Coronavirus vaccines: everything you need to know about finding the formula to immunise populations

The race is on to develop a vaccine that slows the spread of the new coronavirus but scientists have warned it may be 12 to 18 months before one is released. In normal circumstances, a vaccine could take years to receive approval before progressing to the human trials stage, but biotech companies are fast-tracking development with two already conducting human trials.

As confirmed cases soared to more than 472,000 worldwide early on March 26, with more than 21,300 killed by the highly infectious disease, it’s clear that vaccines will need to be made widely available. Even when a vaccine is ready, manufacturing enough to immunise billions of people will be an enormous job requiring time and resources.

In the interim, governments are stepping up social isolation measures, imposing widespread quarantines and reinforcing social distancing guidelines by limiting public transport, closing restaurants and restricting group gatherings. With no immunisation against the disease, it’s unclear how long these dramatic changes to daily life will remain in place.

What progress has made?

At present, there are no approved vaccines to prevent infection with Sars-CoV-2, the virus that causes Covid-19. However, there are more than 20 experimental vaccines in development, several of which have reached the animal research stage before human trials later this year.

One, made by Moderna Inc, has skipped this stage and gone straight to testing on humans with the first shots administered on March 16 by pharmacists at the Kaiser Permanente Washington Health Research Institute in Seattle, Washington state.

Messages of gratitude towards 45 healthy volunteers taking part in the trial flooded social media when pictures of Jennifer Haller, the 43-year-old mother who received the first shot, were posted. “We all feel so helpless. This is an amazing opportunity for me to do something,” she said.

Previous studies into outbreaks of related coronavirus strains, including Sars and Mers, have facilitated these rapid steps towards a vaccine for Covid-19, giving researchers a base to build on. Scientists have also benefitted from the unusually fast mapping of the diseases’s genome, which was made available within a month of the first case reported in Wuhan, China.

Anthony Fauci, director at the US National Institute of Allergy and Infectious Disease, which is collaborating with Moderna, described the development of a safe and effective vaccine as “an urgent public health priority” and said the study was “launched in record speed.”

What are different countries doing to develop a vaccine?

Governments around the world have pledged funding to support the development of prospective vaccines with China, Europe and the US vying to be first over the finish line.

Days after the first tests on humans began in the US, clinical testing got underway in China, where 1,000 scientists are working on developing a successful vaccine candidate. The company behind the programme, CanSino Biologics, began trials on March 19 after being given the go-ahead by authorities in Beijing earlier that week.

China “will not be slower than other countries,” Wang Junzhi, a biological products quality control expert with the Chinese Academy of Sciences, insisted at a news conference in Beijing on March 17.

In the UK, researchers at Oxford University are working on a vaccine that’s due to start animal trials next week. At the beginning of February, the UK government pledged $26 million to help fund the development of a vaccine before announcing an additional £46 million (over $53 million) that would also go towards developing a rapid test for the disease.

The US has also ramped up funding with the $8.3 billion emergency coronavirus spending bill recently approved by congress setting aside about $3.1 billion in federal funding to develop drugs and vaccines and bolster manufacturing capacity.

Updates on clinical trials

Moderna, Inc: The biotechnology company based in Massachusetts is collaborating with scientists at the National Institute of Allergy and Infectious Diseases on the mRNA-1273 vaccine.

Moderna uses genetic material to make vaccines, with nine currently in development for different diseases. This approach has the scope to produce fast results, though a vaccine made using this technology has yet to reach the market.

Clinical trials began on March 16, with 45 healthy adults aged 18 to 55 participating over a six-week period. Different doses are being administered to evaluate the safety and effectiveness of the experimental vaccine.

The participants will then be monitored for a year, but safety data will be available within a few weeks, according to Stéphane Bancel, the chief executive of Moderna. Mr Bancel told The New York Times that if initial results are positive, the company will request permission to move to the next phase of testing before the first is finished, despite the risks involved.

The company is currently boosting its capacity to manufacture millions of doses if the vaccine proves to be effective.

CanSino Biologics: On March 19, the Tianjin-based company began human trials of the vaccine it is co-developing with China's Academy of Military Medical Sciences. The clinical trials are being conducted in Wuhan, with 108 healthy adults aged 18 to 60 participating.

