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A New Entry in the Race for a Coronavirus Vaccine: Hope A New Entry in the Race for a Coronavirus Vaccine: Hope
(12 days later)
In a medical research project nearly unrivaled in its ambition and scope, volunteers worldwide are rolling up their sleeves to receive experimental vaccines against the coronavirus — only months after the virus was identified.In a medical research project nearly unrivaled in its ambition and scope, volunteers worldwide are rolling up their sleeves to receive experimental vaccines against the coronavirus — only months after the virus was identified.
Companies like Inovio and Pfizer have begun early tests of candidates in people to determine whether their vaccines are safe. Researchers at the University of Oxford in England are testing vaccines in human subjects, too, and say they could have one ready for emergency use as soon as September.Companies like Inovio and Pfizer have begun early tests of candidates in people to determine whether their vaccines are safe. Researchers at the University of Oxford in England are testing vaccines in human subjects, too, and say they could have one ready for emergency use as soon as September.
Moderna on Monday announced encouraging results of a safety trial of its vaccine in eight volunteers. There were no published data, but the news alone kindled hopes and sent the company’s stock soaring.Moderna on Monday announced encouraging results of a safety trial of its vaccine in eight volunteers. There were no published data, but the news alone kindled hopes and sent the company’s stock soaring.
Animal studies have raised expectations, too. Researchers at Beth Israel Deaconess Medical Center on Wednesday published research showing that a prototype vaccine effectively protected monkeys from infection with the virus.Animal studies have raised expectations, too. Researchers at Beth Israel Deaconess Medical Center on Wednesday published research showing that a prototype vaccine effectively protected monkeys from infection with the virus.
The findings will pave the way to development of a human vaccine, said the investigators. They have already partnered with Janssen, a division of Johnson & Johnson.The findings will pave the way to development of a human vaccine, said the investigators. They have already partnered with Janssen, a division of Johnson & Johnson.
In labs around the world, there is now cautious optimism that a coronavirus vaccine, and perhaps more than one, will be ready sometime next year.In labs around the world, there is now cautious optimism that a coronavirus vaccine, and perhaps more than one, will be ready sometime next year.
Scientists are exploring not just one approach to creating the vaccine, but at least four. So great is the urgency that they are combining trial phases and shortening a process that usually takes years, sometimes more than a decade.Scientists are exploring not just one approach to creating the vaccine, but at least four. So great is the urgency that they are combining trial phases and shortening a process that usually takes years, sometimes more than a decade.
The coronavirus itself has turned out to be clumsy prey, a stable pathogen unlikely to mutate significantly and dodge a vaccine.The coronavirus itself has turned out to be clumsy prey, a stable pathogen unlikely to mutate significantly and dodge a vaccine.
“It’s an easier target, which is terrific news,” said Michael Farzan, a virologist at Scripps Research in Jupiter, Fla.“It’s an easier target, which is terrific news,” said Michael Farzan, a virologist at Scripps Research in Jupiter, Fla.
An effective vaccine will be crucial to ending the pandemic, which has sickened at least 4.7 million worldwide and killed at least 324,000. Widespread immunity would reopen the door to lives without social distancing and face masks.An effective vaccine will be crucial to ending the pandemic, which has sickened at least 4.7 million worldwide and killed at least 324,000. Widespread immunity would reopen the door to lives without social distancing and face masks.
“What people don’t realize is that normally vaccine development takes many years, sometimes decades,” said Dr. Dan Barouch, a virologist at Beth Israel Deaconess Medical Center in Boston who led the monkey trials. “And so trying to compress the whole vaccine process into 12 to 18 months is really unheard-of.”“What people don’t realize is that normally vaccine development takes many years, sometimes decades,” said Dr. Dan Barouch, a virologist at Beth Israel Deaconess Medical Center in Boston who led the monkey trials. “And so trying to compress the whole vaccine process into 12 to 18 months is really unheard-of.”
“If that happens, it will be the fastest vaccine development program ever in history.”“If that happens, it will be the fastest vaccine development program ever in history.”
