A vaccine for the next pandemic could be ready within “100 days or less” of a new pathogen emerging given the right planning and investment, according to a senior member of the government’s Scientific Advisory Group for Emergencies (SAGE).

By Paul Nuki

GLOBAL HEALTH SECURITY EDITOR, LONDON

13 December 2020 • 6:00am

Source: The Telegraph

Reprinted for educational purposes and social benefit, not for profit.

Scientists around the world are scrambling to prepare for what some fear could be a “new pandemic era” and believe the timeline for vaccine development – squeezed from 10 years to just 11 months for Covid-19 – could be cut much further.

“The fact that the first Covid-19 vaccines are based on a new technology, RNA, is a real breakthrough”, said Sir Jeremy Farrar, director of the Wellcome Trust and leading member of SAGE.

“Technology advances mean it is likely we can move to a future with vaccine platforms agnostic to pathogens, but with a backbone of long-standing safety data. That can, therefore, change the 11 months that it’s taken this time round to 100 days, or less.

“There is the possibility that within a month of a new threat emerging you could have vaccines available”.

It is an irony of the Covid pandemic that the first vaccines to work against the virus were designed within weeks of the genetic sequence for SARS-CoV-2 being released by Professor Yong-Zhen Zhang of the Shanghai Public Health Clinical Center and shared around the world in January.

Although those two vaccines, one produced by Moderna and the other by Oxford University, are now on the brink of being distributed after almost a year of testing, scientists believe similar jabs could be released early enough to catch the first wave of future outbreaks.

Time savings have been made with Covid vaccines by running the three-phase clinical trial process new medicines must go through in parallel. Research into the SARS virus following the 2003 outbreak also meant scientists had prior experience of targeting coronaviruses.

Now scientists like Sir Jeremy and others believe new innovations could again cut the development timeline by a factor of about ten. These include:

  • Creating prototype vaccines for the 50-100 most likely known animal pathogens with pandemic potential ahead of time and stockpiling them
  • Conducting phase one and two human trials speculatively in advance of an outbreak, so that only phase three trials remain
  • Signing up tens of thousands of phase three trial participants ahead of time, so those trials can start the moment a new outbreak is detected
  • Establishing new vaccine manufacturing capacity, spread evenly across the world

The annual seasonal flu vaccine has some of these characteristics. Each year a new vaccine is created to take account of the “genetic drift” of the virus. But it is derived from a trusted process or “platform” that has been well tested in advance and known to be safe.

Prof Sarah Gilbert, the scientist behind the Oxford AstraZeneca Covid vaccine, said veterinary science could help us gain a “better understanding of what constitutes a protective immune response to different families of viruses”.

“We are still trying to work out what type of immune response can protect against SARS-CoV-2, and at what level. However there is a vaccine against a bovine coronavirus and there are four seasonal human coronaviruses, so we could have worked this out before 2020″, she said.

Prof Florian Krammer, professor of vaccinology at Mount Sinai, New York, believes it possible to create prototype vaccines for each of the viral families most likely to cause a pandemic ahead of time.

These – like the annual flu vaccine – would only need to be tweaked to cover the exact strain in the event of an outbreak and could be deployed “3-4 months” into a pandemic.

“Many different viruses may cause a pandemic in future, but we know which virus families have the most potential”, Prof Krammer says in a recent discussion paper.

“From each of the identified virus families… a handful of representative strains with the highest pandemic potential should be selected for vaccine production. Up to 50-100 different viruses could be selected, and this would broadly cover all phylogenies that may give rise to pandemic strains”.

Prof Krammer estimates that the cost of each vaccine would be in the region of £15- £22m, meaning you could get more than ten of them for the £190m price tag of a F-35 fighter jet.

The UK currently has 21 of these planes and plans to eventually take that total up to 138.

Richard Hatchett, chief executive the Coalition for Epidemic Preparedness Innovations (CEPI), the organisation whose early investment from 2017 helped speed the development of Covid vaccines, says a 100-day vaccine is “not pie in the sky or fantasy”.

He told The Telegraph the total investment required would run to billions but that remains small change compared to staggering £21.5 trillion in lost production the International Monetary Fund estimates Covid-19 has cost the world.

“It’s not just the science but also the political commitment, the need for new financing mechanisms, advances in regulatory science and preparedness, and the need for globally distributed manufacturing capability”, said Dr Hatchett.

Sir Jeremy warned there was a danger the world would revert to ad hoc progress on vaccines once the Covid-19 pandemic fades, rather than “effective and sustained collaboration”.

“It is not scare-mongering to say the world will face future epidemics – of known and unknown infectious diseases. The next one could have high transmission rates, like Covid-19, and could have even higher mortality rates.

“We must be prepared for that; to be able to fast-track the development and manufacture of new vaccines, treatments and diagnostics and distribute them fairly and rapidly.

“At the heart of this is achieving a lasting shift in how society makes progress…. We shouldn’t have to go through emergencies with devastating social and economic consequences to speed innovation or future preparedness. The aim should be momentum, improving and building, and undertaking reforms swiftly from lessons learned”.