All are now spending 14 days in quarantine under close observation after receiving varying doses of the vaccine.

The vaccine proved safe in testing on animals and capable of triggering immunity against the virus, CanSino said in a statement. Tests will continue to the end of the year.

CureVac: The German biopharmaceutical company, which also specialises in using messenger RNA (mRNA) technology, has attracted attention in recent weeks after denying reports that the Trump administration tried to acquire the rights to its coronavirus vaccine programme. CureVac uses mRNA as a data carrier to instruct the human body to produce its own proteins capable of fighting diseases.

GlaxoSmithKline: The company, which is one of the world's largest vaccine manufacturers, is providing support to Chinese biotech firm Clover Biopharmaceuticals and the University of Queensland in Australia to develop protein vaccines. Clover's approach aims to initiate an immune response by injecting proteins, helping the body to stave off infection.

Johnson & Johnson: The company's multipronged response involves an investigational coronavirus vaccine program as well as working closely with global partners to screen its library of antiviral molecules to accelerate the discovery of potential Covid-19 treatments, The company is deploying the same technologies used in the development and manufacturing of its investigational Ebola vaccine, and its Zika, RSV and HIV vaccine candidates. Human trials could begin in November.

Sanofi: The company that developed successful vaccines for yellow fever and diphtheria is working with the US government's Biomedical Advanced Research and Development Authority to develop a vaccine candidate for coronavirus. David Loew, Sanofi's global head of vaccines said the company's previous work in developing a vaccine for SARS would help to fast-track its efforts. A prototype is expected to be ready for lab testing within six months, and human testing within a year to 18 months.

The search for a cure

Science: There is no specific medication to treat the new coronavirus but various avenues are being explored in laboratories and hospitals around the world. One possibility is antiviral medication.

Initial hope that the HIV drugs lopinavir and ritonavir would prove effective has waned following disappointing results from trial data, but remdesivir, which was developed to treat Ebola, is capable of killing a wide range of viruses and may yet prove effective.

Another potential remedy is an old antimalarial medicine, chloroquine, which President Trump claimed had been approved for use in treating the coronavirus during a press briefing on March 22.

“It’s been around for a long time, so we know that if things don’t go as planned it’s not going to kill anybody,” Mr Trump said.

However, the US Food and Drug Administration, which licenses medicines in America, states that “there are no FDA-approved therapeutics or drugs to treat, cure or prevent Covid-19”.

Laboratory tests have shown that chloroquine and hydroxychloroquine can kill the virus, but it’s unclear at this stage how they behave in patients with the disease. Trials are under way in the US but experts have cautioned against using these drugs in the meantime.

Controversy surrounding the US President's endorsement of chloroquine mounted on March 23 when a man in Arizona died after trying to self-medicate with a version of the chemical used to clean fish tanks. Nigeria also reported two cases of chloroquine poisoning following Mr Trump's comments.

Several countries have begun exploring the drug's effectiveness for treating the disease, including Jordan, where uncontrolled trials on using the antimalarial drug hydroxychloroquine to treat patients with Covid-19 began on Sunday 22.

On Tuesday, a top health official in Bahrain said that hydroxychloroquine had proved effective in treating existing cases of the coronavirus in the kingdom, and India, which is one of the largest manufacturers of the anti-malarial medication, has banned exports to protect its supplies as hospitals in the US stockpile the drug.

Technology: Supercomputer power is also being leveraged to help speed up research and build a better understanding of the disease. The Covid-19 High Performance Computing Consortium is a new partnership between US tech company IBM and the White House to harness the world's fastest computer, IMB's Summit, to run experiments that could otherwise take weeks or months.

In just a few days, simulations run through Summit produced 77 recommendations of possible drug compounds that could work against the virus. The new tech consortium is reviewing research proposals from the most promising projects around the world looking to access Summit's supercomputing power and technology support.

In Israel, a start-up is working with hospitals and academic institutions to gather voice samples from coronavirus patients to help detect symptoms of the disease. “These voice samples will be analysed using an AI-based algorithm in order to identify the unique vocal fingerprint,” the Israeli Defence Ministry said in a statement.

Signs of distress can be heard in the breathing patterns of people with the disease and could be used to carry out remote testing and monitoring.

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