More than 100 research teams around the world are taking aim at the virus from multiple angles.More than 100 research teams around the world are taking aim at the virus from multiple angles.
Moderna’s vaccine is based on a relatively new mRNA technology that delivers bits of the virus’s genes into human cells. The goal is for cells to begin making a viral protein that the immune system recognizes as foreign. The body builds defenses against that protein, priming itself to attack if the actual coronavirus invades.Moderna’s vaccine is based on a relatively new mRNA technology that delivers bits of the virus’s genes into human cells. The goal is for cells to begin making a viral protein that the immune system recognizes as foreign. The body builds defenses against that protein, priming itself to attack if the actual coronavirus invades.
Some vaccine makers, including Inovio, are developing vaccines based on DNA variations of this approach.Some vaccine makers, including Inovio, are developing vaccines based on DNA variations of this approach.
But the technology used by both companies has never produced a vaccine approved for clinical use, let alone one that can be made in industrial quantities. Moderna was criticized for making rosy predictions, based on a handful of patients, without providing any scientific data.But the technology used by both companies has never produced a vaccine approved for clinical use, let alone one that can be made in industrial quantities. Moderna was criticized for making rosy predictions, based on a handful of patients, without providing any scientific data.
Other research teams have turned to more traditional strategies.Other research teams have turned to more traditional strategies.
Some scientists are using harmless viruses to deliver coronavirus genes into cells, forcing them to produce proteins that may teach the immune system to watch out for the coronavirus. CanSino Biologics, a company in China, has begun human testing of a coronavirus vaccine that relies on this approach, as has the University of Oxford team.Some scientists are using harmless viruses to deliver coronavirus genes into cells, forcing them to produce proteins that may teach the immune system to watch out for the coronavirus. CanSino Biologics, a company in China, has begun human testing of a coronavirus vaccine that relies on this approach, as has the University of Oxford team.
Other traditional approaches rely on fragments of a coronavirus protein to make a vaccine, while some use killed, or inactivated, versions of the whole coronavirus. In China, such vaccines have already entered human trials.Other traditional approaches rely on fragments of a coronavirus protein to make a vaccine, while some use killed, or inactivated, versions of the whole coronavirus. In China, such vaccines have already entered human trials.
Florian Krammer, a virologist at Icahn School of Medicine at Mount Sinai in New York, predicted that at least 20 additional vaccine candidates will make their way into clinical trials in the weeks to come.Florian Krammer, a virologist at Icahn School of Medicine at Mount Sinai in New York, predicted that at least 20 additional vaccine candidates will make their way into clinical trials in the weeks to come.
“I’m not worried at all about it,” he said of the prospects for a new vaccine.“I’m not worried at all about it,” he said of the prospects for a new vaccine.
Many of these vaccines will stumble as the trials progress. As more people are inoculated, some candidates will fail to protect against the virus, and side effects will become more apparent.Many of these vaccines will stumble as the trials progress. As more people are inoculated, some candidates will fail to protect against the virus, and side effects will become more apparent.
But from what scientists are learning about the coronavirus, it ought to be a relatively easy target.But from what scientists are learning about the coronavirus, it ought to be a relatively easy target.
The coronavirus sports tempting targets on its surface, unique “spike” proteins the pathogen needs to enter human cells. The immune system readily learns to recognize these proteins, it appears, and to attack them, killing the virus.The coronavirus sports tempting targets on its surface, unique “spike” proteins the pathogen needs to enter human cells. The immune system readily learns to recognize these proteins, it appears, and to attack them, killing the virus.
Viruses can challenge vaccine makers by mutating rapidly, changing shape so that antibodies that work on one viral strain fail on another. Thankfully, the new coronavirus seems to be a slow mutator, and a vaccine that proves effective in trials should work anywhere in the world.Viruses can challenge vaccine makers by mutating rapidly, changing shape so that antibodies that work on one viral strain fail on another. Thankfully, the new coronavirus seems to be a slow mutator, and a vaccine that proves effective in trials should work anywhere in the world.
