How close are we to a Covid-19 vaccine?

 

Covid-19 vaccine

How close we are to a Covid-19 vaccine research teams in the UK have released promising results from early trials but once a vaccine is

 Developed how do we make sure that everyone gets it this is inside story the race for a Covid in nineteen vaccine is gathering pace

Scientists around the world are competing to develop a safe and effective treatment that may help end the pandemic years of research

has been completed in just a few months a team at Oxford University in the UK has released promising results from early trials but whilst

There’s excitement doctors warn there's still a long way to go before a vaccine is widely available we'll bring in our guests in just a moment but

first this report from paul brannan phase 1 really couldn't have gone much better for the oxford team early positive signs now confirmed in

the published research so this is an important milestone on the path but we we're now moving rapidly forwards to try to evaluate whether

the vaccine actually protects the population by conducting large-scale trials may have 10,000 people already vaccinated around the world we still need to see how the vaccine performs in older people who are more at risk of severe disease than the people we vaccinated in this

study so that's the subject of future work and there'll be more publications to come the oxford vaccine is adapted from a common

Cold virus found in chimpanzees spike glycoprotein a genetic material from the Covid 19 virus was added the hope is the human body.

 

How covid-19 affect in our body

 

Develop immunity to the spike protein stopping the virus from entering cells and preventing infection tests indicate the vaccine produces two

Reactions by producing a defensive antibody response as well as t-cells which attack the infected cells t-cell response peaked just 14 days after

Volunteers were injected antibody response peaked at 28 days and side effects were minor mainly just tiredness and headaches treated with

paracetamol I'm hopeful I got my fingers crossed but to say that I'm in 100% confident that we'll get a vaccine this year or indeed next year is

alas just you know an exaggeration we're not there yet this is a hugely encouraging result for the team here in Oxford but provoking an

Immune reaction is just the first stage in vaccine development phase 3 trials or already underway in the UK South Africa and Brazil are looking

At issues such as optimal dosage and exactly how much protection vaccinated people have when exposed to the actual coronavirus nine in

Ten vaccine projects end in failure and there is no guarantee that the early promise of the Oxford trials will lead to an effective Covid 19.

 

Positive step from Oxford University

 

It is a very positive step Paul Brennan al-jazeera Oxford the World Health Organization is tracking around 160 possible vaccines against

Covid 19 most are still in the preclinical stage being tested on animals at least 24 are in phase one where the potential vaccines are given to a

Handful of people or Phase two where they're tested on hundreds of people three products have reached phase three trials this involves

Vaccinating thousands of people to check for safety and side effects these are from the Chinese companies Tsai Novak it's conducting tests

Now in Brazil there's also the University of Melbourne and Murdoch Children's Research Institute in Australia and the University of Oxford

and AstraZeneca trials in the UK which we mentioned earlier with the World Health Organization says whichever vaccine does succeed it must

be available to everyone we want a groundswell of political leaders believing in making a vaccine or therapeutics global public good and

this should not be considered as a charity to those who cannot afford the advantage of using fairness or access to also poor countries the

World can really be lifted up and lift itself out of this pandemic together which can speed up the economic recovery let's bring now

and in Lancaster in the UK Mohammad Minea lecturer in virology at the University of Lancaster in johannesburg helen ruiz member of the w-h-

o strategic advisory group of experts on the Covid 19 vaccine and in hong kong john nichols clinical professor in pathology at the university

of hong kong a very warm welcome to all of you Helen you are leading this vaccine trial in South Africa how significant is the response that

Humans have had to the Oxford vaccine well in fact I'm not leading it but I'm very involved in the vaccine approvals and the science of

vaccine the research going on in South Africa but in terms of your question it's been very interesting to see that there's been a very

positive response from communities to enrolling in the vaccine trial for the Oxford vaccine there are three sites recruiting and wanting to enroll

2,000 people including 50 people living with HIV infection and people are really queuing up to join the study yeah that's quite interesting in itself I was wondering how you do get people involved in a trial.

