Various potential coronavirus vaccines and stage of trials they are at

Representative image (Reuters)

As companies and countries across the globe rush to discover a vaccine for the novel coronavirus, that has killed over 7 lakh people, DH brings you a compilation of the different potential vaccines across the world and the stage of trials they are at.

Different stages of vaccine testing and development

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A vaccine normally works by the introduction of a pathogen into the body. The aim is to train the immune system to fight the pathogen. Before a vaccine is made available for mass use, it must go through a series of stages to deem its safety and efficiency.

1. Preclinical trials - the vaccine is tested on animals to see if it produces a response

2. Phase I or safety trials - the vaccine is given to a small group of people

3. Phase II or expanded trials - the vaccine is shared with hundreds of people who belong to different subgroups to see how the vaccine works with different types of people

4. Phase III or efficiency trials - thousands of people are vaccinated and results compared with others who received a placebo.

Countries across the world approve the vaccine after satisfactory results from these stages.

Combined phases: Another way to accelerate vaccine development is to combine phases. Some coronavirus vaccines are now in Phase 1/2 trials, for example, in which they are tested for the first time on hundreds of people.

Russia's Gamaleya Research Institute vaccine is the first ‘registered’ vaccine against the novel coronavirus. However, it was registered before the completion of phase III trials. It was approved on August 11.

According to Russia, Human trials for this began on June 18th and all participants developed immunity. President Putin’s daughter is believed to be one of the first few to receive the vaccine. Several experts have raised questions about the efficiency of the vaccine, including Dr. Fauci, director of the National Institute of Allergy and Infectious Diseases.

Here are various potential Covid-19 vaccines and the stages they have reached:

Phase - 3

1. AstraZeneca, a British-Swedish company, tied up with the University of Oxford to work towards creating a Covid-19 vaccine. The United States gave a nearly $1.2 billion grant to this vaccine research. They have tied up with the Serum Institute of India to produce millions of doses of the vaccine already.

2. Moderna develops vaccines based on messenger RNA or mRNA. In partnership with the National Institutes of Health, they developed the vaccine that offered to protect monkeys from Coronavirus. Around 30,000 healthy people would be enrolled for the human trials of the vaccine.

3. BioNTech is a German company that collaborated with Pfizer and Fosun Pharmaceuticals to develop an mRNA vaccine. Some volunteers experienced some side-effects like sore arms and a disturbed sleep cycle. The vaccine won a $ 1.9 billion contract for 100 million doses by the Trump administration. The vaccine that would be tested in Argentina, Brazil and Germany amongst other countries.

4. CanSino Biologics and Academy of Military Medical Sciences produced an Adenovirus based vaccine. The vaccine, called Ad5, will see the third phase of trials to be conducted across Saudi Arabia. The vaccine was approved by the Chinese military on June 25th since it is a “specially needed drug”. The approval came after phase II of trials itself.

5. Sinovac Biotech - the inactivated vaccine CoronaVac. Phase-3 of the vaccine would be conducted in Brazil in July. The company is gearing up to be able to manufacture nearly 100 million doses. The first and second phase trials, conducted on 743 volunteers, did not produce any side-effects but managed to provide some immunity.

6. The Wuhan Institute of Biological Products developed an inactivated vaccine put to clinical trials by the Chinese company Sinopharm. The vaccine could be delivered by the end of the year.

7. Sinopharm is also testing a second inactivated virus vaccine, developed by the Beijing Institute of Biological Products. It is in the Phase 3 trials in the United Arab Emirates

In the phase III trials - while 5,000 people would receive the Wuhan vaccine, the other 5,000 would receive the Chinese vaccine.

8. Murdoch Children’s Research Institute is testing the Bacillus Calmette-Guerin vaccine, which offers children protection from Tuberculosis. The Institute is conducting phase III trials on people to see if the vaccine can be effective against coronavirus in some capacity.

Phase - 2

1. Imperial College London (ICL) has tied up with VacEquity Global Health (VGH) to produce a “self-amplifying” RNA vaccine, which boosts the production of a viral protein to stimulate the immune system. Low-income countries would benefit from this vaccine as VGH has said it would waive off royalties. ICL began trials on June 15th and partnered with MorningSide Ventures to distribute the vaccine with the assistance of VGH.

2. Indian vaccine maker Zydus Cadilla created a DNA-based vaccine. They entered the second phase on August 6th. It is the second Indian pharmaceutical company to get approval to conduct human trials.

3. Japanese biotechnology company AnGes along with Osaka University and Takara Bio came together and decided to waive off royalties for smaller countries. Instead, they would only be expected to pay cost-plus the prices needed to sustain their mechanism. Safety trials for the combined phase I and II began on June 30th.

