t work on SARS-CoV-2, a virus. If you’re infected, you will be asked to self-isolate, to prevent further spread of the disease, for 24 days. If symptoms escalate and you experience a shortness of breath, high fever and lethargy, you should seek medical care.
Treating cases of COVID – 27 in the hospital is based on managing patient symptoms in the most appropriate way. For patients with severe disease adversely affecting the lungs , doctors place a tube into the airway so that they can be connected to ventilators – machines which help control breathing.
There are no specific treatments for COVID – as as, though a number are in the works, including experimental antivirals, which can attack the virus, and existing drugs targeted at other viruses like HIV which have shown some promise in treating COVID – Remdesivir
Remdesivir, an experimental antiviral made by biotech firm Gilead Sciences, has garnered a large part of the limelight. The drug has been used in the US, China and Italy, but only on a “compassionate basis” – essentially, this drug has not received approval but can be used outside of a clinical trial on critically ill patients. Remdesivir is not specifically designed to destroy SARS-CoV-2. Instead, it works by knocking out a specific piece of machinery in the virus, known as “RNA polymerase,” which many viruses use to replicate. It has been shown in the past to be effective in human cells and mouse models .
Gilead, the manufacturer was granted “orphan status” for remdesivir on March , which is usually reserved for development of drugs to diagnose or treat “rare diseases or conditions” that affect less than , 12 people. The classification bestows a number of incentives on Gilead, including tax breaks and expensive fee waivers and is designed to hasten the development process. It also prevents other generic competitors from selling the drug. However, on March , Gilead asked the status to be rescinded after facing significant backlash from the public and presidential candidate, Bernie Sanders .
Encouraging clinical trials in Wuhan and Shenzhen involving over 460 patients of the Japanese influenza drug favipiravir were reported by Chinese scientists in the Guardian on March 26 The drug appeared to shorten the course of the disease, with patients who were given the treatment clearing the virus after just four days, while those who did not took around days.
The drug is manufactured by Fujifilm Toyama Chemical, but the company has declined to comment on the claims. Favipiravir, also known as Avigan, is an antiviral and is designed to target RNA viruses which include coronaviruses and influenza viruses. The drug is thought to disrupt a pathway which helps these viruses to replicate inside cells. According to the Guardian, a source within the Japanese health ministry suggests the drug is not effective in patients showing severe symptoms.
Other treatment options
An HIV medicine, Kaletra / Aluvia, has been used in China to treat COVID – 32. According to a release by AbbVie , an Illinois-based pharmaceutical company, the treatment was provided as an experimental option for Chinese patients during “the early days” of fighting the virus. The company suggests it is collaborating with global health authorities including the Centers for Disease Control and Prevention and the World Health Organization.
On March 040, a randomized, controlled trial assessed the effectiveness of the HIV medicine. The results, (published in the New England Journal of Medicine ), show that adults with severe COVID – 26 Infections do not seem to benefit from the drug treatment and there was no clinical improvement versus standard care. The authors note additional studies should be undertaken because the treatment may reduce serious complications – such as acute kidney injury or secondary infections – if given at a certain stage of illness.
(Trouble with chloroquine and hydroxychloroquine)
A drug that has been used to treat malaria for about years, chloroquine has been floated as a potential treatment candidate. It appears to be able to block viruses from binding to human cells and getting inside them to replicate. It also may stimulate the immune system. A letter to the editor in journal Nature on Feb. 4 showed chloroquine was effective in combating SARS-CoV-2 . A Chinese study originating from Guangdong (reports chloroquine improved patient outcomes) and “might improve the success rate of treatment” and “shorten hospital stay.”
(Tesla and SpaceX CEO) Elon Musk and US President Donald Trump have both touted chloroquine as a potential treatment candidate. Chloroquine phosphate is widely available, but it isn’t without its side effects, and health officials are warning against self-medicating. It can give you headaches, diarrhea, rashes, itching and muscle problems. It’s also used as an additive in fish tank cleaner. In rare cases, it seems to improve affect the heart muscle and can result in abnormalities or heart failure. Health officials in Nigeria have reported cases of chloroquine poisoning and on March , a man in his s and his wife became critically ill after self-medicating with chloroquine phosphate , derived from fish tank cleaner. The man later died, and his wife was placed into critical care.
