The race for a COVID-19 vaccine

All hopes are being pinned on developing a vaccine against a virus that is bringing the world almost to a standstill, with experts warning the race to stop coronavirus, which so far has infected more than 300,000 people around the world, will take 12 – 18 months.

Vaccine developers have worked with unprecedented speed since the first genome sequence of the COVID-19 virus was released in January, and the first human volunteer was dosed with Moderna Inc’s candidate mRNA-127 last week. It took only 63 days from selecting the viral sequence to reach the phase I trial, in which 45 volunteers will be injected with three different doses over six weeks, with the aim of generating initial safety data and showing that the vaccine produces an immune response against the viral DNA.

Other vaccine candidates are close to being tested in humans. With positive data it is hoped that the next phase of testing, which would see promising candidates tested in live situations involving hundreds and later thousands of people, could happen before the end of the year.

There is likely to be a high level of attrition as experimental vaccines pass through these rounds, but any proven safe and effective could hit the market around this time next year, with the help of fast-tracking through the European Medicines Agency’s regulatory process. There are some, like European Commission president Ursula von der Leyen, who argue a vaccine could arrive even sooner.

“Clearly some producers are further along the pipeline than others, but the road to vaccine development is fraught with pitfalls and so there is no guarantee that ‘first’ will necessarily mean ‘best’,” said Robin May, professor of infectious diseases at the University of Birmingham.

In total, the World Health Organisation lists 41 research groups and pharmaceutical companies currently working to develop a vaccine.

Here’s an overview of some of these efforts:

Moderna, US

The first human trial for a vaccine began last week, based on research funded by the US National Institutes of Health at Moderna, a biotech based in Cambridge, Massachusetts. Moderna may be the early frontrunner in getting its test-vaccine to humans, but “we must go with all options, and race ahead,” says Annelise Wilder-Smith, professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine. “There will be problems scaling up anyway, so the more vaccine platforms we use the better.”

DIOSynVax, UK

Jonathan Heeney, head of the laboratory of viral zoonotics at Cambridge University, is CEO of DIOSynVax, a spin-out company set up in 2017. The company has received funding from the Bill & Melinda Gates Foundation and the UK innovation agency Innovate UK, to develop new vaccines for diseases ranging from influenza to Ebola, and has now refocused all of its work on COVID-19. “It’s because what we’re doing for flu is so similar to what is required for coronavirus that we’ve been able to jump on it,” Heeney said. Right now, the vaccine is being tested in mice to establish if it generates an immune response.

Imperial College London, UK

Robin Shattock, head of mucosal infection and immunity within the department of infectious disease at Imperial College London, is leading another effort to create a mRNA vaccine against coronavirus. “We have the technology to develop a vaccine with a speed that’s never been realised before,” Shattock said. Because they are synthetic, rather than containing any live or attenuated virus, mRNA vaccines are expected to be faster and cheaper to manufacture.

Shattock says his team wants to go all the way in its pursuit for a vaccine, but would also “stand down” if a better candidate comes along.

Oxford University, UK

Researchers led by Sarah Gilbert, head of the Jenner Institute’s influenza vaccine and emerging pathogens programme, are planning a trial on humans next month of what is touted to be the UK’s frontrunner vaccine. The product uses a virus that is genetically modified so it is unable to replicate in human cells, to deliver COVID-19 antigens, in the hope of promoting an immune response.

CureVac, Germany

CureVac, another company developing a mRNA vaccine, was last week awarded an $8 million grant by the Oslo-based Coalition for Preparedness Innovation (CEPI), a foundation established after the Ebola outbreak in west Africa, for initial trials of its candidate. The company was also offered a €80 million loan guarantee by the European Investment Bank to fund development of a manufacturing facility, after an alleged attempt by President Donald Trump to acquire the company or its technology (The company has denied it received any offers). The Tübingen-based company’s largest shareholder is billionaire Dietmar Hopp, who made his fortune as a co-founder of software company SAP. The other major investor in CureVac is the Bill and Melinda Gates Foundation. The company expects to start clinical tests by June.

BioNTech, Germany

Another German firm in the vaccine race is BioNTech, also a mRNA specialist. Last week it sealed commercialisation agreements with Shanghai-based Fosun Pharmaceutical Group and Pfizer, the US pharma company, for its vaccine candidate. Founded by immunologist husband and wife team Ugur Sahin and Özlem Türeci, the company is currently testing the vaccine on mice in its lab in Mainz, with trials on humans scheduled to start in April. The Bill and Melinda Gates Foundation has invested in BioNTech, which in common with CureVac and Moderna, initially worked on using mRNA as the basis of cancer vaccines.

CanSino Biologics, China

Hong Kong-listed CanSino Biologics is recruiting volunteers to take part in a six-month clinical trial of a treatment it has developed jointly with the Academy of Military Medical Sciences. This experimental vaccine, to be deployed in Wuhan, formerly the epicentre of the pandemic, is the fastest one out of the traps in China, where up to eight other candidates are reportedly in development.

Migal Galilee Research Institute, Israel

Researchers at this Israeli lab are working to adapt a vaccine initially developed to prevent respiratory disease in poultry, for the prevention of COVID-19. The government-funded institute hailed a scientific breakthrough in February when it isolated COVID-19, with human trials for its candidate expected to start by end April.

Inovio Pharmaceuticals, US

Inovio Pharmaceuticals has had grants from the Bill & Melinda Gates Foundation and CEPI, to accelerate testing of a COVID-19 vaccine which uses the DNA sequence for the spike protein by which the virus attaches to and enters human cells, to deliver viral antigens. Currently in preclinical testing on animals, the firm, which is based near Philadelphia but has its research facility in San Diego, plans to advance into human trials before the summer. Inovio was able to get in early on COVID-19, in part because it’s already testing a vaccine for Middle East Respiratory Syndrome, another coronavirus.

Johnson & Johnson, US

Johnson & Johnson's Dutch vaccine unit, Janssen Vaccines, is applying knowledge gained in the development of vaccines for Ebola, Zika, and HIV to come up with a new vaccine against COVID-19. The US parent company is also pursuing research to find effective treatments, testing numerous candidates for the coronavirus on animals.

Novavax, US

Maryland-based biotech Novavax has received initial funding of $4 million from CEPI to apply its nanoparticle technology to the development of a COVID-19 vaccine. Novavax has produced and is currently assessing multiple recombinant nanoparticle vaccine candidates in animal models prior to advancing to clinical trials. Initiation of clinical testing is expected in late spring of 2020.

University of Queensland, Australia

A team of infectious disease experts at the University of Queensland in Brisbane, backed with almost $17 million from the federal and state governments, CEPI, and a foundation set up by businessman Paul Ramsay, pledges to shave six months off the time it takes to go into human trials. According to Queensland’s interior minister Kate Jones, a government fast track regulatory plan could see the vaccine be available in early 2021.

VIDO-InterVac, Canada

The University of Saskatchewan’s Vaccine and Infectious Disease Organisation-International Vaccine Centre (VIDO-InterVac) has received C$23 million from the Canadian government to expedite work on COVID-19, following a whirlwind three-week application process. A test vaccine is being trialled on ferrets, with researchers at the lab saying it will take about a month to know if the candidate is promising or not. The lab, which has previously worked on vaccines for SARS and the Zika virus, is also exploring alternatives, like antiviral medication, that could fill the gap for patients until a vaccine is available.