 

   

     

How the world is going from corona virus

 

South Africa is perhaps a little bit unique in the sense that we've been grappling with those HIV and TB s major epidemics for many years so

we've set up really very experienced clinical trial sites that are very used to doing both vaccine trials and Prevention trials in communities

with thousands of participants and the clinical trial sites also have Community Advisory boards so one of the ways that we do this is that

we talk very strongly to the community about what we want to do and why we want to do it and they give us equally strong feedback about

acceptability or otherwise and how we should do things so part of it is community awareness but we've had a lot of media attention as you

can imagine to this because it was the first country to do urban vaccine trials in the African region so that in itself has created enormous

Interest okay John so we've got a development here where we see the development equation of antibodies and T cells excited to you about

this milestone yeah I think that's a very interesting aspect because we're looking at both the seller community as was the humoral so

We’ve also been using some filing some antibodies but with a digit Hong Kong is very small so we don't have a clinical trial on vaccines but so

‘We’ve just been focusing more on these small animals especially the hamsters and so we think getting both the t-cells as well as the

Humoral immunity is a crucial part okay and Mohammed other there are a hundred and sixty vaccines in various stages of development

Including I believe one by Lancaster University what stage you at absolutely I mean there are multiple vaccines and multiple technologies

that are being deployed in different part of the world and here at the Lancaster University our approach is slightly different what we are

Doing is to take an avian virus the virus that can cause infection in birds and it's pretty harmless in humans we are using basically the same

Approach as Oxford but a different backbone that is called Newcastle disease virus at the moment we have demonstrated its preclinical

Studies and we are doing some animal work including hamster and mice to demonstrate that it induces the immune responses and as it's

ten so far is pretty encouraging okay Helen as mama says it's all very encouraging at the moment but we must remember these are very

early days and at what stage is a vaccine ready to be mass-produced well I guess there's two answers to that one of the things that we've

done globally as people have invested in these very early vaccine candidates is to in parallel actually say we can't wait till the end to

Actually identify where we're going to manufacture them so there's already work going on to identify manufacturing sites existing vaccine

Manufacturers asking and looking at their capacity to change so that's already being looked at and happened although we don't have yet in

effect maxine but in terms of the vaccine development side of things all of these findings are extremely encouraging and we have three

vaccines where we've got encouraging findings in terms of the immune response what we need to find out from much larger Charles than

many thousands of participants is whether those immune responses are going to turn into either protecting completely from infection or to

Reduce the severity of disease and those are the the advanced stage clinical trials which in terms of the Oxford the vaccine they're moving

very quickly but many of these vaccines will move in the next few months quite quickly into those advanced or called phase 3 clinical

trials and once we have those results and that's when we really would say and if they're favorable that's what we would say we think that

we've got a vaccine that is is that we can roll out but we would also have to then look and say who do we roll it out to because some

Vaccines for example don't work in older people some vaccines won't many most of these vaccines won't have been tested for example in

Pregnant women so they'll then be a secondary look to say how many vaccines we have that appear to work limited numbers who would

We prioritize and what the clinical trials is telling us about how this works absolutely I mean distribution is a very big part of this discussion

I do want to come on to that in just a moment in terms of the timeline of course what everybody wants to know is when a vaccine a viable

vaccine is going to be produced and these usually tends to take a decade don't they the fastest was mumps which took four years is it at

all feasible that a vaccine against covid 19 john could be produced within a year to 18 months well I handed it out it can be done but there's so many crucial questions which she's pointed out which we need to look at basically will it be one dose or two doses birds as in

need an adjuvant in hongkong we have the big problem where 18 to 20 percent of our populations over the age of 55 which is a an age in which

Immune senescence can creep in which means that we may they may not mount a proper antibody response when we give them.

    

Situation of Virus now

Vaccine and that's a population which is nice one in our locality to getting the severe disease so I think it's going to be a big problem

about as well as point that both the you know who you give it to and how many doses you give and also realizing that we will be coming up

in another few months to the winter season where we're going to be also coupling with influenza because right now in many influenza

studies have been put on the back burner and because of COVID and so I'm worried that we'll get a get we're going to get a double whammy

and in this winter with both influenza as well as resurgence of COVID and some research which we've been doing is actually looking at the

the how much influenza can actually influence coded replication because so that's actually one of our greatest fears about what's going

to happen this coming winter mmm that's only one will be watching out for every Helen you say got a successful trial of people you've got a lot

of volunteers but how do you test a vaccine on vulnerable people how do you test a vaccine on elderly people or people with comorbidities

