CHICAGO/BERLIN (Reuters) – The handful of drugmakers dominating the global coronavirus vaccine race are pushing the boundaries of vaccine technology. The next crop under development feature more conventional, proven designs.
The world will need several different vaccines to fight the COVID-19 pandemic, given the sheer size of global need, variations in effects on different populations, and possible limits of effectiveness in the first crop.
Many leading candidates now in final-stage testing are based on new, largely unproven technology platforms designed to produce vaccines at speed.
They include messenger RNA (mRNA) technology used by Moderna Inc MRNA.O and Pfizer Inc PFE.N with partner BioNTech SE 22UAy.F, and inactivated cold virus platforms used by Oxford University/AstraZeneca Plc AZN.L, Johnson & Johnson JNJ.N and CanSino Biologics 6185.HK, whose vaccine has been approved for military use in China.
Merck & Co MRK.N in September started testing a COVID-19 vaccine based on a weakened measles virus that delivers genes from the new coronavirus into the body to stimulate an immune response to the coronavirus.
Of these, only the technology offered by J&J and CanSino that use cold viruses as vectors to deliver coronavirus genetic material have ever produced a licensed vaccine – for Ebola.
The next set of candidates – with late-stage trial results expected in the first half of 2021 – are heavily skewed toward approaches that have produced successful vaccines.
Conventional methods include using a killed or inactivated version of the pathogen that causes a disease to provoke an immune response, such as those used to make flu, polio and rabies vaccines.
Also more common are protein-based vaccines that use purified pieces of the virus to spur an immune response. Vaccines against whooping cough, or pertussis, and shingles employ this approach.
French drugmaker Sanofi SASY.PA is developing a protein-based COVID-19 vaccine employing the same approach it uses for its Flublok seasonal flu vaccine. Sanofi expects to start the final phase of testing in early December, with approval targeted in the first half of 2021.
While Novavax Inc NVAX.O has not yet produced a licensed vaccine, it is using similar purified protein technology and expects to start a late-stage U.S. trial involving 30,000 volunteers in late November.
“Those are more traditional approaches, so we can feel more comfortable that we have a lot of experience with them,” said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.
Offit also sees promise in some of the inactivated virus vaccines being developed by Chinese researchers, including Sinopharm’s China National Biotec Group (CNBG), one of the few first-crop developers using a traditional technique.
Other second-wave developers are making vaccines based on virus-like particles (VLPs), which mimic the structure of the coronavirus but contain no genetic material from it.
VLP vaccines can be produced in a variety of different types of cells, including mammal, bacterial, insect, yeast and plant cells. This approach has been 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 PM.N.
Medicago has yet to produce an approved vaccine, but has completed large-scale testing for a seasonal flu vaccine using this approach. It plans to begin mid-stage trials of its COVID-19 vaccine next month and aims to make up to 1 billion doses a year by 2023.
Others are looking at alternative delivery methods, such as 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 flu virus.
The second crop, however, could face problems completing large studies if the current leaders bring their vaccines over the finish line in the coming months.
“If we get a super vaccine in December, from company x, which is on the market, it will be difficult to recruit participants into other studies,” said Peter Kremsner from the University Hospital in Tuebingen, Germany.
“Then everyone will say, if the vaccine exists, I will get vaccinated now with this vaccine. This will definitely prove a problem for recruitment,” added Kremsner, who is testing CureVac’s CVAC.O mRNA COVID-19 vaccine in early clinical trials with backing from the Bill & Melinda Gates Foundation.
On the flip side, it is easier and faster to prove efficacy when community spread of the virus is rampant as is happening again in the United States, Europe and elsewhere, a potential advantage for companies starting large-scale vaccine trials in the near future.
Reporting by Rocky Swift in Tokyo and Julie Steenhuysen in Chicago; Additional reporting by Kate Kelland in London, Ludwig Burger, Caroline Copley in Berlin, Sangmi Cha in Seoul and Allison Martell in Toronto; Writing by Sayantani Ghosh; Editing by Miyoung Kim, Peter Henderson and Bill Berkrot
British Columbia has reported another 656 new cases of COVID-19.
In Tuesday’s briefing, 140 were announced in Vancouver Coastal Health and 10 new cases were recorded on Vancouver Island.