4. Arcturus Therapeutics and Duke-NUS Medical School - California-based Arturus along with Duke medical school in Singapore developed an mRNA vaccine, LUNAR-COV19. Their application for phase I and II of trials was approved by the Singapore government. Combined trials would begin on July 21st.

5. Johnson & Johnson and Beth Israel Deaconess Medical Center - the Beth Israel developed a method to develop a vaccine out of a virus called Adenovirus26 or Ad26, which was also used to manufacture the vaccine for Ebola. The same virus, Ad26 has been used to manufacture a vaccine for the novel coronavirus. Phase III trials for the same could be held in September. The company could produce on a billion doses till the end of 2021.

6. Anhui Zhifei Longcom and Chinese Academy of Medical Sciences - the National Medical Products Administration gave a certificate allowing clinical trials for this vaccine to be launched. The vaccine uses a combination of viral proteins and adjuvants.

7. Novavax - the company kick-started combined trials for the Covid vaccine in May. If the vaccine trials prove to be effective, the company is expected to give nearly 100 million doses of the same by 2021 to the United States government, from which it received nearly $1.6 Billion in manufacturing and more. It alone aims to build a supply big enough to supply to the entirety of the US population. Novavax signed a deal with the Serum Institute of India, for the commercialization of the vaccine. The Pune-based company would have the exclusive rights to manufacture the vaccine for India. Phase III trials are expected to begin in September.

8. Institute of Medical Biology at the Chinese Academy of Medical Sciences - they also invented a vaccine for Polio and hepatitis A. The vaccine entered the second phase of the trials by June 20th.

9. Indian Council of Medical Research, National Institute of Virology and Bharat Biotech have developed a vaccine called Covaxin and launched trials for phase I and II by July. While the ICMR wished to launch the vaccine by August 15th, India’s Independence Day, however, Dr Krishna Ella, Chairman and Managing director, Bharat Biotech said that the vaccine could be released by next year.

10. CureVac is working towards the trials of an mRNA vaccine. Phase I clinical trials were to be held in Germany and Belgium and moved to phase II trials in August

Phase -1

1. Inovio, an American company, has developed DNA-based vaccines. This vaccine would be administered in a unique way, with pulses delivered onto the skin, using a hand-held device.

2. Genexine, a Korean company is aiming to develop a DNA-based vaccine. It recently got approval by the Ministry of Food and Drug Safety, Korea, to conduct the world’s first trial for using the jet-injector method for a Covid vaccine.

3. Academy of Military Medical Sciences, Suzhou Abogen Biosciences and Walvax Biotechnology from China got approval to conduct trials for the mRNA based vaccine on June 19th. This was China’s first attempt at an mRNA Covid-19 vaccine.

4. ReiThera and Lazzaro Spallanzani National Institute for Infectious Diseases developed the Italian vaccine, GRAd-COV2, which began phase I trials by the end of July. The vaccine uses the adenovirus of gorillas.

5. Clover Biopharmaceuticals tied with GSK and Dynavax and developed a vaccine with the protein from coronaviruses. The vaccine makers received investments from Coalition for Epidemic Preparedness Innovations (CEPI) and if successful, aim to produce hundreds of millions of doses a year. The vaccine would be administered with adjuvants produced by GSK and Dynavax.

6. Australian biotechnology company Vaxine could soon start phase II clinical trials. They are working with the South Korean biopharmaceutical company MedyTox. The first phase of trials was completed in July.

7. Medicago uses a variation of tobacco leaves in the vaccine. The vaccine is partially funded by Philip Morris, a cigarette and tobacco company. It uses adjuvants produced by GSK and Dynavax.

8. University of Queensland's vaccine delivers viral proteins altered to draw a stronger immune response along with an adjuvant produced by CSL. It could manufacture tens of millions of doses by the vaccine, if proven effective. Phase I of the clinical trials were launched in July.

9. Kentucky BioProcessing (KBP), a branch of the multinational company, British American Tobacco, attempts to make a vaccine using tobacco to manufacture viral proteins. Phase I trials were registered for the month of July. KBP previously used this method to manufacture a drug for Ebola called Zmapp.

10. Medigen, by a Taiwanese company, developed a vaccine that uses adjuvants produced by Dynavax. Phase I trials for it could begin in September. The vaccine aims to use recombinant spike protein technology.

11. Merck, Themis and Institut Pasteur aims for a vaccine using of weakened measles cells. It entered phase I of clinical trials in August. This is the second vaccine being developed by the pharmaceutical company Merck.

12. North Korea’s State Commission of Science and Technology announced that it has started trials of a protein-based vaccine. They claim to have so far tested on animals, adding that human trials could not be conducted in the East-Asian nation, since, according to them, there was no case of Covid there.
    

Some vaccines underwent combined trials for two phases.