Coronavirus Vaccine Update: A Candidate Fauci Called ‘Impressive’ Just Got Some Promising Results

The race to develop a coronavirus vaccine is getting crowded — and expensive.
July 17, 2020, 4:15pm
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Editor’s note: VICE News has been tracking developments of all the coronavirus vaccine candidates around the world in human trials. This story was last updated on 7/17. Please check back for new information.

The race to develop the first widely distributed coronavirus vaccine might be the most hotly pursued scientific frontier since the space race.

At least 163 potential COVID-19 vaccines are currently in development, according to the World Health Organization (WHO). The people and entities looking to fund a vaccine include world governments, such as the United States and its Operation Warp Speed plan; pharmaceutical firms, big and small; and even wealthy philanthropists like Bill Gates and Dolly Parton. So far, at least 23 have created potential vaccines that have reached human trials.

President Donald Trump and his new vaccine czar, Moncef Slaoui, have said that a vaccine could be ready for widespread distribution by the end of the year. A vaccine developed by AstraZeneca and Oxford University and another by Sinopharm, a Chinese state-owned company, are already in Phase III of trials, one of the final stages before approval to see if the vaccine works and raises no serious side effects among the many members of a large study.

Most recently, Massachusetts-based company Moderna — whose earliest results Dr. Anthony Fauci called “impressive” — announced positive results from its second round of coronavirus trials. The company has plans to launch a 30,000-person Phase III trial on July 27.

But some public health experts have predicted a less optimistic timeline.

Dr. Marie-Paule Kieny, the director of research at the French National Institute of Health and Research (INSERM) and a former top WHO official, told VICE News that mid-2021 is more realistic to expect the hundreds of millions of doses that would need to be available for herd protection.

The WHO has even warned that the virus may never go away entirely.

“Although it is absolutely possible that a vaccine against COVID-19 can be developed, it is not impossible that the virus will continue to circulate and that we might need to be regularly immunized, like against flu,” Kieny said. “For the moment, all of this is hypothetical.”

How do clinical trials work?

In addition to various companies working on a vaccine, different kinds of vaccines are also being tested, including some that have never been approved for use in humans before.

Most commonly used vaccines are either inactivated, such as the flu shot, or live-attenuated, which is used for the measles and mumps. Some companies, however, are racing to develop genetic-based mRNA vaccines, which introduce a sort of code into the body’s cells to fool it into reproducing molecules of the virus, so the immune system can learn to fight it. No mRNA vaccine has ever been approved for use in humans, but if one is ultimately approved, it’ll be faster and cheaper to produce than conventional vaccines.

“The flu and measles vaccine, they’ve been tested thoroughly for a long time before we have the product,” University of North Carolina research associate Long Ping Victor Tse told VICE News. “We have a very good idea of what to do, but every virus and pathogen is different. Is it safe? Is it effective? All of this costs time and money to test.”

Before a vaccine is approved and widely distributed, it must go through preclinical animal trials and then several phases of human trials. A remarkably small number of vaccines make it to the final stage, so some developers are testing multiple vaccine candidates at once to find their best option.

The process, as described by the Food and Drug Administration (FDA), goes like this:

  • Phase I: Twenty to 100 either healthy or infected participants are given the vaccine to make sure it’s safe for human consumption and what dosage works best. Phase I takes several months, and roughly 70% of the drugs move on to the next stage.
  • Phase II: The vaccine is tested on up to several hundred infected people to make sure it’s efficient and that the side effects don’t outweigh the benefits. Phase II can take up to two years, and only about a third of the drugs reach Phase III.
  • Phase III: Also known as “pivotal studies,” Phase III trials aim to “demonstrate whether or not a product offers a treatment benefit to a specific population,” according to the FDA. Due to the breadth and span of the study, Phase III trials can also catch side effects that went unnoticed during the first two trial phases. The process usually takes between one and four years, and only about a quarter of the drugs make it through.
  • Phase IV: The product is continuously tested on thousands of people who have the disease to study effectiveness and long-term side effects. These trials are carried out after the FDA has approved the vaccine.