Well you're obviously going to be I mean I mentioned that we've got a small subgroup for HIV infected and one of the things there's several

Things we want to check there one is is the vaccine going to be safe because the immune system is compromised even if people are on

antiretroviral and the second one is it going to work because again you've got an immune system that isn't necessarily as robust as

somebody who's not living with HIV so they're you often have much more rigorous safety mode even more rigorous than we're seeing in the

in the few like the general population so you look carefully at safety and you look very closely and carefully at the immune response and

that would be the same for older people you'll be particularly as John was saying interested to say do they amount do they mount the same

Immune response as we're seeing in younger populations is that and if they don't is that an indication that this vaccine doesn't work if it's not

quite as good do we know that we won't know that that's the problem the immune response if it's there we can't tell you for sure whether it

will we'll protect and if it protects in younger people and we see a lesser immune response than older people we still can't say for sure

whether that means that we need to give more doses booster doses or whether we shouldn't be giving it at all because it won't be effective

 we're still going to need clinical data and Mohamed there's a very strong group isn't there that's calling for what they call challenge trials this is where vaccinated people are deliberately infected with covid 19

this raises up all sorts of ethical questions doesn't it because when they've happened in the past they've always had an effective treatment

but of course there isn't even an effective treatment now for coronavirus what's your idea of response to challenge trials yes I mean this idea has been client just to expedite the whole process of trial

Basically what we do any vaccine that come into the human has to pass through a sort of animal safety trial anyways but this idea is being

Applied before for the flu vaccine validation as you said that if there are proper treatments available and we understood the disease enough

that in case any severe consequences appear we would be able to tackle that but beside that there is a very less motivation really to get into this trial and by all mean it should be avoided that is my personal

Stance on that but of course there are countries where the disease is getting down and they are a bit really getting into human trials so that

they can demonstrate the efficacy in a timely manner but I think there are other elements that we are talking about for example South Africa

Countries are moving into the into the population where the disease is really high so there are alternatives so we can avail doe that up going

into the human trial is there any evidence Muhammad that in the rush to find a vaccine that there's there any evidence that safety trials have

been bypassed or sped up well the element that I am more worried about is because we are compressing at 10 15 years’ time into 1 year or

so and there is a unprecedented pressure onto scientific community for the Pharmaceuticals and also for the for the general public to apply on

but one thing is pretty clear that wuh-oh and other regulatory authorities they have its hundreds of years of experiences all together

to really set up pipeline how the vaccine need to be assessed before it can roll out into the into the manufacturing and the scaling up so I'm

pretty confident that whatever the outcome of this vaccine would be that is depending on the nature of the vaccine but when it comes to the

rules it would only be possible when we have really safety immunogenicity and all of the parameters that are required for the vaccines to be rolled out that is the only one will be approved okay

John do you share that confidence I'm a little bit more skeptical because one of my concerns is that certainly what we've been seeing in the Hong Kong population is that a lot of when you get the mild disease

and the aged symptomatic is and that's going to be is that the you know the media says that only about 50% of the population as the adult

Population would actually have the vaccine because I think that many people say it's and they're very mild disease why should I go vaccine so

I think there's going to be the incentive for those who just see this as being a very low disease I should get the vaccine and then the second is

some of the work which we've been looking at is that it may prevent a severe disease but will it actually stop replication and the upper

respiratory tract and millet would actually stop transmission so we may be successful at avoiding a pneumonia but I'm not too sure whether not

Vaccine themselves may actually will how much they'll stop transmission and as has been pointed out we're really compressing a

Watson normally a ten year program into one to two years and there's always this safety aspect I think we've got memories of what happened

With the with the Dinny vaccine in the Philippines we and we had the side effects and so it meant that people then stopped having their

Measles vaccination so we saw a big outbreak of the measles so it's always that big concern of the possible side effects leading to the air

the general public staying away from it mmm hello it's such an interesting point isn't it what if there is a low uptake I mean a recent

poll also showed that 50% of Americans don't want to take a vaccine they simply don't trust in the process they think it's too sped up it's too

Politically motivated they've we've got a vaccine but no one's taking it you may as well not have a vaccine so it's funny that you say that

because it almost feels like there's a global world divide debate going on the one hand it is that will there be uptake and so there

would be considerations for example in the country like the US where it appears that many people might be a reluctant or hesitant and you've

got an older population in whom it might be much less effective so you might not be able to immunize a quite a significant proportion now if

you only have a partially effective vaccine that's the other thing we haven't mentioned we're not anticipating that every vaccine and

