Never before have so many brilliant minds, machines, and groups come together so quickly in an attempt to develop a vaccine. The first human trial involving a vaccine product against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the novel coronavirus disease 2019 (COVID-19), began in March in Seattle, Washington. However, some experts in the field say creating unrealistic expectations may be harmful and warn that maintaining standard protocols during the pandemic is essential.
The genetic sequence of SARS-CoV-2 became available online in February. Subsequently, investigators have been able to use this information to find the protein that is critical for the virus to be able to infect humans. The hope is to use a portion of that protein to create a vaccine that will generate an antibody response to prevent the virus from infecting human cells. Some investigators are working on DNA-based vaccines that contain genes that produce the virus’ protein, whereas others are looking at vaccines that include a portion of the actual protein.
“We have never known as much as we do today [about] how to make vaccines. So if there is any bright spot to the pandemic, it is that the scientific world has many tools at hand to make an effective vaccine,” said William A. Petri, MD, PhD, a professor of medicine and vice chair for research in the Department of Medicine at the University of Virginia School of Medicine in Charlottesville. “I hope that COVID-19 will transform medicine by strengthening public support of science, public health, and medicine, and by teaching us that regardless of race, color, ethnicity, or nationality, we are all in this together.”
Petri is working with colleagues at the Infectious Disease Research Institute in Seattle to make a spike glycoprotein vaccine using novel toll-like receptor (TLR) adjuvants. Essentially they are hoping to use COVID-19’s spiked shape against the disease. His group’s vaccine is one of approximately 50 vaccines currently in various stages of development. What will take significant time is that scientists may have to study a range of virus strains in a variety of animal models before any vaccine product could even make it to a phase 3 level of testing.
At The Johns Hopkins Hospital in Baltimore, Maryland, vaccines with different approaches are under development, and scientists have been testing several avenues of crippling COVID-19 in animal studies.1 “The speed of the testing has been incredible,” said Tzyy-Choou “TC” Wu, MD, PhD, MPH, director of the Gynecologic Pathology Division at Johns Hopkins Medicine. He studied the SARS virus in 2002 and 2003 and is drawing on that experience to come up with a safe and effective vaccine.
On March 16 in Seattle, Kaiser Permanente Washington Health Research Institute’s Vaccine and Treatment Evaluation Unit launched a trial of the mRNA-1273 investigational vaccine.2 This experimental vaccine product is produced by Moderna, Inc, and the trial is expected to take 14 months. It involves 45 healthy individuals, aged 18 to 55 years, from the Seattle region. The product includes messenger RNA for the viral spike (S) protein. It does not include any form of live virus, and the trial will not expose participants to the virus.
The vaccine involves a series of 4 injections, and the investigators are testing safety and antibody production. It is an mRNA vaccine encoding for a prefusion stabilized form of the S protein, which was selected by Moderna in collaboration with the National Institute of Allergy and Infectious Diseases.2 The S protein complex is necessary for membrane fusion and host cell infection and has been the target of vaccines against the coronaviruses responsible for Middle East respiratory syndrome (MERS) and SARS virus.
Coronaviruses are a family of viruses that include MERS and SARS. They are transmitted between animals and humans and can evolve into strains not previously identified. Wu and his colleagues have found that COVID-19 is continuing to evolve; consequently, it may be necessary to ensure that the portion of the protein and its genetic sequence will remain effective should the virus mutate or change.
1. Shapiro M. New coronavirus vaccine in development at Johns Hopkins. Johns Hopkins Medicine. March 21, 2020. Accessed April 7, 2020. https://www.hopkinsmedicine.org/coronavirus/vaccine-development.html
2. NIH clinical trial of investigational vaccine for COVID-19 begins. News release. National Institute of Allergy and Infectious Diseases; March 16, 2020. Accessed April 7, 2020. https://www.niaid.nih.gov/news-events/nih-clinical-trial-investigational-vaccine-covid-19-begins
3. Altimmune and The University Of Alabama at Birmingham to collaborate on development of single-dose, intranasal COVID-19 vaccine. News release. Altimmune; March 30, 2020. Accessed April 7, 2020. https://ir.altimmune.com/news-releases/news-release-details/altimmune-and-university-alabama-birmingham-collaborate