Tuesday 16 June 2020

The Vaccines Race

Covid-19 is wreaking havoc globally. At the moment more than 8 million people have already been infected with more than 440,000 death registered.

Like any other viruses such as HIV, the hope to find a medicine to cure it is slim. So, the only way is to develop a vaccine to prevent the infection.

Who gets the vaccine first, who will rule the world. It's like the space race during the cold war era.

You can imagine that the most kiasu leader in the world will definitely go all-in and do whatever he can to make sure that he beats everyone else.

Experts say that the development of vaccine usually takes 12-18 months. As Covid-19 starts in January 2020, we might see its availability early next year if we're lucky enough.

However, this is no ordinary vaccine. This is the vaccine that can rule the world in term of politics and economy. 

So it's not a surprise that its development will be at a breakneck speed, and funding is not an issue at all. There is a chance that we might get it sooner than usual.

Once the vaccine is successfully rolled out, all of the 7.8 billion people in the world need it. I guess those who have been infected and recovered also want to have it even though they might not need it.

A development of a vaccine generally needs three phases. A few of the Covid-19 potential vaccines have entered the final phase at this moment, which involves large scale trials to ensure its efficacy and safety.

Optimists have anticipated the availability of Covid-19 vaccines by the end of year 2020, with all manufacturing and delivery of the vaccines planned ahead.

When this Covid-19 vaccine is available, it will be an extremely good news for humankind. It will save lots of people's life and livelihood. It will save lots of businesses and countries.

The only party which might be negatively affected are those businesses who thrive on the Covid-19 pandemic.

If the vaccine trials are making good progress towards the end of 2020, personal protective equipment (PPE) orders such as medical gloves and face masks might gradually reduce and go back to the usual demand once an effective vaccine is available.

Investors who invest in Covid-19 related stocks predicting a sustained explosive demand for their products should be careful about this.

Of course if the trials of vaccines fail or keep on being delayed, then Covid-19 will be never-ending until everyone gets infected and acquires natural immunity. 

HIV is a well-known virus which has been discovered for more than 30 years, so far scientists fail to develop a vaccine for it.

Dengue virus, another virus that kills many Malaysians every year, still does not have a convincing vaccine even though it has been approved in recent years.

Vaccines for SARS & MERS which are also coronavirus, are not available may be the outbreaks were relatively short-lived and well-controlled.

Nevertheless, we have vaccines against viruses such as Hepatitis A & B, HPV, mumps, measles, chicken pox and influenza.

I don't know whether we will ever get a vaccine for Covid-19. From the Covid-19 vaccine updates by WebMD below, it looks promising.

Covid-19 vaccines update from WebMD last updated on 15 June 2020. 

Moderna. Moderna's vaccine, mRNA-1273, uses messenger RNA, an approach that does not require a virus to make the vaccine. The messenger RNA, or mRNA, carries instructions for making the spike protein, a key protein on the surface of the SARS-CoV-2 virus that allows the virus to enter cells when a person gets infected. When the vaccine with this instruction molecule is injected, it goes to the immune cells and instructs them to make copies of the spike protein, acting as if the cells have been infected with the coronavirus. Allowing other immune cells to develop ways to protect you gives immunity.

mRNA-1273 is in phase II of its clinical trial, designed to evaluate safety and effectiveness. Moderna, a biotechnology company working with the National Institute of Allergy and Infectious Diseases, intends to enroll 600 healthy volunteers equally divided into two age groups: 18 to 55, and 55 and older. The company announced on June 11 that it will start phase III of its trial in July with 30,000 volunteers. Phase III, the final clinical trial phase, evaluates effectiveness in a much larger group and compares how well the vaccine works compared to a placebo. Moderna will test a 100 microgram dose and said the company is on track to deliver 500 million doses per year. In mid-May, the company announced that all eight initial trial volunteers given two different dose amounts reached or surpassed the level of antibodies capable of neutralizing the virus.