Development a is going to work for B is going to be 100% effective so what if you only have a partially effective vaccine with partial uptake

what does that do to community transmission as John mentioned I mean do it are we able to interrupt transmission what does that do that

you know in the next winter season when you've got many vulnerable people who are not going to have antibodies and will not have been

Immunized you're going to see resurgence as and resurgence but I think the other side of that is that if I think about the African region

at the moment is that we are deeply concerned that actually what we might see is a sort of mass purchasing is called vaccine nationalization

 so that mass purchase ting and a very restrictive allowance from countries that are manufacturing the vaccine will that developed the

Vaccine and we saw this with the US with Ramez aveer which is a therapeutic agent and there will be enormous pressure on

Governments who have done the research and manufacturing of vaccines there's going to be enormous pressure on them to say well it

has to be my population first so from the African region we're arguing very strongly that there needs to be equitable access WHO is also

Arguing this incredibly strongly many of the global agencies we need equitable access because at the end of 2021 what we anticipate is that

we think we might have an effective vaccine but we're not going to have enough for the whole world so we're saying how do you divide up limited-access and who should be the priority for that and in fact the

Africa the African Union it has become quite vocal in saying there needs to be consideration of this now so on the one hand we've got people

Saying we don't want to take the vaccine in the global North and on the other hand in the global South we're saying we want the vaccine.

 

Vaccine demands in whole world

 

 And we demand that we get our fair share so this is these are really

Important we've got to be talking absolutely and distribution is a key

Part of this argument isn't it Mohamed we've got the UK buying a hundred and ninety million doses of different vaccine it's hedging its

 

bets it's certainly part of the global north us trying to buy up as many samples or doses as it can yeah absolutely I think a primary reason for

Those to buy different vaccine from different manufacturer are really because none of the vaccine is yet at the stage where everyone can

Count on and the vaccines that you could go might have contracted those are based on different technologies so just to ensure that

Whatever the technology out of that would become available in terms of approval and regulatory processes they would be in the position to

Purchase them and to deploy in the field but beside that of course different vaccines are at different stages so none of that vaccine is

Really at the stage where we can really count on could there be a global vaccination program well that would be an ideal choice to move to

Move forward because many of the points that we've been touching upon is really to take up and also the distribution and access I mean

even the vaccines those have been there for centuries really are not really possible to get them to every point of the need so therefore if such initiative is is in place at this moment and we are in the position to set up old international law I think that would be ideal moving forward

as it stands now I can't see anything happening although Gave here in the in the UK last month I applied to a quite significant amount of

Money to really dedicate on to the Covid 19 vaccine into the countries where they cannot afford but that is thing that probably need to be

seen when it comes to execution Tom we've gone from the very top of this show being rather excited about this breakthrough at Oxford

University to the discussion rather downplaying the significant of these developments throwing up all sorts of questions do you think a vaccine

is going to be the thing that stops coronavirus pandemic no I die because I think all the issues which we raised is that it I think if it is

Effective it will there's been mentioned before will probably decrease the amount of severe pneumonia in the younger to middle age group

but I think that probably is that it will have to be together with what we've been using now for the past six month which are the social

factors you know the distancing the masks and the contact tracing together with the dedicated hospitals units to look after the coded

Patients I'm my personal views I think the countries were saying we wait towards the vaccine we wait till vaccine is are going to be a bit

Disappointed because it has have we pointed out if the vaccine is not totally effective if it's not it's got some maybe a few side effects you

Know what we've found in Hong Kong we've had you know the lockdown and we've come out early to say now what you know we

can't keep on with this so much restricted isolation so I think that we all have to try and find a medium we're balancing out yeah use of a

Vaccine versus antivirals versus preventive measures probably what we've been also doing for influenza and for other viral diseases for the

Past 80 90 years it's been such an interesting discussion I do wish we had more time to continue it but we will return.

 

Conclusion

We are accepting corona virus vaccines in 2021 but if the situation will not be in control then vaccines will be short and patients will die more we have to wear masks use sanitizers and make our self-germs free to be careful.

So stay safe. Stay home. Be healthy J