Written by: Sarah Wornow
Edited by: Ashley Nee
Coronavirus has consumed our lives since January. The world’s top scientists and public health experts have stated that our lives won’t get back to normal until there’s a successful COVID-19 vaccine. Even though vaccines typically take years to run through clinical trials and safety tests, a few number of COVID-19 vaccines have already moved to the human trial phase. According to the Coalition for Epidemic Preparedness Innovation, or CEPI, there are 5 vaccines in human trials as of April 9. Another vaccine was recently approved for clinical trials, bringing the total up to 6 . However, more and more are being added to the list as more vaccines show positive results in animal testing.
mRNA-1273 is an mRNA vaccine created in partnership between Moderna and the National Institute of Allergy and Infectious Disease (NIAID). The vaccine uses viral messenger RNA, or mRNA, to trick the body into coding viral proteins that will then be attacked by the person’s immune system . More specifically, the mRNA codes for the spike protein found in abundance on the outside of the coronavirus. Following delivery of the vaccine into the patient’s cells, the coronavirus mRNA is then able to be translated into proteins. Because the proteins are foreign to the patient’s immune system, it is theorized that strong T cell and antibody responses against the proteins will be induced. This immune system activation would hopefully allow for the development of immunological memory to the coronavirus protein, which means that if a patient were to be infected with actual coronavirus, the patient’s immune system would be able to recognize the spike protein and combat the infection accordingly. Initial Phase I trials of the mRNA-1273 vaccine began on March 16 at the Kaiser Permanente Washington Health Research Institute in Seattle . The main goals of the trial are to monitor any adverse effects that directly result from taking the vaccine and to study different doses of the vaccine. 45 adults were enrolled in the trial, with each participant receiving two doses of the vaccine 28 days apart. The second dose of the vaccine was reported to be given on April 23, showing promising signs the first round of dosing didn’t produce any severe side effects.
A second vaccine is currently starting human trials at Oxford University. The vaccine utilizes a technology known as ChAdOx1, which is an adenovirus vector from chimpanzees that can not replicate in humans . Similar to the Moderna vaccine, ChAdOx1 nCov-19 tricks a host’s cells into manufacturing the coronavirus spike protein, which the immune system can then recognize. The Phase I trial for ChAdOx1 nCov-19 began on April 23 and included 1,100 patients [5, 6]. Half of the participants received the coronavirus vaccine, and half received a vaccine that protects against meningitis and sepsis. Through continual monitoring, the researchers will track the number of patients who end up contracting COVID-19 in the vaccine recipient group compared to the control group.
Lastly, Inovio Pharmaceuticals created a DNA-based vaccine in conjunction with the Bill and Melinda Gates Foundation. INO-4800 aims to create targeted antibodies towards a specific virus through a patient’s own cell mechanisms . The vaccine is first delivered through injection, followed by electroporation using Innovio’s proprietary COLLECTRA 2000 technology . Electroporation uses electrical currents to briefly create pores in cell membranes to allow for DNA to enter. This type of technology has never been used in humans before, though promising results have been observed in animals. The trial enrolled 40 adults who will receive two doses of the vaccine four weeks apart. Results from this initial Phase I trial are expected to be released in Fall 2020.
In addition to these three vaccines, there are currently three more vaccines beginning human trials. In China, two vaccines, developed by Sinovac Biotech and the Wuhan Institute of Biological Products, are currently in trials. Most recently, a vaccine created jointly by Pfizer and German company BioNTech was approved for human trials in Germany. Even though data from these trials most likely won’t be seen until late this year, we have made a significant amount of progress since the virus was first sequenced in late January. While we may have a while to wait for a coronavirus vaccine, all we can do now is stay home and wear masks when going outside. Small prevention efforts like these will push back the number of people with the disease until hopefully a vaccine gets licensed.
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 NIH Clinical Trial of Investigational Vaccine for COVID-19 Begins. National Institutes of Health. [Internet]; 2020 Mar 16. [Cited 2020 Apr 26] Available from: https://www.nih.gov/news-events/news-releases/nih-clinical-trial-investigational-vaccine-covid-19-begins
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 Etherington D. A Second Potential COVID-19 Vaccine, Backed by Bill and Melinda Gates, is Entering Human Testing. Tech Crunch. [Internet]; 2020 Apr 6. [Cited 2020 Apr 26] Available from: https://techcrunch.com/2020/04/06/a-second-potential-covid-19-vaccine-backed-by-bill-and-melinda-gates-is-entering-human-testing/
 INO-4800 DNA Vaccine Description. Precision Vaccinations. [Internet]; [Cited 2020 Apr 26] Available from: https://www.precisionvaccinations.com/vaccines/ino-4800-dna-coronavirus-vaccine
 Image source: https://www.pcma.org/coronavirus-business-events-industry-preparation/