In January, Chinese scientists shared the full sequence of the coronavirus genome. Just 10 months later, there are more than 200 vaccines against COVID-19 in development, around 40 of which are in clinical trials. How did we get here so fast – and how can this knowledge be used to power successful vaccine development in the future?
Experts put forward their thoughts at CPhI Festival of Pharma, which is being held online October 5-16.
1) Working together
COVID-19 has demonstrated in an unprecedented fashion that industry, researchers, governments, NGOs, regulators and various other stakeholders across the supply chain can pull together when the need arises.
And with COVID-19 there’s also the need to work together on a global scale, with initiatives such as COVAX that aim to provide fair and equitable access to vaccines.
IAVI, a non-profit science research organisation has been working for years on addressing global unmet health challenges such as HIV and tuberculosis. “The public-private collaboration: I hope this really stays,” said Ana Cespedes, COO, IAVI. “And also this global mindset - you don’t fight infectious diseases with a nationalistic approach. Sometimes I find at organisations that work at a global level, we struggle to get individual country commitments for a global project, it’s only when the country is directly impacted that they seem to commit, and they don’t seem to understand it’s a global problem – one person infected will soon travel. I hope this [global mindset] stays with us.”
2) New technologies
Many of the vaccines in late-stage trials are based on new approaches. Approaches such as mRNA use new technologies; while viral vector vaccines have only been used once in human therapy against Ebola.
“It really is a massive achievement to already have all of these vaccine candidates in phase 3 trials,” noted Gunnveig Grodeland, research group leader at the University of Oslo. “What I find particularly cool is that several of the frontrunners are new vaccine formats: new in the sense that there are no or very few vaccine candidates licenced for human use with these formats. As such, I hope the pandemic represents the actual breakthrough for DNA, RNA, adeno-viruses and protein-based vaccines.”
It’s a sentiment that Mike Whelan, project leader of CEPI, agrees with: “There’s a whole load of technologies that have never been used before. This is a game-changer, if these can be proven to be safe and efficacious. I think that’s the legacy.”
New vaccine technologies could offer advantages such as increased potency or simplified production.
3) Personalized vaccines
The race for a COVID-19 vaccine has focused all our attention on speed and scale. But researchers eye up different focuses for vaccine development moving forward – areas that could prove to be more and more important with the challenge of ensuring large groups of people are effectively vaccinated.
“I think we need more information on how immune responses are influenced by different genetic backgrounds, age, sex and previous exposures,” said Grodeland of the University of Oslo. “I think this will lead to development of strategies that are optimized for use in particular groups of populations.
“I think vaccine development should now progress in the direction of personalized medicines, with enhanced efficacy as a result. I think we still have a lot to learn about immunity, which is motivating and exciting for the future.”
4) More knowledge
Vaccine development has come to the fore during COVID-19: but of course it’s been going on since Edward Jenner in the 18th century. Similarly, vaccines are not just about COVID-19. There are many other diseases to be tackled, many vaccination programs to be expanded, and the threat of the next pandemic to be addressed.
“There are many other diseases for which we need novel vaccine development,” said Grodeland of the University of Oslo. “I do hope that the present funding and attention going into COVID-19 will not diminish the efforts and attention needed against tuberculosis, malaria, ebola, influenza viruses with pandemic potential, or virus X.
“I think we are presently at the stage where our combined knowledge in immunology... can lead to a massive jump in understanding the foundations for immune foundation: knowledge I believe is needed for the efficient management of the next pandemic that emerges.”
5) Collecting and analysing vaccine data
The enormity of the challenge of immunizing 7 billion people is evident. The next question is how we track this process and learn from mass vaccination programs.
“Given the size of the immunization program ahead, I think a lot of countries will invest in data collection and management,” said Marie-Liesse Le Corfec, global portfolio marketing head, Pharmaceutical Systems, BD. “A sheer simple database building and analysis to identify who’s vaccinated with what vaccine; what boosters are needed; avoiding mixing different vaccines. It’s a simple issue, but needs to be solved, and data will help.
“And also identifying any signal of waning immunity, any signal of some populations that may not get the impact expected from the vaccine, any safety signals – all of that is going to be driven by real life, real time collection and analysis of data.
Some countries are already working on these kind of data systems; and others can learn from the advances being made. And then work can be taken to the next level by looking at how data can be linked.
“And in many countries, that kind of data is collected but not linked with other databases – so it’s the linkage that’s going to be piloted in this massive immunization program, at least in the most advanced countries,” she added.