In some cases, companies are conducting combined Phase I/II or Phase II/III, in which they test for safety and for efficacy in hundreds or thousands of people.

A vast majority of what’s known about the various stages of these vaccines also comes from the developers, which have a vested interest (stock prices, funding, etc.) in being seen at the front of the pack. While many companies have said their results are promising, most of their vaccines aren’t being examined in peer-reviewed studies. Essentially, the world is just supposed to take their word for it until the data gets released.

After the developer has enough data from two large-scale vaccine trials where up to thousands of people are tested, they have to go through a number of other steps — such as filing a marketing application, obtaining licensing for manufacturing and transportation, and undergoing inspections of the facility where the vaccine is manufactured — before the FDA approves their vaccine for distribution.

The 23 entities below have already started or received approval to begin testing their vaccine candidates on humans.

Oxford University/AstraZeneca

Country: United Kingdom

Trial stage: Phase III

In April, one of the biggest global pharmaceutical companies signed an agreement with the oldest university in the predominantly English-speaking world to develop a vaccine. The type of vaccine being tested has never been approved for use in humans before, but AstraZeneca’s CEO told a Belgian radio station last month that the company believes it would protect the user from coronavirus for up to a year.

The company started enrolling participants for its Phase II/III trials in May, while the Phase III U.S. trial will begin in August, according to the National Institute for Allergy and Infectious Diseases. In late June, AstraZeneca reached a nine-figure deal with Brazil to produce tens of millions of doses beginning in August if it receives full regulatory approval, and the WHO’s chief scientist recently called the company the “leader” in the vaccine race.

The Phase I trial showed the Oxford data showed the vaccine produces a “double defense” of antibodies and Killer T cells, an unnamed senior source told the Telegraph.

Sinopharm

Country: China

Trial stage: Phase III

China’s state-owned pharmaceutical company said its vaccine — developed by an institute based in Wuhan, where the virus was first discovered— “was found to have induced high-level antibodies in all inoculated people without serious adverse reaction,” after early results from a 1,120-person clinical trial conducted in April.

In July, the United Arab Emirates confirmed that Sinopharm has started Phase III trials in Abu Dhabi using up to 15,000 volunteers.

The company has also reported positive results from animal trials and has said its facilities in Beijing and Wuhan will be able to produce a combined 220 million doses of the vaccine annually.

Moderna/National Institutes of Health

Country: U.S.

Trial stage: Phase II

Researchers reported on July 14 that Moderna’s Phase II trial, which tested 45 healthy adults, “induced anti-[coronavirus] immune responses in all participants, and no trial-limiting safety concerns were identified.” The company said in a release earlier that week that its Phase III trial, with 30,000 participants, would begin on July 27.

In addition to positive comments from Fauci, the director of the National Institute for Allergy and Infectious Diseases, who serves on the Trump administration’s coronavirus task force, the WHO’s chief scientist said Moderna was “not far behind” AstraZeneca in the vaccine race.

But there’s a catch: Moderna’s history of delivering on its promises is shaky at best, and the company has been compared to Theranos, the notorious blood-testing company run by Elizabeth Holmes, for its practice of not publishing its scientific data for peer review.

CanSino/Beijing Institute of Biotechnology (Academy of Military Medical Sciences)

Country: China

Trial stage: Phase II

Working with a branch of the Chinese military, CanSino became the first company in the world to begin a clinical trial for a vaccine back in March, but the May results of its Phase I trial — the first peer-reviewed study completed for a vaccine — were mixed, particularly because older patients were less likely to develop neutralizing antibodies.

In June, however, CanSino got a surge of good news when the Chinese government authorized usage of the vaccine, which has only been through the first two phases of clinical trials so far. It’s the first coronavirus vaccine approved for use in any of the world’s armed forces, according to the South China Morning Post.