When work on a coronavirus vaccine started, some researchers worried that antibodies actually might worsen Covid-19, the illness caused by the coronavirus. But in early studies, no serious risks have emerged.When work on a coronavirus vaccine started, some researchers worried that antibodies actually might worsen Covid-19, the illness caused by the coronavirus. But in early studies, no serious risks have emerged.
“That doesn’t mean that there won’t be, but so far there hasn’t been any indication, so I’m cautiously optimistic on that point,” said Dr. Alyson Kelvin, a researcher at the Canadian Center for Vaccinology and Dalhousie University.“That doesn’t mean that there won’t be, but so far there hasn’t been any indication, so I’m cautiously optimistic on that point,” said Dr. Alyson Kelvin, a researcher at the Canadian Center for Vaccinology and Dalhousie University.
Ensuring that vaccines are safe and effective demands large trials that require careful planning and execution. If successful vaccines emerge from those trials, someone’s going to have to make an awful lot of them.Ensuring that vaccines are safe and effective demands large trials that require careful planning and execution. If successful vaccines emerge from those trials, someone’s going to have to make an awful lot of them.
Almost everyone on the planet is vulnerable to the new coronavirus. Each person may need two doses of a new vaccine to receive protective immunity. That’s 16 billion doses.Almost everyone on the planet is vulnerable to the new coronavirus. Each person may need two doses of a new vaccine to receive protective immunity. That’s 16 billion doses.
“When companies promise of delivering a vaccine in a year or less, I am not sure what stage they are talking about,” said Akiko Iwasaki, an immunobiologist at Yale University. “I doubt they are talking about global distributions in billions of doses.”“When companies promise of delivering a vaccine in a year or less, I am not sure what stage they are talking about,” said Akiko Iwasaki, an immunobiologist at Yale University. “I doubt they are talking about global distributions in billions of doses.”
Manufacturing vaccines is profoundly more complex than manufacturing, say, shoes or bicycles. Vaccines typically require large vats in which their ingredients are grown, and these have to be maintained in sterile conditions. Also, no factories have ever churned out millions of doses of approved vaccines made with the cutting-edge technology being tested by companies like Inovio and Moderna.Manufacturing vaccines is profoundly more complex than manufacturing, say, shoes or bicycles. Vaccines typically require large vats in which their ingredients are grown, and these have to be maintained in sterile conditions. Also, no factories have ever churned out millions of doses of approved vaccines made with the cutting-edge technology being tested by companies like Inovio and Moderna.
Facilities have sprung up in recent years to make viral-vector vaccines, including a Johnson & Johnson plant in the Netherlands. But meeting pandemic demand would be an enormous challenge. Manufacturers have the most experience mass-producing inactivated vaccines, made with killed viruses, so this type may be the easiest to produce in large quantities.Facilities have sprung up in recent years to make viral-vector vaccines, including a Johnson & Johnson plant in the Netherlands. But meeting pandemic demand would be an enormous challenge. Manufacturers have the most experience mass-producing inactivated vaccines, made with killed viruses, so this type may be the easiest to produce in large quantities.
But there cannot be just one vaccine. If that were to happen, the company that made it would have no chance of meeting the world’s demand.But there cannot be just one vaccine. If that were to happen, the company that made it would have no chance of meeting the world’s demand.
Updated June 1, 2020
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
“The hope is that they will all, at some level, be effective, and certainly that’s important because we need more than just one,” said Emilio Emini, a director of the vaccine program at the Bill and Melinda Gates Foundation, which is providing financial support to many competing vaccine efforts.“The hope is that they will all, at some level, be effective, and certainly that’s important because we need more than just one,” said Emilio Emini, a director of the vaccine program at the Bill and Melinda Gates Foundation, which is providing financial support to many competing vaccine efforts.