That brings the island’s active case count to 247.
The province also said 16 more people have died from the virus, leaving the death count at 457.
Provincial Health Officer Dr. Bonnie Henry says we must make an impact through our own personal actions to lower the transmission of the virus.
“Without exception, follow the provincial health officer’s orders in place. Remember that events, which refer to anything that gathers people together – whether on a one-time, regular or irregular basis – are not allowed for now. This includes religious, cultural or community events. Do not gather at home with anyone other than your household or core bubble.
“Let’s make today a day to slow community transmission and continue to protect everyone in our province.”
Local leaders in Revelstoke say there’s no signs yet that the resort municipality is turning a corner, as it deals with a growing cluster of COVID-19 cases.
As of Tuesday, there were 46 cases connected to the cluster and 32 active cases, which has now spread to a local elementary school.
City councillor Cody Younker says there’s concern that the number of cases is probably going to grow before the situation improves.
“My fear, and I think most of the community’s fear, especially our mayor by the statement he put out this morning, is that it sounds like this is still pre-emptive and it’s probably going to get a lot worse. We base that just off of what we’re hearing from more restaurants closing down, confirming they’ve now had exposures. More businesses, now a school exposure.”
Revelstoke Mountain Resort also opened last weekend, and Younker says he’s waiting to see if that has any impact on the virus spreading.
“The ski hill, I mean, I have to commend them. From what I saw in the pictures of what they put up, they did a really good job of ensuring social distancing in the lines. Compared to years previous when you’re just basically packed in like sardines. But still obviously really concerned about that,” Younker says.
“Thousands of people using the ski hill, many still riding up in the gondola together. Congregating in the parking lots, that kind of thing. I saw a large group walking downtown Friday and Saturday night. Just by my house even, in the downtown core, there were large groups walking down the streets. Not sure where they were going but concerning, of course, to see that.”
Now a week after the cluster was first reported, Younker says the reality has set in for residents about the cluster, saying many residents have actually done “an amazing job” to follow public health orders and to avoid non-essential travel out of their homes.
But he points out it feels a bit like a “ghost town.”
“There’s no nightlife, obviously most of the restaurants have moved to take out. A few more have just confirmed exposures in the last few days so now they’ve shut down. So in that sense it’s actually gotten better, in the sense that there’s less people congregating downtown. But worse, in fear of obviously what it’s going to do to the economy and local businesses.”
Yesterday, Revelstoke mayor Gary Sulz warned people to avoid travelling to the community while the cluster of cases remains, saying cases are likely still going to go up and he doesn’t want the virus spread to other communities or places like care homes.
The World Health Organization on Wednesday tightened guidelines on wearing face masks, recommending that, where COVID-19 is spreading, they be worn by everyone in health-care facilities and for all interactions in poorly ventilated indoor spaces.
In June, the WHO urged governments to ask everyone to wear fabric masks in indoor and outdoor public areas where there was a risk of transmission of the virus.
Since then, a second global wave of the epidemic has gathered pace. In all, more than 63 million people globally have caught COVID-19 and 1.475 million have died of it, according to a Reuters tally.
In more detailed advice published on Wednesday, the WHO said that where the epidemic was spreading, people — including children and students aged 12 or over — should always wear masks in shops, workplaces and schools that lack adequate ventilation and when receiving visitors at home in poorly ventilated rooms.
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Masks should also be worn outdoors and in well ventilated indoor spaces where physical distancing of at least one metre can’t be maintained, WHO said.
In all scenarios, masks needed to be accompanied by other precautions such as hand-washing, WHO said.
Depending on the type, WHO said masks can be used either for protection of healthy persons or to prevent transmission.
Medical masks to care for patients
In areas of COVID-19 spread, WHO also advised “universal” wearing of medical masks in health-care facilities, including when caring for other patients.
The advice applied to visitors, outpatients and to common areas such as cafeterias and staff rooms.
Health-care workers could wear N95 respirator masks if available when caring for COVID-19 patients, but their only proven protection is when they are doing aerosol-generating procedures which carry higher risks, the WHO said.
It recommended that people doing vigorous physical activity not wear masks, citing some associated risks, particularly for people with asthma.
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