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How Close are We to a COVID-19 Vaccine?

With COVID-19 continuing to spread drastically across the world, developing a vaccine (sooner rather than later) is necessary. However, the process for developing vaccines and making them available to the public takes time, as clinical trials need to be done to measure safety and effectiveness[1].

First, research is needed to determine what could actually be viable as a vaccine, and then testing needs to be conducted on animals to see whether the proposed vaccine triggers an immune response that is strong enough without any harmful side effects[1]. These initial steps alone can take 5 to 6 years! If the vaccine even makes it to the process of being tested on humans, it must first be done on a small group of individuals, and then slowly opened up to more participants, eventually being tested on hundreds or thousands of people to determine if there are any long-term side effects, or even side-effects that spring up in large groups. All this can take up to an additional 10 years before a vaccine is even approved, manufactured, marketed, and eventually distributed to the public[1].

Does this mean we will have to wait 10 to 15 years for a COVID-19 vaccine? The answer is, hopefully, no, thanks to advancing technologies and previous research[2, 1]. According to Gavi, the Vaccine Alliance, there are already 35 COVID-19 vaccines being developed[3].

One of the most promising is being spearheaded by U.S. company Moderna and the U.S. National Institutes of Health (NIH). Prior to the COVID-19 outbreak, Moderna researchers had already been working on a vaccine for related virus MERS-Cov, which was responsible for the Middle East respiratory System (MERS) outbreak in 2012[1, 4]. As a result, Moderna has been able to skip the animal testing phase of the trial, and as of 16 March 2020 has already started testing on 45 human volunteers[1, 4]. Testing is being conducted on healthy individuals who have not yet experienced COVID-19 to see if the shots are safe and to determine which dosage (out of 3) provides the strongest immune response[4].

Many other vaccines are also in the works: Imperial College London developed a vaccine 14 days after receiving the genetic sequencing of COVID-19 from China and is currently testing on animals; researchers at Oxford University are planning to test out a COVID-19 vaccine on humans in April; and Johnson & Johnson in the U.S. is using previous research completed on Ebola, Zika, and HIV vaccines to come up with a COVID-19 vaccine[2, 5]. CureVac, a German company backed by the Bill and Melinda Gates Foundation and the European Investment Bank, is also developing a vaccine and is planning to start testing on humans in June[6]. In Asia, China has started testing different dosages of a vaccine on 108 participants from Wuhan, and Malaysia is also planning to test existing local vaccines they have on the Infectious Bronchitis virus (IBV), a type of avian coronavirus[7].

While all of this is great news, it is still unlikely that a vaccine will be available to the public for at least another 12 to 18 months, as after testing, even large-scale manufacturing and distribution will take time[2, 8]. Nevertheless, certain key populations could get access earlier, such as health workers and other higher risk groups. There are also now currently two known strains of COVID-19, one of which causes much stronger symptoms than the other. One concern is whether an approved vaccine will be effective against mutated strains[2].

In the meantime, research is also being conducted to see if current antibiotics already on the market can be used to treat patients with COVID-19. One called remdesivir, which had been developed to treat Ebola, is being tested after a U.S. patient who was not responding to any treatment took it and recovered. Certain HIV antiretroviral medications have also worked in some cases, such as in Thailand, where a COVID-19 patient took a mixture of HIV drugs and subsequently tested negative 48 hours later[2].

 

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References

[1] Joi P. HOW CLINICAL VACCINE TRIALS ARE SPEEDING UP IN A PANDEMIC. Gavi, The Vaccine Alliance [Internet]. 2020 [cited 26 March 2020];.
Available from: https://www.gavi.org/vaccineswork/how-clinical-vaccine-trials-are-speeding-pandemic

[2] Gulland A, Knapton S. How long will we have to wait for a coronavirus vaccine?. The Telegraph [Internet]. 2020 [cited 26 March 2020];.
Available from: https://www.telegraph.co.uk/global-health/science-and-disease/coronavirus-vaccine-latest-covid-19-cure-uk-trials/

[3] McCarthy C. WILL CORONAVIRUS HERALD A NEW ERA IN VACCINE INNOVATION?. Gavi, The Vaccine Alliance [Internet]. 2020 [cited 26 March 2020];.
Available from: https://www.gavi.org/vaccineswork/will-coronavirus-herald-new-era-vaccine-innovation

[4] Park A. As the First Coronavirus Vaccine Human Trials Begin, Manufacturer Is Already Preparing to Scale Production to Millions. TIME [Internet]. 2020 [cited 26 March 2020];.
Available from: https://time.com/5807669/coronavirus-vaccine-moderna/

[5] Sample I. Trials to begin on COVID-19 vaccine in UK next month. The Guardian[Internet]. 2020 [cited 26 March 2020];.
Available from: https://www.theguardian.com/society/2020/mar/19/uk-drive-develop-coronavirus-vaccine-science

[6] Kelly E. The race for a COVID-19 vaccine. Science|Business [Internet]. 2020 [cited 26 March 2020];.
Available from: https://sciencebusiness.net/news/race-covid-19-vaccine

[7] New Straits Times. IMR begins testing to develop vaccines for COVID-19.[Internet]. 2020 [cited 26 March 2020];.
Available from: https://www.nst.com.my/news/nation/2020/03/578079/imr-begins-testing-develop-vaccines-covid-19

[8] Gallagher J. Coronavirus: How close are we to a vaccine or drug? BBC News [Internet]. 2020 [cited 26 March 2020];.
Available from: https://www.bbc.com/news/health-51665497. 

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