The approval means the vaccine can be used to try to stymie major outbreaks within the military. CanSino said the vaccine has gone through the first two phases of clinical trials so far, according to SCMP. CanSino is now in talk to begin Phase III trials in several countries including Russia and Saudi Arabia, Reuters reported in July.

Novavax

Country: U.S.

Trial stage: Phase I/II

The Maryland-based company, which has secured hundreds of millions in funding from Bill Gates’ Coalition for Epidemic Preparedness Innovations, announced in May that it was beginning Phase I of human trials, with results expected in July. In early July, the company received a $1.6 billion contract from the federal government via Operation Warp Speed.

Though Novovax is still in the early stages of testing, it’s already ramping up manufacturing. The company’s CEO told the Wall Street Journal that it hopes to produce 100 million doses this year and more than a billion next year.

Pfizer

Country: U.S. & Germany

Trial stage: Phase I/II

U.S. pharmaceutical giant Pfizer and German partner BioNTech are in the early stages of human clinical trials to develop an mRNA vaccine. In May, the company began testing four vaccine candidates on roughly 360 participants.

Pfizer CEO Albert Bourla told CNBC in May that the company expects to find out which vaccine performs the best in June or July and hopes to launch a trial with thousands of participants in September, with the hopes of delivering “millions of vaccines in the October timeframe.”

In early July, the company released a promising study from one of its vaccines, which had been tested on 45 participants. Later that month, the U.S. government approved Pfizer’s vaccine candidates for “fast track” status.

“It’s the first positive data I’ve seen coming out of Operation Warp Speed,” Baylor College of Medicine’s Peter Jay Hotez told the Washington Post. “I’m really happy Pfizer took the initiative to publish it, whereas the others haven’t. I think we need to see more of this.”

Sinovac

Country: China

Trial stage: Phase III

Sinovac said in mid-June that 90% of its 600 volunteers in its Phase II trial showed an immune response to the virus. One of the company’s executives claimed in June that the developer could wrap up trials by the fall.

The company’s Phase III trial is set to run on 9,000 volunteers at 12 sites in Brazil, which has seen the worst coronavirus rates in the world outside of the United States. The company received approval to run the trial from the Brazillian government in mid-July.

Imperial College London

Country: United Kingdom

Trial stage: Phase I/II

This vaccine candidate began a trial on about 300 people in the United Kingdom in June, with an mRNA vaccine similar to the one pursued by Pfizer and Moderna.

"We've been able to produce a vaccine from scratch and take it to human trials in just a few months,” Professor Robin Shattock told the BBC. "If our approach works and the vaccine provides effective protection against disease, it could revolutionise how we respond to disease outbreaks in the future." Shattock said in July that if the trials go well, the vaccine could be available in the first half of next year.

AnGes/Osaka University/Takara Bio

Country: Japan

Trial stage: Phase I/II

AnGes, a Japanese company linked to Osaka University, began the country’s first clinical test on humans in late June, the Japan Times reported. The company will run its safety trials at Osaka City Hospital through July 31 with hopes to receive approval to begin manufacturing a vaccine sometime next year.

Bharat Biotech

Country: India

Trial stage: Phase I/II

The first vaccine candidate from India to begin human trials, Hyderabad-headquartered state drugmaker Bharat Biotech began a combined Phase I/II human trials with its vaccine Covaxin in July. The government’s Indian Council of Medical Research is pushing the company to have its vaccine ready for launch on August 15, but there’s cause for skepticism.

“Even with accelerated timelines, this seems really rushed, and hence with potential risks, inadequate attention to process," researcher and former International Association of Bioethics president Anant Bhan tweeted in early July.

Zydus Cadila

Country: India

Trialstage: Phase I/II

Another India-based company, Zydus Cadila, began a combined Phase I/II trial earlier this week. The company’s chairman told Indian financial site Moneycontrol that he expects the combined trial to be completed within the next three months.

Inovio

Country: U.S.

Trial stage: Phase I

The Pennsylvania-based company entered the clinical trial stage in April and has said it hopes to enter Phases II and III later this summer. A study released by the company showed that all but two of the 36 participants from Phase I had an immune response, but the results haven’t been examined in a peer-reviewed study.