University of Oxford and AstraZeneca. University of Oxford scientists are partnering with AstraZeneca to develop a COVID-19 vaccine made from a weakened version of a common cold virus, the adenovirus, taken from chimpanzees. The adenovirus is genetically altered so it can’t reproduce itself. The vaccine is combined with genes of the spike protein to trigger production of vaccines against it that allows the immune system to destroy the SARS-CoV-2 virus.

A phase I/II clinical trial began in April in the U.K. to assess its safety and how well it works in more than 1,000 healthy volunteers 18 to 55 years old. Now, recruiting has begun for phase II/III trials, which will enroll up to 10,260 adults and children. For both phase II and III, volunteers will receive one or two doses of either the COVID-19 vaccine or a licensed vaccine that will be used as a control for comparison. In early June, Brazil, hard hit with COVID-19 cases, joined the clinical trials, planning to test 2,000 volunteers there.

After reaching a license agreement with Oxford University and others, AstraZeneca agreed to supply more than 2 billion doses globally, anticipating delivery of 400 million doses before the end of 2020.

Pfizer and BioNTech. The companies are testing four vaccines, each using messenger RNA, with a different combination of mRNA to targeted antigens (to produce antibodies). Called BNT162, volunteers in Germany and the U.S. have received the vaccine in a phase I/II clinical trial. This trial will evaluate the safety, ability to give immunity, and the optimal dose of the four candidates in a single and continuous study. Initially they are testing the vaccine on people 18 to 55. Once a given dose level is proven safe and effective, older adults will be immunized. Pfizer is predicting the production of millions of vaccine doses in 2020, increasing to hundreds of millions in 2021. Manufacturing sites have been identified both in the U.S. and elsewhere.

Inovio. Inovio's vaccine, INO-4800, is a DNA vaccine in phase I clinical trials, with 40 volunteers. The technology uses DNA designed to produce a specific immune response. A handheld smart device uses a brief electrical pulse to open small pores in the skin to deliver the vaccine. Once the DNA is inside a cell, it instructs it to make many copies of the artificial DNA, and this stimulates the body's natural immune response.

Results from the U.S. phase I trial are expected in June, and a phase II/III trial is expected then to begin. Human trials are also expected to begin this summer in China and South Korea. Multiple partners and collaborators are involved, including the Bill & Melinda Gates Foundation, the National Institutes of Health, and others.

CanSino. CanSino Biologics in Tianjin, China, is working with the Beijing Institute of Biotechnology on a coronavirus vaccine using a type of genetically altered adenovirus known as Ad-5. The platform has been used successfully to develop the Ebola virus vaccine.

In late May, researchers reported on results of the phase I safety study, in which 108 people got three doses (low, middle, high) of the vaccine. Most volunteers developed immune responses, but fewer had the neutralizing antibodies experts say are crucial to fight off the virus.

The company launched phase II in mid-April, with over 500 enrolled.

Sinovac Biotech. Sinovac Biotech's vaccine, CoronaVac, uses an inactivated version of the virus. Early results of a Phase II clinical trial released in June show that the vaccine induced antibodies to neutralize the virus after 14 days in 90% of people who received it. The vaccine requires two injections, given two weeks apart, according to the company.  No serious side effects have been reported in either phase I or II trials, which included 743 healthy volunteers.

Sinovac will partner with Instituto Butantan in Brazil to launch a phase III trial. The company said it will develop the vaccine for global use.  

Johnson & Johnson. The company said it expected to start testing its vaccine in people in the second half of July. The vaccine combines genes from the coronavirus with a modified adenovirus. The first trial will include more than 1,000 healthy adults aged 18 to 55 and others 65 and older, and will take place in the U.S. and Belgium.

Other efforts. The Trump administration chose five companies for Operation Warp Speed, the national program to accelerate the development, making, and distribution of COVID-19 vaccines, treatments, and diagnostics. They are: Moderna, Johnson & Johnson, Merck, Pfizer and BioNTech, and AstraZeneca/Oxford University.

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