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The handful of drugmakers dominating the global coronavirus vaccine race are pushing the bounds of vaccine technology. The following crop under development feature more traditional, proven designs.
The world will need several different vaccines to fight the COVID-19 pandemic, given the sheer size of international need, variations in effects on various populations, and possible limits of efficacy in the first crop.
Many prominent candidates now in final-stage testing are based on new, largely unproven technology platforms designed to produce vaccines at rate.
They include messenger RNA (mRNA) technologies used by Moderna Inc and Pfizer Inc with partner BioNTech SE, and inactivated cold virus platforms utilized by Oxford University/AstraZeneca Plc, Johnson & Johnson and CanSino Biologics, whose vaccine was approved for military use in China.
Merck & Co in September started testing a COVID-19 vaccine based on a weakened measles virus which delivers genes from the new coronavirus into the body to stimulate an immune reaction to the coronavirus.
Of those, only the technology provided by J&J and CanSino that use cold viruses as vectors to deliver coronavirus genetic material have produced a licensed vaccine – for Ebola.
The following set of candidates – with late-stage trial results expected in the first half of 2021 – are heavily skewed toward strategies that have produced successful vaccines.
Conventional methods include using a killed or inactivated version of the pathogen which causes a disease to provoke an immune response, such as those used to make influenza, polio and rabies vaccines.
Also more common are protein-based vaccines which use purified pieces of the virus to spur an immune reaction. Vaccines against whooping cough, or pertussis, and shingles employ this approach.
French drugmaker Sanofi is growing a protein-based COVID-19 vaccine using the same approach it uses for its Flublok seasonal flu vaccine. Sanofi expects to begin the final phase of testing in early December, with acceptance targeted in the first half of 2021.
While Novavax Inc hasn’t yet produced a licensed vaccine, it is using similar purified protein technologies and expects to start a late-stage US trial between 30,000 volunteers in late November.
“Those are more conventional approaches, so we can feel more comfortable that we’ve got a lot of experience together,” said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.
Offit also sees promise in a number of the inactivated virus vaccines being developed by Chinese researchers, such as Sinopharm’s China National Biotec Group (CNBG), one of the few first-crop developers using a conventional technique.
VLP vaccines can be produced in an assortment of different types of cells, such as mammal, bacterial, insect, yeast and yeast cells. This approach was used to develop vaccines for hepatitis B and human papillomavirus.
Quebec’s Medicago is testing a VLP COVID-19 vaccine grown in tobacco plants with the backing of tobacco company Philip Morris.
Medicago has yet to create an approved vaccine, but has completed large-scale testing for a seasonal flu vaccine using this approach. It plans to start mid-stage trials of its COVID-19 vaccine next month and aims to create around 1 billion doses a year by 2023.
Others are looking at alternative delivery methods, like the nasal spray vaccine being developed by a team at Xiamen University, Hong Kong University and Beijing Wantai Biological Pharmacy Enterprise, which is based on a modified influenza virus.
The second harvest, however, could face problems completing large studies if the present leaders bring their vaccines over the end line in the coming weeks.
“If we get a super vaccine in December, from company x, which is on the market, it will be tricky to recruit participants into other research,” said Peter Kremsner in the University Hospital in Tuebingen, Germany.
“Then everyone will say, if the vaccine is present, I’ll get vaccinated today with this vaccine. This will definitely prove a problem for recruitment,” added Kremsner, who is testing CureVac’s mRNA COVID-19 vaccine in early clinical trials with backing from the Bill & Melinda Gates Foundation.
On the flip side, it’s easier and faster to prove efficacy when community spread of the virus is rampant as is occurring again in the USA, Europe and elsewhere, a potential advantage for companies starting large-scale vaccine trials in the near future.