As part of a public-private partnership the White House calls Operation Warp Speed, the Trump administration has promised to design a kind of parallel manufacturing track to run alongside the clinical trials, building up capacity well before trials are concluded, in hopes that one or more vaccines could be distributed immediately upon approval.As part of a public-private partnership the White House calls Operation Warp Speed, the Trump administration has promised to design a kind of parallel manufacturing track to run alongside the clinical trials, building up capacity well before trials are concluded, in hopes that one or more vaccines could be distributed immediately upon approval.
President Trump said on Friday that the goal of the project was to distribute a vaccine “prior to the end of the year.” To do that, Mr. Trump is relying on the Defense Department to manage the manufacturing logistics related to vaccine development.President Trump said on Friday that the goal of the project was to distribute a vaccine “prior to the end of the year.” To do that, Mr. Trump is relying on the Defense Department to manage the manufacturing logistics related to vaccine development.
But in an interview on Thursday, Gen. Gustave F. Perna, who will manage the manufacturing logistics, said discussions about the equipment and facilities needed for production were just beginning.But in an interview on Thursday, Gen. Gustave F. Perna, who will manage the manufacturing logistics, said discussions about the equipment and facilities needed for production were just beginning.
He described his work as a “math problem”: how to get 300 million doses of a vaccine that doesn’t yet exist to Americans — by January.He described his work as a “math problem”: how to get 300 million doses of a vaccine that doesn’t yet exist to Americans — by January.
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Finding the supplies and planning their distribution would occur at the same time, he said. “I need to have syringes,” General Perna said. “I need to have wipes, right? I need to have Band-Aids. I need to have the vaccine.”Finding the supplies and planning their distribution would occur at the same time, he said. “I need to have syringes,” General Perna said. “I need to have wipes, right? I need to have Band-Aids. I need to have the vaccine.”
He added: “Now, how am I going to distribute it? What is it going to be distributed in? What do I need to order now to make sure I have the distribution capability? The small bottles, the trucks.”He added: “Now, how am I going to distribute it? What is it going to be distributed in? What do I need to order now to make sure I have the distribution capability? The small bottles, the trucks.”
Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins University Center for Health Security, said that seemingly minor aspects of production and distribution could complicate progress later on.Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins University Center for Health Security, said that seemingly minor aspects of production and distribution could complicate progress later on.
“This is on a scale we’ve never seen since the polio vaccine,” he said. “It’s the little things like the syringes, the needles, the glass vials. All of that has to be thought about. You don’t want something that seems so simple to be the bottleneck in your vaccination program.”“This is on a scale we’ve never seen since the polio vaccine,” he said. “It’s the little things like the syringes, the needles, the glass vials. All of that has to be thought about. You don’t want something that seems so simple to be the bottleneck in your vaccination program.”
A coronavirus vaccine doesn’t yet exist, but already there are questions about who will be able to afford it.A coronavirus vaccine doesn’t yet exist, but already there are questions about who will be able to afford it.
At the World Health Assembly meeting this week, a proposal from the European Union was adopted recommending a voluntary patent pool, which would put pressure on companies to give up their monopolies on vaccines they’ve developed.At the World Health Assembly meeting this week, a proposal from the European Union was adopted recommending a voluntary patent pool, which would put pressure on companies to give up their monopolies on vaccines they’ve developed.
Oxfam, an international charity, has published an open letter from 140 world leaders and experts calling for a “people’s vaccine,” which would be “made available for all people, in all countries, free of charge.”Oxfam, an international charity, has published an open letter from 140 world leaders and experts calling for a “people’s vaccine,” which would be “made available for all people, in all countries, free of charge.”
“These vaccines have to be a public good,” said Helen Clark, a former prime minister of New Zealand, who signed the letter. “We’re not safe till everyone is safe.”“These vaccines have to be a public good,” said Helen Clark, a former prime minister of New Zealand, who signed the letter. “We’re not safe till everyone is safe.”
Sui-Lee Wee contributed reporting from Singapore.Sui-Lee Wee contributed reporting from Singapore.