The company had identified a coronavirus vaccine just three hours after it received access to the genetic sequencing in January, according to Inovio’s CEO Joseph Kim. But the company later admitted it had created a vaccine construct (essentially a precursor) and not a complete vaccine. After the company’s stock tanked, a class of shareholders sued in March.

Notably, the company has never brought a product to market in its nearly four decades of existence.

Institute of Medical Biology at the Chinese Academy of Medical Sciences

Country: China

Trial stage: Phase I

Not much is known about the Institute of Medical Biology’s vaccine candidate except that it has reportedly moved into Phase II testing. The institute is, however, the country’s “largest production and research base” for the polio vaccine, according to the Chinese Academy of Sciences.

Genexine Consortium

Country: South Korea

Trial stage: Phase I

Genexine recently said it’s moving into a Phase I trial for its DNA-based vaccine, which is the first that’s been approved for testing by the South Korean government, according to BioWorld.com.

If Phase I goes well, Phase II is set to begin in the second half of the year in multiple countries.

Gamaleya Research Institute

Country: Russia

Trial stage: Phase I

Gamaleya is perhaps best known in the vaccine race because the head of the institute injected himself with the potential vaccine, a move that was met with mixed reactions in Russia and among the scientific community.

But in mid-June, the vaccine began trials in liquid and powder-based forms on about 38 human participants each. In July, Russian media reported the institute hopes to begin its Phase III trial in August.

Clover Biopharmaceuticals

Country: China

Trial stage: Phase I

The China-based company is collaborating with both U.K.-based GlaxoSmithKline and California-based Dynavax Technologies in trying to find a vaccine. Phase I human trials began in Australia in June, with results expected in July.

Anhui Zhifei Longcom

Country: China

Trial stage: Phase I

The Chinese government approved Zhifei’s vaccine candidate for testing in June, and in July, the company said it had begun Phase II of its clinical trials without providing details of the Phase I trial. The results of that study are expected in September.

CureVac

Country: Germany

Trial stage: Phase I

The German government recently invested $338 million (300 million euros), or a 23% stake, into this company, which was once rumored to be in talks to be sold to the United States. The company said it wanted to start Phase I trials in June but hasn’t given any updates since the end of the month.

In early July, Tesla CEO Elon Musk said that his company was working with “CureVac and possibly others” on the vaccine race “as a side project.”

People’s Liberation Army Academy of Medical Sciences/Walvax

Country: China

Trial stage: Phase I

The military-run research institute got approval from the Chinese government on June 19 to begin human trials of its mRNA vaccine, becoming the eighth Chinese-developed vaccine to reach clinical trials.

Vaxine

Country: Australia

Trial stage: Phase I

The first Australian-developed candidate to reach human trials, Vaxine began a Phase I trial in early July in Adelaide. The trial will test 40 healthy candidates and results are expected in six to eight weeks, according to the Australian Financial Review.

"From there we will look to commence phase II and III trials straight away,” the company’s chairman told the paper. “The follow-on trials will need to go broader into the elderly and people with chronic disease, because they’re the most vulnerable to COVID infection.”

In July, the company said the vaccine could be ready by early 2021.

University of Queensland

Country: Australia

Trial stage: Phase I

The Australian university began its Phase I trial earlier this week. The trial will include 120 people with preliminary results expected in the early fall.

Medicago

Country: Canada

Trial stage: Phase I

The Quebec City-headquartered company is developing a plant-based vaccine, which it began testing on 180 people in its Phase I trial on July 13. The company says it hopes to produce 100 million doses of the vaccine by the end of 2021.

Cover: Coronavirus model is seen with American flag displayed on a screen in the background in this illustration photo taken in Poland on June 9, 2020. American biotech company Moderna has announced on June 11 that will start final stage of covid-19 vaccine trial in July. (Photo Illustration by Jakub Porzycki/NurPhoto via AP)