A hint of hope in search for a vaccine

A hint of hope in search for a vaccine

EXPLAINER
Coronavirus
There's still a way to go on the quest for a COVID-19 vaccine. Picture: Shutterstock

There's still a way to go on the quest for a COVID-19 vaccine. Picture: Shutterstock

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Will "vaccine nationalism" push Australia to the back of the queue?

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It looked at one time as though we in Australia had dodged the bullet.

While the virus was rampant in other countries, we thought, perhaps smugly, that our heroic efforts were being rewarded with a swift return to what passes for normality.

But the full outbreak in Victoria and the expanding spot-fires in Sydney have strengthened the belief that only a vaccine will really halt this thing.

So what's the state of play?

A glimpse of hope yet?

There is.

In the past week or so, several groups of researchers have reported that their trials on real people have gone well.

The University of Oxford and the pharmaceutical company AstraZeneca published promising results from the first two phases of their joint trial.

The researchers tried their compound out on 1,077 healthy adults aged from 18 to 55 and found that a "single dose of AZD1222 (their candidate vaccine) resulted in a four-fold increase in antibodies" to the virus.

Separately, the American company Moderna said its trials had also led to positive antibody responses.

And vaccines developed by China's Cansino Biologics, the American Pfizer pharmaceutical company and German BioNTech also showed promising signs.

So are we nearly there?

Not so fast.

The World Health Organisation says there are 140 groups around the world researching a vaccine, of which four are in the all-important Phase 3 of trials. Vaccines are developed on computers and in test-tubes and petri dishes in laboratories before going anywhere near the inside of a human being. Scientists theorise about what might succeed against the disease while also not causing harmful side-effects.

If all that theory adds up, there are then phases of trials.

Phase 1 involves a small group of adults, usually no more than 80. It assesses the safety of the vaccine and gives some information about how it behaves in the body of the recipient.

Phase 2 involves a bigger group of people, some of them at risk of catching the disease. The aim is also to study safety, including side-effects, but mainly to see whether the potential vaccine might prevent people catching the disease and give immunity from it.

Phase 3 is the big one. It's the large-scale test of whether the vaccine actually works. Doses are given to people in areas where the disease is prevalent. Outcomes in different groups are compared.

This phase involves a lot of people. The Oxford study, for example, is testing the substance on people in Brazil and South Africa where COVID-19 is rampant. We are now in Phase 3 with four of the studies.

If Phase 3 is successful, the vaccine still has to be licensed by regulators. Production has to be ramped up on a huge scale, ideally to vaccinate the population of the planet.

If you think any of this should be rushed, think of thalidomide, the drug that was meant to help pregnant women with morning sickness but which also caused disabilities in their babies.

Who'll get the vaccine when (and if) it is made?

There are signs that governments are taking a me-first attitude. Last week, the Trump administration announced a $2.8 billion contract with Pfizer and a German biotech company for 100 million doses of their vaccine if it is successful.

The British government has signed a deal for 190 million doses of potential vaccines from two groups.

At the end of June, the United States government announced that it had secured the entire supply of a drug which may shorten the hospital stay of patients with COVID-19 (not a curative vaccine but a help).

Who knows who else is trying to corner the market?

The Australian authorities are thought to have been in discussions with the British and French governments about access to vaccines if any are developed in those countries.

So 'vaccine nationalism' will mean a grab by the richest?

Canadian professor of health policy, Joel Lexchin, said: "It certainly doesn't seem that we're all in this together - it's looking more and more like a dog-eat-dog world. The group that's most likely to be eaten are those living in low-and middle-income countries."

But there is another view. A group called COVAX is made up of more than 150 countries, plus the WHO, the Bill and Melinda Gates Foundation, research groups and drugs companies. The aim, according to the World Health Organisation, is to "guarantee rapid, fair and equitable access to COVID-19 vaccines for every country in the world, rich and poor".

The countries involved make up 60 per cent of the world's population but they haven't been identified. It is not known if Australia is a member. It should be said that there are some doubts to be ironed out.

"Under the agreement, rich countries will get the first crack at enough vaccine to cover 20 per cent of their population, and only then will poorer countries be guaranteed the vaccine - and only for their highest priority populations," according to Professor Lexchin.

What about you and me?

If the vaccine happens and if production can't meet demand, how should it be distributed? Should health workers be first? What about older people? What about very old people? Whoever has the money to buy it?

Philosophy departments may be working on these life-and-death conundrums but no politician has pronounced. It comes under the "we'll cross that bridge" heading.

Yes, there is hope

Professor Adrian Esterman, an epidemiologist at the University of South Australia, told this paper that he was more optimistic now than he was two months ago.

He thinks the Oxford University results are particularly promising. They indicate that their candidate vaccine may give at least 56 days of immunity, and more with a booster. One question still to be answered is whether it would work with older and younger people.

He reckons that if all goes according to plan there could be a vaccine by the end of the year, with production starting at the beginning of next. But it's not 100 per cent certain.

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