Listening to the nightly news and its update of COVID-19 cases and deaths can put you in a less than happy-hour mood. While the situation with the pandemic remains critical and protective measures remain crucial, there are also some glimmers of hope, both on the treatment and vaccine fronts.

Faster Cures, a center of the Milken Institute, tracks the progress of both; as of May 5, it lists 199 treatments and 123 vaccines under study for COVID-19. Another vaccine tracker is maintained by the Regulatory Affairs Professionals Society. They are, of course, in various stages of development and not all will make it to market. Still, it’s amazingly fast progress considering the World Health Organization declared COVID-19 a pandemic March 11.

Human Vaccine Trials

• An mRNA vaccine, which does not require a virus to make it, is under study by Moderna,a biotech company, partnering with another company, Lonza, for manufacturing. Phase I (to look at safety) is underway and the company has asked the FDA for an OK to start Phase II (to look at safety and effectiveness), aiming for the second quarter of 2020. The vaccine targets a key protein (the spike protein) on the surface of the virus that causes COVID-19. Instructions for making the protein are encoded into an ”instruction molecule,” mRNA. The vaccine with this instruction molecule is injected, traveling to the immune cells and triggering them to make copies of the spike protein as if they have been infected, creating immunity.  
• A DNA vaccine by another company, INOVIO, has also started Phase I trials. A hand-held smart device that uses a brief electrical pulse opens small pores in the skin to deliver the DNA, which has been specially designed to produce an immune response. 
• In the UK, scientists at the University of Oxford have begun a Phase I/II trial of a vaccine made from a weakened version of an adenovirus, a common cold virus, from chimpanzees. It’s altered genetically so it can’t grow in people. The vaccine is combined with genetic material that triggers antibodies to fight the virus.
• Four vaccine candidates, involving mRNA, are under study by Pfizer and an immunotherapy company, Biopharmaceutical New Technologies.  Phase I/II is underway.

What’s next for vaccines or treatments

On the treatment side, the FDA gave emergency use authorization for an antiviral drug, remdesivir, to treat COVID-19 patients hospitalized with severe disease. 

Senior Planet asked experts to weigh in on the status of vaccines and treatments.

“There are several candidates that are leading the pack,” says Amesh Adalja, MD, infectious disease expert and senior scholar at the Johns Hopkins University Center for Health Security. “Vaccines by Inovio and Moderna, as well as now Pfizer, are rapidly moving in clinical trials. It’s too hard to say, at this time, which is the most promising, but they are all utilizing novel technologies. Everyone in the field is eagerly waiting clinical trial results.”

“The Oxford vaccine is the farthest along,” says Litjen (L.J.) Tan, MS, PhD, chief strategy officer for the Immunization Action Coalition. Its developers have said they hope to have batches ready by September. Pfizer says it aims to have millions of doses ready in 2020.  Other experts, however, caution that a 12- to 18-month timeline would be incredibly—and perhaps impossibly—fast. 

“For treatments, there is a lot of enthusiasm regarding the positive result that occurred with remdesivir,” says Adalja, citing research that led to the FDA’s emergency use authorization. “Although it wasn’t a blockbuster result, it is something that we now have to treat severe patients with.”

Other bright spots? Unprecedented global cooperation, Tan says, in data sharing on the disease and on vaccine development.  Funding has been plentiful, too, he says. However, many in the medical profession remain cautious on the chances of a vaccine ever being discovered, since, for instance, HIV has been around for decades with no vaccine yet established for it.

Photo by Ani Kolleshi on Unsplash