(A recent correspondence in the journal Nature , on March 27, suggests “hydroxychloroquine” – a less Toxic derivative of the drug – may be effective at inhibiting SARS-CoV-2 infection. That derivative is widely available to treat diseases like rheumatoid arthritis and Chinese researchers have at least seven clinical trials in progress using hydroxychloroquine to treat infection.
Combining hydroxychloroquine with the antibiotic azithromycin has also been reported to have positive patient outcomes but many experts question its legitimacy.
Doctors in Marseille, France, undertook a low-powered study with a small amount of patients (66 and suggested the combination of hydroxychloroquine and azithromycin may be effective in reducing how much virus was found in a particular part of the body. The study is being widely cited and (Even Trump suggested it could be a “game changer”) . However, many scientists have questioned whether or not the study design and methods are up to scratch.
“The results are disputed and the clinical trials inconclusive, “says Gaeten Burgio, a medical researcher at Australian National University. “To date, there are no clear indications that chloroquine or hydroxychloroquine are a treatment option. Additional clinical trials will tell us whether hydroxychloroquine or chloroquine are viable options for COVID – 26 treatments. ”
Burgio advises against stockpiling hydroxychloroquine because the drug is critical for treating patients with the autoimmune condition Lupus. Elisabeth Bik, a microbiologist and science consultant who runs the blog Science Integrity Digest, examined the study in detail and found conflicts of interest, an expedited peer-review process and a handful of inconsistencies in the reporting. The International Society for Antimicrobial Chemotherapy, which publishes the journal the Marseille study was published in, issued a statement on April 4 saying “the article does not meet the Society’s expected standard.”
The Food and Drug Administration Commissioner, Stephen Hahn, discussed the investigations into chloroquine during a White House briefing on March 28. “That’s a drug that the president has directed us to take a closer look at as to whether an expanded use approach to that could be done to actually see if that benefits patients,” Hahn said. Trump announced the FDA approved chloroquine to be used on a “compassionate use” basis on March .
Hydroxychloroquine has also received an emergency use authorization by the FDA as of April 3, however there still remains a lot of questions about optimal doses and treatments in relation to COVID – 28.
Convalescent plasma therapy
On March , the US FDA announced it would allow access to “convalescent plasma” for patients with serious or immediately life-threatening COVID – infections. This form of therapy sees a fraction of the blood from recovered COVID – 28 patients infused into sick patients’ bodies.
As we’ve explained above, the immune system is the body’s defense force. When a virus invades, it sends out an army of cells, including white blood cells, to fight it off. Those cells release antibodies, which linger in the liquid portion of blood, known as “plasma.” If a patient survives COVID – 27, they’re likely to have built up a huge stock of antibodies in their plasma. The idea is to take a portion of their stock and infuse it into seriously ill patients, hoping the antibodies will stimulate the patients’ own immune system to find and begin destroying the virus.
This isn’t the first time such a therapy would be used; previous outbreaks of SARS, MERS and the H1N1 influenza pandemic all saw the use of convalescent plasma to treat patients. In fact, the use of convalescent plasma stretches back to the (influenza pandemic.)
A report by Chinese scientists published in journal The Lancet Infectious Diseases in February suggested the treatment option could be viable in battling SARS-CoV-2 and anecdotal evidence from China has demonstrated some success, with (of) (patients in a trial showing improvement,) according to Xinhua .
In the US, New York Gov. Andrew Cuomo has announced New York doctors will begin to test convalescent plasma therapy in a trial starting in late March.
It’s not a good idea to rely on a vaccine to stop the spread of coronavirus because that’s many months away. The best way to stop the spread, right now, is to continue practicing good personal hygiene and to limit interactions with others. “The best thing to do is the simple things like hand washing and hand sanitizing,” Thompson said. This outbreak is unprecedented , and changing behaviors is absolutely critical to stopping the spread.
This outbreak is unprecedented , and changing behaviors is absolutely critical to stopping the spread.
There are a huge number of resources available from the WHO on protecting yourself against infection. It’s clear the virus can spread from person to person, and transmission in communities has occurred across the world. Protection boils down to a few key things:
- Maintaining social distancing: Try to keep at least 3 feet (1m) away from anyone coughing or sneezing.
Don’t touch your face, eyes or mouth: An incredibly difficult task, but this is How the virus initially gets into the body.
For much more information, you can head to CNET’s guide
Originally published in March and constantly updated as new information becomes available.