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As communities, states, and countries begin to reopen, the
question top-of-mind for many is when will a vaccine, or other
treatment, be available? Many hold out hope that a vaccine will be
the magic bullet. It's not that simple.
Although there is still considerable uncertainty about the
duration of protective immunity developed in the population after
COVID-19 infection, and even the feasibility of generating an
effective vaccine with any long-term effect, a large number of
researchers and companies have initiated a diverse selection of
vaccine projects, using a broad mix of established and innovative
technologies. Development for COVID-19 has been accelerated
considerably by acquired knowledge developed during the generation
of candidate vaccines for related SARS and MERS coronaviruses, as
well as recent research into Ebola vaccines.
Vaccine candidates
Ten COVID-19 vaccine candidates are currently in clinical trials
(as of 4 June). These are listed in the below, in approximate
descending order of advancement, taking into account scale of
development and expected reporting dates. So far, one has entered
Phase II/III development, two are in Phase II, and several more are
in Phase I/II and Phase I. In addition, some selected high-profile
preclinical-stage projects have also been listed. The success of
any of these will depend on safety, level of immunogenicity, and
duration of protection.
Five vaccine candidates are
currently being developed in China, including those from CanSino
and Sinovac. China itself has a chequered history in
biopharmaceutical clinical development, but this is a unique and
watershed opportunity to prove itself on the world stage. While
data on its candidates remain relatively scant at this stage, China
may indeed succeed in becoming first-to-market in this space, or at
least provide a critical option on the global stage for vaccines
against COVID-19 in 2021.
Alternative therapeutics
In the absence of a vaccine, effective therapeutics for COVID-19
and its complications are urgently being sought to help mitigate
the most serious consequences of infection and to reduce the
duration of virus shedding and infectivity. This is especially
important since the timeline for approval of a repurposed known
medicine would be much shorter than that for a vaccine, since
safety would already be established. There has been a major
research effort worldwide, with hundreds of trials and
investigations having been initiated for a wide range of existing
and novel compounds, with varied degrees of success. Medicines that
are currently receiving EUAs are highly likely to be superseded by
more effective products - some with similar mechanisms - as results
from controlled trials become available.
We expect the most dramatic developments in the research and
development (R&D) landscape here not to come from remdesivir,
hydroxychloroquine, or other repurposed treatments, although we do
see a critical role for existing treatments being repositioned to
deal with the various effects of COVID-19 - such as the promising
data for interleukin-6 [IL-6] therapies. Instead, while data remain
very scant because of the early stages of development, we are more
interested in the development of "antibody cocktails" such as those
being developed at Regeneron (US) and Vir (US).
Posted 11 June 2020 by Gustav Ando, Vice President, Industry Services & Life Sciences, IHS Markit and
Janet Beal, Senior Research Analyst, Life Sciences, IHS Markit